Surgeon Charge for Medical Leave Paperwork????

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Kim B

Well-known member
Joined
May 28, 2003
Messages
54
Location
DFW Area
I just called Dr. William Ryan's office to let them know I was getting ready to fax over my medical leave form and asked what the standard time off was that they put on the forms so I can be consistent with what I'm requested. I was told that they charge $25 to complete the paperwork. I said "wow" and the person said "well wow, we're about the last group to start charging to do this." I said so you can't start filling out the form until I pay $25 and was told that is correct and they accept cash or money order only. WTH????

The $25 doesn't bother me nearly as much as the way it was communicated to me and the fact that they want cash or money order. I know there are a lot of people on this board who were happy with Dr. Ryan's staff. Did anyone encounter this situation from his office or another surgeon's staff? They were willing to take my Visa debit for a copay, but want cash or money order for the short medical leave form. This makes me question my choice of surgeon and I hope I'm just overreacting because I don't want to find another Dr. and have to start over and get a new date.

All comments welcome.
 
I noticed recently that my Internist's office posted a massage for all patients that they are charging for filling out forms now.

So, sadly, I guess it is the norm. It does take someone a while to fill those out, so I understand, but still----- seems like everyone has their hands out lately.
 
Is he a participating provider in your managed care plan? If so, it is probably a violation of his contract for him to do this. It explains why he wants cash or a money order - no records! Call your plan and ask. Of course, this could disintegrate your relationship with this provider, but it may also be one of those warning bells. Often, the provider is not really aware of what the staff is doing, especially in larger practices where there is a business person that handles these types of things. The provider may not be aware that it violates his contract, if in fact it does.
 
Nancy,
You're correct. Apparently this is standard practice to charge for filling out the forms. I just talked to a couple coworkers who had surgeries and they had to pay $25 (but not cash or MO)>

Lisa,
Yes, he is a participating provider in my HMO. You brought up an interesting point. If it is a violation of his contract, he probably doesn't know since he is part of a larger practice. I just need to get this surgery done on the 28th and this Dr. is really one of the best in the country. If his business office is not following the contract, I'll wait until after surgery to rat them out on that. :) At least that is a plausible explanation of of why they want cash or money order.

Thanks y'all, I'm already much calmer now.
 
What a good point, Lisa. The surgeon may not even know someone on his staff is doing this.
On the other hand, with some medical professionals seeing changes in our medical system afoot, maybe they're trying to make as much money as possible while they can. :( (Now I'm really sounding cynical).

I definitely would not jeopardize a relationship with an excellent surgeon you want to do your surgery over this but it is prickly.
 
My surgeon charged me $93.00 for paperwork. Let's just say.......I was ticked off! I got this bill AFTER surgery and they said it was for paperwork and arranging for home nurses (I barely needed) and home oxygen I never used. My insurance, ofcourse, did not cover this cost. The only thing I can say, out of the entire surgery, including all the doctors and hospital and everything, this is the only thing I paid. Just ticked me off because of what it was for. I thought this is what doctors offices did???? Oh well............I have heard more and more doctors are charging for paperwork. Whatever!
 
I have never been charged for this paperwork. However the last time I needed such forms filled out was in 2000. The best way to handle this is to call your insurance provider and ask, without telling them who you are, if this is a normal practice.

Also, I would like to wish you well with your upcoming surgery.
 
I thought most doctors charge now for those forms. I think there's a note at my PCP's office for such and I think there was at Dr. Ryan's office 2 years ago when John had his MV repair.

But -- cash or money order? Seems it would be easier to take a debit or credit card by phone. They have to account for the income in some way.

Wonder if the office person was misinformed??

Money order? Cash? Those are unbelievable in today's world.

That aside, Kim, you will be very pleased with having Dr. Ryan for your surgeon. If I ever need a re-op, I will certainly go to Dr. Ryan.
 
Keep your priorities straight.

You don't want to fire a Top Rated Surgeon because his office wants to nick you for a $25 processing fee. You can fight that battle AFTER your get your heart fixed.
 
My husband and/or I have paid $ 25 for at least twenty years to have forms completed. I cannot believe it is not higher now. I have not had any completed for several years...but I used to have to drop off a check at the office when I dropped off the forms....I think they waited for the check to clear before they called for me to pick up the completed form.....of course, they never mailed it directly to the employer....I think first class mail was about twenty-five cents at that time!! LOL!!
 
This is my first time having surgery or taking medical leave, so the $25 charge surprised me for such a small amount of paperwork. I understand now after reading the replies and talking to several people today that paperwork charges are the norm. The thing that really bothered me was that they demanded cash or money order up front. That just seems so shady for a reputable surgical team, and was the only reason I briefly questioned whether I chose the right surgeon.

Marsha, I do believe I will be pleased with Dr. Ryan. I have been reading about him here and elsewhere on the internet for a very long time and everything has been overwhelmingly positive. I also felt good about him when I had my consultation last week, so I won't do something stupid over $25. I expected a few weird miscellaneous charges anyway, so it really isn't the money so much as the way they want it paid and that they won't do paperwork until they have the money (but they'll do major $$$$$$$ surgery without up front cash payment).

Anyway, thanks for all the comments. I truly appreciate the input from each person on this thread. I've run out of energy to be angry over the money order/cash requirement and dealing with the person who had an attitude. I'll just pay the cash when I go for my CT scan (and ask for a detailed receipt for my healthcare spending plan, hehe). But I'm not going to let it get to me if I don't get a receipt. In fact, I'll just laugh it off. I'm also going to stick to talking with my regular contact there as she seem to have much better people skills. This will all be over in a few weeks thank goodness!
 
Kim:
One question: Are you going to have minimally invasive surgery? I saw at a website that Dr. Ryan has written textbook chapters on MIS.


When I had surgery in 2003, I had to have a doctor sign short-term disability forms and fax them to the STD insurance carrier every week in order for me to get a check for 60% of my pay (my employer picked up the other 40%). When I went back to work part-time, I thought I would be able to just gradually work longer until I had built up stamina and slide into full-time.
But because of STD rules, I found I had to set a part-time work schedule because of the forms faxed by my PCP to the insurance company. So ... I chose to work half-time for 4 weeks.
I didn't have to pay for these forms and all the faxing. I do remember one person in my PCP's office grinching because of the paperwork; that person didn't know I was in the next room having an INR test!! I mentioned it to my PCP, who apologized profusely.

I wonder if the request for cash or money order is correct. That's puzzling...
 
Marsha,
The plan is to either have the Ross Procedure (full sternotomy) or On-X (about a 3" incision down the center of the chest, which maybe qualifies as MIS). The CT scan of the aorta will help determine if I'm even a candidate for the RP. My employer's STD policies and paperwork seem pretty simple and the form shouldn't take more than a couple of minutes to complete. I was told the standard time off they put on the form is 6-8+ weeks, the + to cover extra time for complications and half days when first returning.

That's pretty funny you overheard someone complaining about the paperwork, and nice of the PCP to apologize. I can just imagine, though, how a lot of those forms could be really cumbersome.

I do hope that the request for cash or money order was incorrect because as I stated before, it strikes me as shady business. My sister-in-law, a nurse who has had several surgeries herself, said she has heard of places with that same policy for cash for medical leave forms. She said it is probably something that is done to get away with collecting extra money off the record, just as Lisa guessed in an earlier post. That's why I'm going to ask for a receipt. I'm curious to see if I'll get one, but won't get bent out of shape if I don't. My short supply of energy needs to stay focused on more important things right now. Getting ticked off at office staff is just too draining for me at this time. :)
 
I am not surprised about the $25- charge. Over the years, medical practice has changed, and not for the better. I am not talking about the doctoring, but the enormous clerical hoops that the doctors have to get through with insurance companies. Costs for paperwork processing is staggering, and reimbursements from insurance companies have not kept up with the doctors' office expenses.

I know of a doctor (a specialist) who charges $500- once a year for a "general checkup" for his Medicare patients. Most of his patients see him on an ongoing basis. The patients are told (and are asked to sign a form) that this service is not covered by insurance. At first I was ticked off, but after awhile, I realized why this is happening. I still am a little annoyed, because I only see him now on a yearly basis. I may switch my visits to two years now.

This doctor is world class, and Medicare does not give him the kind of reimbursement that he deserves. So, if you want to be treated by him, you pay up. I do so, gladly.
 
Braveheart...I agree with your thinking. Medicare and most insurance companies seem to treat all things by the diagnosis and do not allow for the difference in the quality of the doc. As long as I am able (even by making monthly payements) I will opt for the quality doc.
 
Braveheart said:
I know of a doctor (a specialist) who charges $500- once a year for a "general checkup" for his Medicare patients. Most of his patients see him on an ongoing basis. The patients are told (and are asked to sign a form) that this service is not covered by insurance. At first I was ticked off, but after awhile, I realized why this is happening. I still am a little annoyed, because I only see him now on a yearly basis. I may switch my visits to two years now.

This doctor is world class, and Medicare does not give him the kind of reimbursement that he deserves. So, if you want to be treated by him, you pay up. I do so, gladly.
Click to expand...

I'm sure this is concierge medicine. You pay a flat fee per year upfront; doctor does not accept insurance or Medicare/Medicaid, and I don't know how lab, X-ray, etc., charges are handled. I've seen quite a few stories in medical journals about such.
Sicker patients are referred to doctors with traditional practices that do accept insurance.
 
Oh my goodness - sometimes I feel awful for you guys down in the States, so much fudging around with insurance companies and such. Yikes.
I can't even imagine how much I would have had to cough up by now for all the surgeries and related care, or how much I would have to pay in premiums!

Kim - this is off topic, but you might ask your surgeon about aortic aneurysms following RP - there are a couple of us on here that have had aneurysms develop as a result of/following the Ross. (It doesn't happen to everyone - we could have inherently weaker aortas or something - but it's worth mentioning.)

Good luck with your surgery - I'm glad you've found a great surgeon! Just too bad that his front staff seem to be sketchy.

Take care
Melissa
 
I've not been charged and have had paperwork done twice.

I have been charged for medical records before and I was just charged $50 for a CD of a recent echo done before surgery!
 
MissMelis said:
Oh my goodness - sometimes I feel awful for you guys down in the States, so much fudging around with insurance companies and such. Yikes.
I can't even imagine how much I would have had to cough up by now for all the surgeries and related care, or how much I would have to pay in premiums!
<snip>

Take care
Melissa
Click to expand...
Just to provide a broader 'picture'. I've had two OHS in four years and both times left Mass General with absolutely no bill. My insurance, with no contact from me, paid all my bills. My doctor's offices and the hospital did all the insurance company business and I got the care I needed promptly and with no out of pocket money assessed to me. Through two OHS, multiple echos during those four years and on-going now, TEE, cardiac cath and all related care, I never once called my insurance company. No need.

I fully acknowledge that is not the case for everyone in the U.S. but that is my experience. No system is perfect. We've heard horror stories about all the world's healthcare systems.... and we've heard wonderful, exemplary experiences.
 
Jkm,
I actually know very little about the system down in the US. I guess I only do hear the horror stories and never the good experiences! Thanks for setting me straight!
Glad that you had such an easy road (in terms of insurance that is) :)

Melissa
 
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