Physicians Need Aid Of Small Business Advocates

June 5, 2002
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The Michigan Medical Group Management Association has succeeded in getting “Timely Payment” legislation introduced to the state Senate, a proposed bill adamantly opposed by the insurance industry.

Every business owner knows the danger of “30, 60, 90, never” for services billed but forever in receivables. Physicians, generally the epitome of a small business, almost always wait ‘forever” for insurance payments, thus the seriousness of the issue. Small businesses are usually able to resolve such matters in court, but the insurance industry and medical cost/payment issues so muddy the waters, it is hardly an option for remedy. The “system” is fraught with roadblocks and disqualifiers.

“Timely Payment” legislation made its way to the Governor’s desk last year, when John Engler promptly vetoed it, ostensibly because of “procedural” problems. In essence, the legislative initiative is akin to asking the fox to guard the hen house since Medicare payments lag as much or further behind than the insurance industry. Adding to the misery of the situation, the state and federal governments do not even reimburse the cost of medical procedures but use ‘formulas” only Big Government officials understand (or pretend to understand). It is socialized medicine, and government “insurance” accounts for a full 40 percent of the billings on which physicians await payment. And it will not become easier as the population becomes dominated by the elderly.

The waiting game is protracted by billing codes heaped upon every type of procedure or type of Band-Aid, by which government and insurance companies often dispute claims — if the procedure or Band-Aid is deemed “covered” at all. The cost to these small business owners in additional staff — who must attend government seminars to even begin to understand the coding, changes in coding, what is “allowable” and what is not — is indeed outrageous and more fuel on the fire of rising costs.

Indeed, physicians also can argue that insurance companies profit from such manipulation of payment and the “float” of money.

It is no wonder the physician of Norman Rockwell’s painting no longer exists. Physicians working in the metropolitan area have indicated new docs cannot afford to hang a single shingle, but are forced to group together to share costs and liability in a litigious society.

Meanwhile, in state the House, Rep. Barbara Vander Veen, R-Allendale, is holding hearings across the state to determine “viable answers” to create more legislation aimed at continually rising health care costs. She need look no farther than her home (or House).

Medical “reimbursement” is a system affording courtesy and safe harbor to sharks and shysters. If small businesses, chambers and other advocates of health care reform intend to walk the talk, it is time to step to the microphone.

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