Friday, November 30, 2012

Soon Highmark will be asking you to pay $69 NOT to see the doctor . . .

You can't make this stuff up.

Highmark is now rolling out a new dermatology idea:  instead of actually being seen by a doctor, you photograph the affected area and send it in digitally.  Then the doctor decides whether or not you need to come in for a real appointment, or whether s/he will simply diagnose a picture.

The cost for this "service" will be $69, because it is NOT a covered benefit on any Highmark Blue Cross Blue Shield plan.

So let's get this straight:  instead of paying my Highmark co-pay (usually around $25 but never higher than $50) and having the opportunity to be examined by a real live dermatologist, I am now going to be asked to pay $69 NOT to be seen at all.

Highmark is simply gushing over this new "service":

"This new process makes it convenient for patients to access care," said Eric Starr, director of business innovation and development at Highmark. "They will just simply take a photo with a smartphone device or digital camera and then go to the secure website and send the image. Based on the image, the physician can determine if the patient can be treated virtually. This really modifies the workflow of the dermatologist allowing office visits to be used for the most critical cases."  A win for both the doctor and the consumer.
Yeah.  Aside from the fact that I cannot wait to see what happens when a doctor misdiagnoses something carcinogenic from a blurry digital image, this is a win for Highmark's accountants and nobody else.

You get stuck with a bill for more than your co-pay and don't see a doctor.

You also have absolutely no assurance that any particular doctor (or even any doctor) is the one providing your treatment advice.

Meanwhile, Highmark is spared having to pay out anything in claims.

Your doctor, by the way, will probably embrace this service for the following reasons:

1.  S/he first charges you $69 that s/he gets to keep for spending fifteen seconds looking at a photo.

2.  Then, in the well-grounded practice of defensive medicine, s/he tells you that you need to come in for an appointment, collecting another $25 from you, as well as the insurance company payment.  (In other words, Highmark has found a way to increase the doctor's capitated pay without actually having the company pay it.  Your effective co-pay to see a dermatologist just increased from $25 to $94.)

Thank you thank you thank you Karin Weldin Stewart, for allowing the unbridled philanthropy that is Highmark to set up shop in Delaware.

Read more here:


NCSDad said...

Watch for outsourced virtual exams performed by doctors in India next. I'd go for it too if I could get a prescription from there filled and it saved me money.

Anonymous said...

WOW! this is insane!