Medicare Reimbursement: Fill & Download for Free

It is unlawful for any hospital that receives any sort of federal funding (and there are very very few that do not: very few hospitals will refuse to accept Medicare reimbursement, and that counts as “federal funding”) to refuse lifesaving or life-preserving treatment to a person for the sole reason that that patient lacks the means to pay for it.Emergency department personnel do not ask about insurance status before rendering lifesaving treatment. It’s not until the patient is out of immediate danger that this question is even addressed.

This is one of the big reasons why healthcare in this country needs an overhaul.Hospitals that are Medicare certified have to accept the Medicare reimbursement sum as payment in full. As you can see, that's far less than what the hospital sets as the cost of your care. The difference is recouped when hospitals make their contracts with private insurance companies. So they may charge $270,000 for the same surgery to a patient with private insurance. That's the only way that a hospital can keep afloat.So we have an aging population in America which means more people will be going on Medicare and since elderly people typically require more healthcare dollars, that will mean more increases in cost for younger, working age people with private insurance. We do not have enough younger, working age people entering the workforce to balance out the number of people leaving the workforce and going onto Medicare.Medicare reimbursements to healthcare diminish every year and it is more difficult for healthcare agencies to qualify a patient to reach the higher reimbursement tiers. For example, in home health, the reimbursement is determined by the diagnosis and a scoring system that addresses things like a patient's functional status. The benchmarks for getting more reimbursement are higher, so a person has to be much sicker today than they had to be 10 years ago. Meanwhile, this makes it difficult to pay staff, give cost of living and merit raises and so forth.This is why we have to do something drastically different with healthcare and it needs to happen soon.

I was just discussing this with my med school roommate the other day.We both did 4-year long residencies and finished.His base salary is 50% higher than mine, but both of us feel very well paid, especially since we both have the opportunity to earn more.I think there are a few things at play in how someone can earn those salaries and still not feel well compensated:It depends on what “normal” feels like for you. If you feel like half the people you went to school with are earning a lot more than you, it’s easy to feel underpaid. And when you’re a doctor, it’s with your peers that you compare your income, not with the average earner, who is irrelevant to your calculations.There is so much delayed gratification and student loan borrowing to become a physician that it’s easy to feel that you deserve to get paid a lot more than you currently are.If you live in Manhattan or San Francisco, you definitely won’t feel rich on $300K. You’ll feel like you’re at most a member of the upper middle class. My friend and I happen to live in places with very low costs of living.If you’ve been on the receiving end of 20 years of reimbursement cuts, it’s impossible not to compare your current inflation-adjusted earnings to what you used to make. So, right now, I can look at Medicare reimbursements and know that there have been several rounds of cuts in the past few years alone. But when you’re a new graduate, this new lower pay is the most you’ve ever been paid. You don’t know any different. But if they keep cutting your pay, even at the rate of 1% a year, you’re bound to notice.Not all physicians make that much. My base salary is well South of that. Primary care physicians often earn in the $200–220K range.So, when physicians complain about their salaries, they’re not saying that they don’t realize that most workers earn much less; they’re saying that they feel that for the effort they have put in getting there, and when they compare themselves with their peers, they feel they should be earning more.Still, I have a hard time feeling underpaid.