I Saved Insurers $100,000 this Morning

I saw 4 patients with upper respiratory infections. Three got Z-Paks, one got Tamiflu. I performed one nasal influenza swab. Little did I know how much I saved insurers until I read the story “For Her Head Cold, Insurer Coughed Up $25,865.” Apparently, $25,000 is the going rate at one Manhattan Park Avenue office. Not only did the office and lab charge that much, Blue Cross paid it.

“Alexa Kasdan had a cold and a sore throat. The 40-year-old public policy consultant from Brooklyn, N.Y., didn’t want her upcoming vacation trip ruined by strep throat. So after it had lingered for more than a week, she decided to get it checked out. Kasdan visited her primary care physician, Roya Fathollahi, at Manhattan Specialty Care, just off Park Avenue South and not far from tony Gramercy Park. The visit was quick. Kasdan got her throat swabbed, gave a tube of blood and was sent out the door with a prescription for antibiotics. She soon felt better, and the trip went off without a hitch. Then the bill came.”

Old fashioned primary care physicians get criticized for indiscriminate use of antibiotics. Maybe the next time I get a form letter from an insurance company complaining about overuse of antibiotics, I will send them a copy of this article and ask that an asterisk be placed next to my name for providing cost-effective healthcare.

By the way, all of $25,000 cold patient’s tests came back negative.

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  2 comments for “I Saved Insurers $100,000 this Morning

  1. R Stuart
    January 6, 2020 at 11:57 am

    The doc’s a crook. but the insurer that paid 28k out-of-network is far worse.

    Meanwhile, of your four money-saving claims:

    -one will be denied because it’s the first of the year and their employer hasn’t sent in the correct demographics;

    -one will sent to review pending your submission of 10 years of old records;

    -the influenza swab will be written off as not clinically indicated; and

    -one will be paid correctly.

    No good deed goes unpunished.

  2. Bill Ameen, MD
    January 6, 2020 at 9:34 am

    Dude, I hope you were kidding about the Z-paks. They aren’t indicated for upper respiratory infections. Maybe you were concerned about your Press-Ganeys?

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