Talking with my ER Doc customer today and this and that …
subject got around to collection from clients …
he said doctors average collecting about 25 cents outta every dollar billed!
No wonder the insurance world is so screwed up and Dr bills are thru the roof.
I’d be jacking up my rates if I had to cover that loss too.
I’ve seen it from inside my own family …
one who shall remain nameless told her husband .. how needed emergency dental surgery a coupla yrs back … to just go to Dr So and So … ask for the payment plan …. we’ll just send in the first payment and then find another dentist!
She made the mistake of saying this within my range of hearing …
after no so calmly explaining this dentist was just another self employeed guy much like myself … I related it to how she was stealing food off his kids table … just as a nonpaying customer would be doing to me.
Not sure if that ever sunk in … as … but dentists make lotsa money ….
Good thing I’m not a doctor … I’d be unfixing 75% of my patients!
What’s wrong with people?
Jeff
Buck Construction Pittsburgh,PA
Artistry in Carpentry
Replies
It is nice to know I am in the top 25 % of something!
Mr T
Do not try this at home!
I am an Experienced Professional!
Remodeling Lead Carpenter w/ 20 years exp.
+ A Construction Engineering Degree
Located in Elmira, NY
Incessantly Whining Liberal
Sarcastic Smartass
Cunning Linguist
Family Man
Dog Lover (NOT THAT WAY YOU PREVERT!!!)
I never beat the exact figure out of any of my bosses, they may not have known them, as to what percentage of bills were actually paid. I do know that bills presented in person before the mechanic leaves after a service call were paid more often than those presented after the fact.
A common line was that getting jobs was never a problem. Getting paid for what was done was. Usually followed by the statement that if everyone paid every crew would have a new service truck and the boss would have a heart attack.
Hate it! Can't stand it! My sister had a significant other who had the same train of thought. Every Christmas we would argue about some other poor so and so he beat out of money.
Then he would finish off my evening by telling me how lucky I have been to have the nice things I have, or the equipment I have, or the nice truck I drive and every year I would finish him off with "sure, just walked out in the front and someone dropped it all out of an airplane you putz".
Anyway she finally got rid of the dumb b-stard.
Ummm, sorry, sensitive area as you can see. DanT
I got a better story ...
same person ...
back in taxes something like 6 or 8 years ...
why pay if they're never gonna collect, right?
anyways .... they get notice the jig is up ... pay or get the salery garnished ...
only problem ... if the hubby gets the wages garnished ... his contracts states immediate dismissal!
Uh oh .... suddenly this is a bad idea ...
so after begging and crying .. the local tax office says Of couse we're not gonna put anyone out of a job ... we'll set up a payment plan ...
They owe $3K ...
Guess how much a tax refund they're getting this year?
That's right ... $3K!
So "their plan" ...
take $1K and make a down payment ...
then make payments on the other $2K ...
after all ..... if they paid all that money to the tax office ... they'd have none left
"for themselves" ... and "after all, it's been a hard year ... we deserve a vacation"!
I'm half tempted to call the tax office and rat them out .... not even under the cover of darkness ... I'd love to let all involved know just who told the truth.
Jeff
Buck Construction Pittsburgh,PA
Artistry in Carpentry
There's a special IRS phone number just for telling stories like that. I think you even get a cut if you turn someone in and it results in collection of taxes that would otherwise have been evaded.
Once they go on a payment plan, they better stick to it. Otherwise the garnishing of wages and freezing of bank accounts can start without warning if they miss a payment. Once you're on their screen they're gonna crush you.
well that sounds even better ....
sit back and watch .. and wait.
Trust me ... once on the payment plan ...
they'll soon "forget" ... the next time money get's tight ... due to one too many trip out for steaks after a big spending spree at Wallmart!
it is local township taxes ... so they may be a bit more forgiving?
Hmmmm.
JeffBuck Construction Pittsburgh,PA
Artistry in Carpentry
Jeff,
And its not limited to people with low or medium incomes either. I had a boss 10 years ago that made 100k and his wife made another 45k.
He gets a 12k bonus. Shows me the check. They book a flight to Chicago (5 hour drive from here) and a room at the biggest grandest hotel in downtown Chicago. (forgot the name) They go for a 4 day weekend and shop like crazy, eat big, and drink huge. All while paying a babysitting service 4 days, 24 hours a day to babysit the 3 kids.
Come back. Catch up a few credit card payments and put down some money with a trade in of a near paid off Volvo (he said it needed tires anyway) for a 5 series BMW. Get this, a lease, with the full maintenance package. Even with the Volvo and money it cost him $525 a month.
After it all (only took 2 weeks) I am sitting eating lunch and he walks up to me and says "hey you have an accountant don't you?". I answer yes and he says "could you ask him a question for me, I owe the IRS 4k from last year and I need to know how to get that worked out in payments".
The final chapter is he got mad at the company we worked for and took a job in Puerto Rico, so he had to pay, that right pay, the lease company 6k to take back the 6 month old BMW. It worked out for me though I bought some of his furniture and I still use his lawn mower. PR job lasted 1 year.
I know what you mean about calling the tax people. DanT
It doesn't work that way.
If you owe the IRS any refund amount is credited in its entirety toeward the amount owed. I know because I was inthat situation. A patnership gone bad left me holding the bag on 25K in back taxes. Just paid them off last fall.
As for your ER doctor friend, I don't buy it. Kind of like auto dealers crying that they only make a few bucks on each car. Last time I checked most ER docs, (my cousin's husband by example) do just fine. they get their money one way or another.
Thats not to say our insurance and medical system aren't totally screwed up.
Guess how much a tax refund they're getting this year? That's right ... $3K!
Ok, maybe it's because I've been the boss, and had to make quarterly payments. Or maybe because I've been a recipient of the rainbow checks. Maybe both. But I just don't understand folks who get those huge refunds on purpose, like they are getting something out of dumb ole Unc' Sam . . .
Really, $3000 is $250 a month. Ok, so, at 1.5% annually, you are only giving $20.71 away to Uncle Sam (he collects the interest, not you)--but still. I just can't imagine not living with as much as $250 per month. In my 1% credit union checking account, that $250 per month is $13 in interest at the end of the year--a decent lunch.Occupational hazard of my occupation not being around (sorry Bubba)
can't agree with ya on the refund deal ...
growing up our tax refund paid for all of our summer vacations!
forced savings ... or
extra money.
But I don't disagree with ya so much that I don't try to pay as little as possible myself ... must be the self employ thinking ....
JeffBuck Construction Pittsburgh,PA
Artistry in Carpentry
Jeff no issue with anything other than your client's initial quote
I would imagine an ER might be lucky to receive 25cents on dollar billing / your doctor client was paid for every moment he worked
my more cynic take on the quote would be doc's average take on each dollar billed is he nets 25 cents on each dollar billed after staff, overhead, nonreceivables etc...
"your doctor client was paid for every moment he worked
my more cynic take on the quote would be doc's average take on each dollar billed is he nets 25 cents on each dollar billed after staff, overhead, nonreceivables etc..."
Hospitals are shifting away from paying per hour towards basing pay on billings. If do pay per hour, then there would be an assessment of "productivity" in each quarterly review.
25% of billings would be low for doctors in private practice. After the insurance, rent, staff salaries are paid, there typical is more than that left. A doc on salary or on a production basis in an ER would be lower - the hospital takes a big cut for their overhead and profit and the doc doesn't have to sweat the management, hiring and scheduling decisions. Just show up for 14-hour shifts and deal with unpleasant people in bad situations while trying to practice good medicine.David Thomas Overlooking Cook Inlet in Kenai, Alaska
Jeff
I got a brother in law that is an ER doc, I don't know if this is just in Iowa or if it is all over but, his money is guaranteed, meaning that if people fail to pay he gets it from gov. they make up the difference in what doesn't get paid by insurance or people just paying out of pocket.
BIL can not turn anyone into collection agency because of this guarantee. Problem with that is that most people know that. This may just be something that the hospital he works at has, don't know the specifics.
Don't get me wrong I certainly don't condone not paying for good's received. Problem is that I am paying for goods that other people receive, and I don't really care for that.
The story that you related about the couple and the tax return, I know a couple just like that, they owed about 6 months in back rent(don't know what the hell the stupid landlord was doing) they get about 4k in tax return, pay 3 months worth of rent and split the rest of the money between the two of them and go blow it.
I have a friend who gets SS benifits, has two kids and receives several other gov. handouts. He and I are in lumbar yard one day and he buys something for $9.95(local tax 5%) so the bill comes to $10.45, He only had a ten spot, I give him the 45 cents, on the way out to the car he's bitching about the taxes on the item, I told him that he of all people should never bitch about taxes, did'nt know what I was talking about.
Doug
"I got a brother in law that is an ER doc, I don't know if this is just in Iowa or if it is all over but, his money is guaranteed, meaning that if people fail to pay he gets it from gov"
ERs are in a difficult spot in a number of ways. They are required to render emergency care regardless of the patients ability or willingness to pay. Also, ERs have become urgent care (and not so urgent care) for the underclass that has no regular physician. And therefore encounters problems in billing that demographic for services.
Some regular, upstanding citizens come in on the ambulance. But, on average, drunk drivers, domestic-voilence participants, gang-bangers, and bar-room brawlers are not the customers you'd pick first, if you had a choice.
Also, whereas the middle class used to go to the county hospital for childbirth (a money maker) and other care, now they can get more friendly service at a doc-in-a-box clinic without having to rub elbows with the riff-raff at county.David Thomas Overlooking Cook Inlet in Kenai, Alaska
You can't put a mechanic's lien on teeth, I suppose. (Though I have heard of dentures being repossessed.)
whats wrong with people ?? they suck !!
always looking for a way out !!at someone elses exspense !!!
i grew up in an area where you would hang your head in shame !! if people got wind of what you did, today they really thanks for the info & then bitch about the risen costs !!
A guy that used to be a friend of mine...a developer. From 1985 to around '98 or so he built nine commercial buildings. Some of the nicest looking commercial buildings in the city. Block and steel with brick facades (one building used wood trusses and they blew down the night after they were put up, "I'll never use them again.").
In the mid-eighties everybody liked working for him. He paid promptly and fairly. Good guy. Drove a BMW.
Today (or a few days ago), he has two Porches (sp?) and a Benz SUV. I've known him to buy thousand dollar pens, very expensive cigars and wines. Frequent dinners out at high end steak restaurants, etc., etc.
Today he no longer controls a single property in this county, this includes the house and "farm" that his father built. The banks have seized every one (he had them all leveraged as far out as he could get them).
Rumor has it that the banks were concerned that they would never recoup their money from the properties. They quickly learned that after all the monthly expenses were covered, there was still $10,000. That's $10,000 of excess cash flow a month! But the guy couldn't live on that.
Rumor has it that the banks got bad news when the IRS filed liens on all the properties.
Rumor has it that the bankruptcy court filed a bench warrant for the guys arrest when he didn't show for the last hearing.
Rumor has it that there was also a federal warrant out for him, but that he has turned himself in.
Rumor has it that he owes two individuals over 100,000 each.
In a way, it is so sad. But I have little sympathy for him. All he had to do was live within his means.
Rich Beckman
Another day, another tool.
he said doctors average collecting about 25 cents outta every dollar billed! No wonder the insurance world is so screwed up and Dr bills are thru the roof
Read a fascinating item the other day. There is on facet in medicine where costs consistently go down. It's elective procedures. These are rarely covered by insurance, so people shop around for the service. The docs providing the service also tend to collect the money as there are no excess bureaucracies between them and the customer.
One example is in Lasik. Not that long ago, this was a thousand dollar procedure. There are ads out now as low as $299. We can argue the cost-to-quality benefits, but the fact remains, these are dropping prices for medical procedures.
People who think of themselves as honest are consistently dishonest when it comes to dealing with institutions (government, doctors, etc), and completely rationalize it in their minds.
Case in point: a chiropractor acquaintance whose income is in the low 6 figures. He's bragging to my husband about what a great accountant he has because his kids all receive school lunch. Grrrr. Good thing I wasn't in ear-shot. My state is 51st out of 50 states plus D.C. in dollars per student, and this schmuck is taking free lunch for his kids. But this guy considers himself to be an honest, decent, churchgoing man. He doesn't see that he is stealing food from kids who really need it, stealing books from the school so they can educate children, and stealling dollars out of very poorly paid teachers' pockets.
However, on the ER note, some doctors bill for services not rendered, so it doesn't surprise me that they have a low billed to collected ratio. Another acquaintance took his son into the ER for a childhood accident. He was with his son for the entire duration of the visit. He received a bill from an ER doc on duty who never saw his son and refused to pay the bill. Eventually, after a long time, the claim against him was dropped. So that doctor didn't collect what was billed, but it was falsely billed in the first place (the doc wasn't a radiologist who looked at pictures, he was billing for seeing the boy).
51st out of 50 states plus D.C. in dollars per student
Utah ? as I'm still new to the state. it seems very odd mix of very GOP and very take advantage (and then some) of every gov. dime there is. most think that they are entitled to it. cheating the gov seems to be the excepted norm. tax payer to tax user ratio is very lopsided here.
Yes, Utah. Home of the legislative morons who think it is more important to pass a resolution asking the feds to pull out of the UN than to fund the education of our students. They axed a bill to fund education that would have removed some tax deductions for large families with greater than $325,000 annual income. That's anti family, they say. The hard-right wing republican voters who think their marriages are threatened by allowing same sex marriage to even occur in other states are the very same ones that are bilking the government out of every dime of assistance they can get.
People here are weird. I only hope the governer gets out her veto pen and uses it wisely.
I missed the part where somebody held a gun to your head and made you move to Utah.
Last time I checked, per student school spending correlates negatively with school performance. DC schools have the highest per student spending and disasterously bad school achievement. New Hampshire is very near the bottom in per student spending and very near the top in achievement. (I can't remember where I read this. I went Googling last year to try to find the actual numbers and had no luck at all.)
What is it exactly that your schools are not doing that you think they need more money to start doing?
"What is it exactly that your schools are not doing that you think they need more money to start doing?"
Well, judging by the knowledge that isn't in the heads of some A students I've spoken to, they aren't teaching the kids very well. But that is strictly anecdotal and isn't the only reason why I complain about the problem with funding. Our area schools expect to have something like 100,000 more students next year than this year. So those already thinly spread dollars will be even thinner. Too thin, especially since we told the feds to take their No Child Left Behind and stuff it, so we don't know if we are going to get federal dollars or not to complement our dollars.
Nobody held a gun to my head to make me move here, and there's a lot I love about this place. I think your comment "I missed the part where somebody held a gun to your head and made you move to Utah" is a bit petty. I can disagree with my legislature's dumb decisions, and I can dislike some of the people here who take advantage of the system, but that doesn't mean the benefits of living here don't outweigh the drawbacks. Luckily, I live in the United States where I can complain about the dumb decisions my legislature makes and people still won't hold guns to my head, they can make all the comments that they want on the net though.
>> Our area schools expect to have something like 100,000 more students next year than this year.
Won't there also be a corresponding number of new houses and apartments next year generating property tax revenue? Or are all these families going to be living in their cars?
I'm willing to believe the schools in your area haven't been doing a very good job, based on your anecdotal evidence. It seems to match everybody else's anecdotal evidence. My question is, is there any reason to believe that a shortage of money caused the problem, or that more money would alleviate the problem, or that less money would aggravate the problem?
Everybody in the schools wants more money. Lots of people have lots of really good ideas to spend the money on. But there's no evidence - or at least I haven't seen any evidence - that any of those ideas will result in better learning.
>> ... there's a lot I love about this place.
Glad to hear it. It's depressing to live someplace you don't want to be and feel like you're stranded in Hell, and that's what your post sounded like to me.
>> I can disagree with my legislature's dumb decisions ...
Yes you can, but you can't pretend that the legislature is sharply unrepresentative of the electorate. You have the dumb legislators you have because a majority your (dumb?) neighbors voted for them.
"Won't there also be a corresponding number of new houses and apartments next year generating property tax revenue? Or are all these families going to be living in their cars? "
Yes and No. Our population is exploding more because people believe that 5 children is too few, rather than because of immigration. We are building new homes, but property tax accounts for only some of the school funding. Income tax accounts for more, but those same large families get deductions for each child, so pay less in taxes for each child they throw into the system..
Thirty years ago I heard nothing but good about Utah's public schools. Utahns' committment to education was widely heralded. Utah residents attended more years of school than any other state in the nation, by quite a wide margin, IIRC.
Thirty years ago there were far more of Those People (the ones who think five children are not enough) in Utah than there are today, as a percentage of the state population. No doubt Those People's birth rate is higher than their neighbors, but it has also been going down, in parallel with the national numbers, since the 60's. I'd be surprised to find out Those People have twice as many children as their neighbors, on average, but I could be wrong about that.
If the school problems in Utah are due to excessive numbers of Those People's children in schools, relative to the tax revenue their parents generate, then it seems like the problems should have been much worse thirty years ago, but they weren't.
Edited 3/13/2004 6:01 pm ET by Uncle Dunc
I don't know what it was like 30 years ago. In the past 10 years our test scores have remained flat while the rest of the nation has improved. If by 'those people' you mean LDS, then you are right, the percentage of the population that is Mormon has gone down, although the real numbers have exploded. However, a large percentage of that increase in 'others' has been of Mexican origin, practicing Catholics who also believe in large families. The lion's share (88%) of our growth has been through birth rate, not immigration. We have several counties that have almost doubled their populations (and some more) in only 10 years between 1990 and 2000. Also, in 30 years the relative costs of things have changed simply by nature of inflation. While the amount of food that a dollar, adjusted for inflation, will buy has gone up, many other things related to schooling have increased in relative expense: land, building materials, teaching materials and teachers.
There is no corellation to spending per student & test scores. What do you teach your children when they are with you? Don't count solely on professional educators.
Baseboard been VERRRY good to me