Semi-Annual "Follow-Up" and Additional Fee? for Patient Certification?

SurettaW

SurettaW

Member
I received my certification from Integr8 Heath in March, which expires on 3/2014. Now, I'm being contacted to make a six-month "follow-up" appointment for $125. I was on a sliding scale to begin with. Why do I now have to pay another fee six months into it?

The dispensary says I'm good for a year. Are there doctors who don't charge for this six-month crap? Can I just transfer care from one doc to another?

Also, if I have a card, can I enter any dispensary in Maine, or do I have to sign up and go through everything all over again? Meaning, can I be a member of more than one at a time?
 
M

mdanforth

Well-Known Member
legally you are supposed to be a member of only one, however since there is no way to monitor this one could sign up for as many as one wants I would expect....try Dr Phillips in scarborough.....
 
tet1953

tet1953

Well-Known Member
In my experience with Integr8 you only have to do the six month follow up one time, then it is annual. They told me it had to do with establishing the doc/patient relationship. I think it's a fee grab too, but also has legitimacy. Your cert is good for a year in any case, so if you don't go for the follow up you may need to go elsewhere to renew.
 
jujubee

jujubee

Active Member
Has the condition you went to the Dr for cleared up?

Any legitimate Dr would want to follow up with the patient after they reccommend a treatment. That is standard proceedure for real doctors.

Script mill doctors won't care about the follow up. Maybe that is what you are looking for.
 
SurettaW

SurettaW

Member
jujubee said:
Has the condition you went to the Dr for cleared up?

Any legitimate Dr would want to follow up with the patient after they reccommend a treatment. That is standard proceedure for real doctors.

Script mill doctors won't care about the follow up. Maybe that is what you are looking for.
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No, the condition has not cleared up. 50 years worth of chronic insomnia doesn't go away in 3 months.

That being said, there is nothing about my condition that requires a six-month follow-up, since I have other doctors for those. I will look into this.

If the doctor offers a sliding scale to start with, how can the follow-up be this expensive?


It's not that I don't *want* an appointment, but as you are aware, I have to pay for these appointments. My rent is over 50% of my monthly income -- I'm not able to go to random doctors; I'm covered by Medicare for everything else.


<B> Thank you for all your comments, everyone! </B>
 
NoSwagBag

NoSwagBag

Well-Known Member
jujubee said:
Has the condition you went to the Dr for cleared up?

Any legitimate Dr would want to follow up with the patient after they reccommend a treatment. That is standard proceedure for real doctors.

Script mill doctors won't care about the follow up. Maybe that is what you are looking for.
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Sounds like more of a concern about the buck 25 fee.
 
E

ezwdr420

Member
Any legitimate doctor would charge your insurance if they had "concerns" regarding your well being. go see Phillips for your recert in six months.
 
SurettaW

SurettaW

Member
NoSwagBag said:
Sounds like more of a concern about the buck 25 fee.
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Exactly. If it was covered by insurance, I wouldn't have a problem. It took me so long to save up for the original fee, and to plan to pay it again next year ... this is an unexpected financial burden ....
 
tet1953

tet1953

Well-Known Member
Bear in mind your only problem at the moment is who you are going to go to for renewal after a year. Not going to a mid-year appointment with Sulak does not affect your eligibility. Your certificate is good for the whole year. Sulak likely won't see you for renewal if you don't go for a mid-year, but as someone else mentioned there are other doctors, some of whom might charge less anyway.
 
jujubee

jujubee

Active Member
ezwdr420 said:
Any legitimate doctor would charge your insurance if they had "concerns" regarding your well being.
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Insurance companies are a big part of the reason the medical industry is so messed up in this country.

I applaude any doctor that is not willing to deal with insurance companies.

But if you want to go thru the hassle of dealing with an insurance company, you can try to get them to pay for the appointment. GLWT.
Insurance Reimbursement

Although we do not directly bill insurance, many plans will reimburse you for part of your payment. We will provide you with a receipt and superbill which you can submit to your insurance company. Depending on your plan, you may need a referral from your primary care provider. For more information, call your insurance company and tell them you would like to see an out-of-network provider.
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Anyway, like tet said, just decline the appointment. Let them know you don't have the money.
 
tet1953

tet1953

Well-Known Member
Sure, insurance companies generally suck. However there are plenty of doctors that contribute to the problem with unnecessary tests, procedures.
 
jujubee

jujubee

Active Member
I think a lot of the unnecessary test and procedures are the things the medical industry know the insurance companies won't question. If the insurance companies didn't cover those tests and procedures 100%, the doctors wouldn't request them nearly as much. If the patient had to pay part of the cost, the patient would refuse tests and procedures they think are unnecessary.

I don't like most doctors.
 
SurettaW

SurettaW

Member
ezwdr420 said:
Any legitimate doctor would charge your insurance if they had "concerns" regarding your well being. go see Phillips for your recert in six months.
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Agreed. I am not claiming the doctor is not legitimate, but I still have to pay out-of-pocket for visits and/or meds. When you don't have it, it's tough to come up with.
 
GreenMountain71

GreenMountain71

Member
Been seeing Sulak in Manchester office on fourth year an still paying 6 month visit ! Falmouth office requires you to do 6 months for first year then once a year if you have a pcp.
 
GreenMountain71

GreenMountain71

Member
It was 100 then they raised it to 125! I payed 300 when first started and 100 every 6 months! Oh an the only thing they do to help in Manchester is put you on a payment plan when your on disability or not working! Falmouth office allows sliding scale fee! So if I transfer to the Falmouth office I have to pay 300 all over again! Not impressed!

So yeah you'll have to pay for your 6 month visit!
 
GreenMountain71

GreenMountain71

Member
They will work with you though! Just pay what you can monthly find a caregiver so you can get meds cheaper. I know ones that will give you a oz a month an anything more is 200! Chemdog, OG Kush , ecsd, ect!
 
SurettaW

SurettaW

Member
I heard there's a doctor in Biddeford or Arundel, which would be a heck of a lot easier for me, anyway. Anyone know who, what, where, when, etc?
 
SurettaW

SurettaW

Member
jujubee said:
Insurance companies are a big part of the reason the medical industry is so messed up in this country.

I applaude any doctor that is not willing to deal with insurance companies.

But if you want to go thru the hassle of dealing with an insurance company, you can try to get them to pay for the appointment. GLWT.


Anyway, like tet said, just decline the appointment. Let them know you don't have the money.
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They can be willing to work all they want, but if the Insurance you have isn't the insurance that covers them, you're screwed. If I could AFFORD real insurance, I wouldn't be so frustrated. But, paying dispensary prices, an annual fee AND a semi-annual fee, is absurd. Anyone on disability knows how much other "medication" we take and pay $2 to $6 (if anything) for, and how we couldn't pay more. So, this only ADDS to our medical expenses for the month.

When you're on disability, you don't pay income taxes. No income taxes means no medical deductions. Basically, we are PAYING for the 'privilege' of 'not taking' pharmaceuticals.

Soooooooo ....... I can rationalize the need to pay a once - a - year price; I'm having a hard time rationalizing every six months.

Sorry, just being me.

:mrgreen:
 
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