POLICY-- Medicos Plan

MEDICOS PLAN FOR UNINSURED PATIENTS

More will follow, but I hope that Medicos physicians can continue to use these general guidelines for billing of global OB services in the world of  insurance and for patients who are uninsured and earning less than 250% of  federal poverty guidelines as published in the Federal Register each year.  Currently any family of four earning less than $50,000 per year qualifies.

WE will be rewriting the MEDICOS guidelines and will discuss them at our administrative meetings. In the meantime, please note the recent updates.

The global fee for uninsured patients with an uncomplicated vaginal delivery is $1600+ $200 paid at the first visit for ultrasound service. Total =  $1800..

Medicos offers unlimited ultrasound services for an additional $200, but, when complications arise and additional consultative ultrasound services are needed,  the patient will have to pay extra for them. Same for additional lab. MSAFP and  quad screen are examples.
         
The global fee  includes prenatal lab, but does not include sickness visits. Doctors have the  right to determine which sickness is too complicated to be included in  the global fee. Trauma, IV therapy, NST/AFI  are not part of 59400 for example.

Charity is encouraged  where appropriate, but failure to cover overhead will cause the service to be  discontinued. One residency director of Family Medicine  in  Tennessee has gone on record stating that this service costs them money. Medicos will have to disprove this.

Cesarean costs $400  more. Anesthesia and hospital are not included. Newborn services in the hospital are included in the MEDICOS PLAN. For Cesareans, Baptist anesthesia expects a  $600 deposit and St Francis expects $500. We ask all patients to PLEASE bring their hospital bills to this office such that we can engage in advocacy on their  behalf. Same for all ER bills.

Nashville has not been able  to gain access to Cesarean privileges at Nashville General Metro Hospital, and therefore, cannot collect the extra fees for surgery. These fees go tothe  department of OB. But, since emergency Tenncare is being granted to most Nashville patients, MEDICOS physicians should bill for newborn care, circumcisions, and newborn visits WHEN performed by Medicos(versus Meharry) faculty. We hope that Lebanon will offer us the opportunity to correct some of  this.

Yoru comments are appreciated. 

Wm MacMillan  Rodney MD
Clinical Professor of Family Medicine
Adjunct Professor  Surgery/Emergency Medicine
Meharry/Vanderbilt School of  Medicine

Medicos para la Familia
Memphis, Nashville and rural  Tn.
www.psot.com

Index--POLICY, Fees, OB

Comments

[Robert]

Nice beginning for cost transparency. It's a bold step in the right direction, and in a market where you have a lot of industry leading competition, those other hospitals should be red-faced that they are not as open as you are.