Will I not get paid if the hospital isn't reimbursed with Medicare/Medicaid?
Posted By: Unknown on 2009-01-19
In Reply to:
I was told by a coworker that California is in so much debt that I may not get a paycheck if CA goes bankrupt because the hospital I work for will not be getting subsidized any longer....
could this be true?
Complete Discussion Below:  marks the location of current message within thread
The messages you are viewing
are archived/old.
To view latest messages and participate in discussions, select
the boards given in left menu
Other related messages found in our database
Cuts in medicare and medicaid are about to take place
I have mentioned this but it was always deleted as I think the monitor thought I was talking politics.
There will be a marked decline in coverage for services to medicare and medicaid patients and I believe to offset this, medical facilities are finding ways to cut costs.
The cuts will be significant. You could do a Google search for Deficit Reduction Act. Radiology will be most severely hit, especially stand alone facilities.
Many physicians in my area don't want to take Medicare, Medicaid, Tricare
or other insurances because the insurance companies require a huge buydown of charges and then disallow quite a bit for being "above the reasonable amount."
For example, I had double insurance of Blue Cross/Blue Shield and Tricare when I had surgery. The bills totaled $15,000. Blue Cross knocked $5,000 off the physician's $7,800 bill, paid him $600 and left Tricare and me to deal with the $1,200 balance. Tricare wouldn't pay because they disallowed the amount as unreasonable, the physician's office forced me to make payments on it, and I had to fight just so I didn't owe them another $1,200. It was ridiculous that I had double insurance coverage and wound up owing anything. Meanwhile, the doctor didn't even get paid that much, and he did my presurgery appointments, the actual surgery, two postsurgery appointments to remove hardware, plus coordinating everything between cardiology, radiology, anesthesia, laboratory, surgery, and having special equipment trucked in from out of state.
If I had not had insurance at all, I would have had to pay the entire amount. I think it's crazy that noninsureds have to pay the full amount but insurance companies can disallow or buy down the amounts due. Anyway, you hit a big rant of mine. Shortly after I lost my Blue Cross coverage, my son needed to be seen but we couldn't find a provider to even take Tricare at all. So much for my husband serving his country and being away from his family in the line of duty. The doctors get rich and refuse to treat military personnel who fight for their freedom. Talk about a total lack of appreciation.
At the hospital, I did - only not 39 hours, 40. But I was a paid SM
employee (production only) with benefits. It was always kind of an iffy thing as far as labor laws went, as I was considered an employee, but we did it nonetheless for the whole 2 years I worked there...until the day I did 3000 lines and was chastised because "other people need to work too" meaning the 4 in-house people who sat there on their tails and yakked all day.
Yep, I bailed. :-)
ICs at our hospital were paid $1.50/minute for the first
Does that help?
Those are reimbursed, so nothing. nm
nm
I get paid hourly $18.00. The hospital I work at don't believe sm
in production because of the error rate, blanks, etc. just to make money. I am sooooooooooooooooooooooo happy.
Hospital job is "work-at-home" paid hourly
Thank you for well wishes.
Rules state anything not reimbursed by employer deductible.
/
But because of having Medicaid...sm
Those who abuse the Medicaid system look at it like who cares when I take my child, it'll be paid for. The ER docs know when Friday night comes, in comes tons of children who could have seen an walk-in doc all week long.....these are not urgent cases. The moms sit on cell phones, talk to everyone, it becomes a free for all night at the ER.
The uninsured and those with Medicaid
often use the ER for their medical care. I was in the hospital with gastroenteritis because I was having syncopal spells from dehydration. While still undergoing testing in the ER there was a woman on the other side of the curtain who had a headache. She called a friend on her cell phone and had her friend come keep her company. They talked nonstop. I have migraines and I want quiet when I have them. This woman had never even taken anything for the headache, just came to the ER. An incidental finding was thrush because she had a baby and when the baby dropped the pacifier the mother stuck it in her mouth to "clean" it.
I also type ER reports. What gets me is when the patient has abdominal pain for 2 weeks and never sought treatment, then decides to come to the ER.
Our local "indigent" ER is also in the only hospital to take pediatric patients, so if we should have to go to the ER we go to that one. We thought my son had appendicitis and took him and were told they had no acute beds and he'd have to wait, yet they took several with flu symptoms ahead of us, so he was considered acute but not only no bed, but no care. Although as I type this, I'm thinking we had no insurance at the time as DH has changed jobs and we couldn't afford Cobra. We were less than a week away from having insurance, but had none at the time of the visit, although we did pay the bill in full, so maybe that played a factor in things.
Depends on what kind of hospital? Large urban hospital or small community hospital? SM
Also, is it a large teaching hospital? If so you have to consider there will be A LOT of different residents dictating, usually a lot of ESLs at teaching hospitals, and the residents rotate out and new ones rotate in every summer. So you can't expect to get the same dictators and build up your macros because the dictators change all the time.
I would say 9 cpl would be a pretty good offer for a small to medium community hospital where you will be doing the same dictators on a daily basis. But for bigger, urban or teaching hospitals I would want at least 12 to 15 cpl.
I asked about this too, you can get medicaid if you get hospitalized and spend a certain amount.
If you have out of pocket expences equalling up to 2000, then you can get Medicaid. I think it is still based on your income, but it is not as strict as it normally is. You have to still pay that first 2000 but they do help with future bills.
For QA consulting I'm paid per hour; QA instructing (college) paid salary, QA editing paid per li
I am an IC and work for two different MTSOs as well as instruct at a business college.
SE Medicare and SS are taken out, not fed tax.
I looked on the IRS website. You do get a SE W2 and then you can deduct business expenses to lower your fed tax, but you still are responsibile for fed tax yourself. I double checked at the IRS website.
Question about Medicare.
I hope I'm posting on the right board, but here it goes. My elderly mother was in the hospital back in January and on Friday received a bill from a nephrologist who saw her briefly once and billed Medicare $375 for his in-hospital consultation. Medicare paid them $15.68, they "wrote down" $240.40 and the supplementary paid $3.92, and now they are billing her $115. This is the first time she has ever received a bill from anyone as her insurance has always paid. I keep thinking that they have used a wrong CPT code for their billing as it is beyond me that Medicare would only pay $15.68 for an in-hospital consultation. I will have to wrangle with these people tomorrow, but wanted to know if anyone had any opinions about this and feels like I do. I don't think this is her deductible amount as she had seen many physicians before him seeing her in the hospital. I know I will also have to call Medicare to see if in fact they are the ones that got their bill in first and this is in fact her yearly deductible, but as they say, knowledge is your best tool before someone tries to pull the "wool over your eyes."
yes..they are taking out for SS and Medicare...
a friend of mine said when she wasn't making that much money she had them withold an extra 10.00 for federal so i may have to do that...
Forgot to say this was for Medicare Supplemental Insurance (NM))
nm
Your national is liable for SS and Medicare tax not you. They thinkyou are self employed. nm
:
I've actually found Medicare very easy to deal with...
wouldn't dread the call. It will probably go better with Medicare than with the nephrologist.
Yes, you're cranky. The docs may be instructed to do so to appease Medicare or other such entity.
x
Medicare is offering free installation of EMR to physicians and hospitals.
http://www.medscape.com/px/instantpollservlet/result?PollID=1502
If government is involved, it will be as screwed up as the Medicare medication program.
Heaven save us from all these wanna be kings that sit on top of the hill.
oh our lovely government does give illegals medicaid, foodstamps, and housing so in term we give tha
i have been through some rough times lately and had to apply for some help. there are signs, big signs, all over our offices saying "YOU DON'T HAVE TO BE LEGAL TO GET HELP". so we and our government do give them our benefits whether they are legal here or not. now that is messed up. i am helping to support them so they can take away my jobs and i can't even support my kids and yes i get benefits, wow $75 a month in food stamps which lasts not even a week in a household of 6. don't get me wrong, i am thankful for any help at the moment, but i get penalized for trying to work my tail off and still can't survive.
there was recently an article in our local newspaper where one of our local school districts tried to charge $1000 a year for each illegal student enrolled. it was bulked and the illegals got a lawyer to sue for discrimination. the school district merely stated that they had to HIRE extra teachers that could speak the foreign language just to teach these children and were trying to offset some of the expenses. ridicilous!! so again our taxpayers money is paying to educate illegals as well.
if mt paid 9, editor paid 4 or 5...how can company charge 14 and make it..sm
I know the going rate in our area is 14 cents per line. As MTs most companies here pay us 8 or 9 cents a line. Now add in the Editor rate at 4 or 5 per line..you are paying OUT more than you can charge a line. How would companies stay in biz?
Unless all work is sent by the company overseas at pennies per line, this would not pay for a company.
just curious how this works out
Not sure, I have deductions for federal income tax, SS tax, Medicare tax, and state income tax. ???
nm
But how much are the US EDs gonna be paid? Typically this work is paid at 2-3 cpl. nm
:+
You don't get paid an hourly rate you get paid by line - sm
so because of how you are paid (not an hourly rate) you don't get OT, especially if you are an IC.
I would move on. I think it is so unfair not to be paid for spaces! I think we should get paid
per keystroke, but that'll never happen. I just think that these national companies are going to keep finding ways to cheat us. I found a job working for a hospital as an employee, paid hourly plus incentive, and they let us expand everything! Somebody's gonna have to kill me to make me give up this job. I will never go back to the national's again.
I feel for you though. I know that for us MTs those good jobs are few and far between and some have little choice but to work for the nationals. I just happened to luck into the job I have now. I just applied at the right time.
Good luck to you whatever you decide.
If those companies paid a fair wage, and paid more
all came out equal, people wouldn't feel the need to try to make up the deficit by going for the good stuff. I actually prefer the harder, juicier reports. But I can't make a living doing only that, because the pay is not commensurate with the difficulty. So even though I prefer not to, sometimes I have to pick up some of the easier, more boring 'line-o-matic' reports just to make ends meet. Tell your MTSO to make it work their while, and MTs will stop taking all the easy work away that you obviously would prefer to keep for yourself.
You wont show UE being paid because it is employer paid -
the employee will never have to pay this.
What you "should" be paid and what you "are" paid
sadly are two very different things. Good luck on demanding more..because someone else will just come along and take it for what they offer and they know it. 
10$ late if invoice is not paid within 10 days. At day 15 work stops until invoice is paid. Hardly
xx
Hospital. I wish I'd never left my hospital job.
They'll only take me back if I start off working nights and weekends again at the bottom of the totem pole.
If you work for a hospital - how come no one from the hospital
called you?? Were they in the dark, as well?? How sad, that no one in your hospital communicates with the at home staff.
hospital MT
Call the hospital. You can offer a better deal to them. Most MTSOs charge the hospitals a lot more than what they pay out for the actual work done. I work for a hospital. I asked for a raise after 10 years, they baulked, started looking at outsourcing. They changed their mind really quick when they found out how much they would charge them. (four times what they paid me).
Hey, if you don't want that hospital job can I
have it? Just kidding (only because it's probably not where I live in central Florida). Started working at home for the kids over 10 years ago, but they are all grown now and I realize I don't know anyone because I hardly ever leave the house!!
hospital job
My situation too. Son out of the house now. Still know all the people at the hospital as I worked there for 10+ years and still do side typing for one of the units there that were not taken over when they outsourced! So seriously considering it....Sorry, its in PA!
I think they did that to us at the hospital
but no O/T. But you could get on there and do BONUS MINUTES at 6/cents a line all you wanted.
I always felt like that should have been illegal. If I'm working, then I'm working. If I'm an hourly employee - then anytime I'm working!!!!! I should be an employee and thus paid HOURLY WAGES. But they got away with it. Sort of a hybrid deal.
They screw us any way they can.
 (good little screws all in a row)
 (Medical Records Supervisor yucking it up drinking coffee, practicing snapping her whip)
 (Me at the end of the day saying WHY AM I HERE?????)
Hospital pay
I make about $15 per hour at my hospital job in Washington state and have recently quit that to work out of my home. However, I have not yet found any home job that even comes close to that when being paid based on lines.
hospital pay
i make 21/h. living in the hawaiians islands, thats actually pretty good
hospital pay
my main job is at the hospital and i would never leave it especially with all the benefits and good pay. ic has its benefits when it comes to tax time, but as far as job security and being a single mom, i choose to stay at a guaranteed $20/h. too many people are unhappy with the problems of security in this line of work and i dont want that to happen to me.
Hospital pay
Out here in Oregon, all hospitals pay from 14 to 19 plus benefits. Am considering going with Kaiser after the first of the year and having my I/C's run my business. Have one doctor retiring after the first and deciding whether to do all my own accounts and make $40K doing 30 hours per week without benefitis enjoying life and not saving much or going with Kaiser at 18.50 per hour with benefits and having the I/C's doing 80% of my work and I will type parttime on the weekends. Have only 10 more years to work. Have been offered work at Kaiser, Providence and Good Samaritan Hospitals so the work is out there.
Hospital pay
At least with the hospitals out here in the west, they always have posted salary ranges and you can usually always exept with decent experience to start in the middle somewhere and reach the top in 5 years. Worked in HR in a large hospital for a bit. They always post the salary ranges here with positions and with that you go in with a bit of knowledge. I never did see one start at the top though. Good luck.
Hospital job
Let us know how things go. I would fear that they see MT as just "typing" and would give you so many secretary duties that the MT part would be pushed to the back burner.
TAKE THE HOSPITAL JOB - sm
national services lose accounts all the time whether it is nonrenewal of contract or fired, or whatever, your pay is never the same from week to week with a service, you may have extra transcriptionists on your account all of a sudden, work load varies, etc.
With the hospital work, you know your doctors, you have guaranteed hours and work and even down time (some services don't offer that), overtime, benefits, etc. Some hospitals even offer reimbursement on college courses - CAN AN MTSO SERVICE OFFER THAT?? Some hospitals have family leave time for 12 weeks of maternity!! Can an MTSO service offer that?
Take the hospital job!
Take the hospital job...
Those are only real "for sure" MT jobs out there anymore. I worked for years for a service but since I took my at-home hospital job, I feel like somebody for the first time in the eyes of my employer. We are all local, so we have staff meetings and come into the department for different things, yearly reviews, parties, etc. We're all in touch via e-mail and know each other face-to-face too. I get paid by the house, have a set schedule, and can earn incentive pay too. I have paid holidays, benefits, and am a hospital employee except work at home. I love it, would never EVER go back to clawing for lines at a service who barely knows my name.
Hospital Job
One thing you have to be careful of -- are there witches in that hospital who will send you the "worst" work or not send it at all and keep it for themselves? Be sure - I know one hospital who "punishes" the work at homes because they're afraid their dept. will be outsourced completely. Be careful who you deal with. Don't like MTSO's so I started my own, but family sickness and my own illness forced me to retire (temporarily, I hope). When offered work at home from a hospital, I had to say no and glad I did, another person said yes and just sits there waiting, and waiting, while the in-house people make the bucks and if they do send, it's all stuff they don't want to do. Be careful and good luck!!
HOSPITAL JOB ALL THE WAY!!! the Way (sm)
That's good pay and bennies to boot!!! I would die for that.
I worked for a hospital as an IC for many years at home. That's the only way the hospital bigwigs would allow it, not employee status. Never ran out of work except in the first few weeks in a new year. Never had "just the junk" as some suggested. I did the same work as everyone else. I tried to get my employee status back (which I was once) but no luck. I was at home. Some rule about that, but I was happy.
I'd go back to my hospital in a flash. My buddies want me back. The boss wants me back. For some reason, they still won't give me employee status. That sucks. ('scuse my French).
Don't even THINK about what to do, DO IT. You'll never be sorry.
Hospital
I work full-time from home for a local hospital and am paid per hour. I also work an IC on a part-time basis. I would say if you need the benefits and steady paycheck and can handle working possibly rotating weekends and holidays, yes. The only good thing with working with some nationals is having the flexibility with your schedule but you will NOT make a steady income. You will constantly run of out work, loose money and find yourself clocking in and out all day long just to make 8 hours. With a hospital, you know that the work will be there everyday and if you have downtime, you will still get paid. Also, having that security in knowing that you can speak to management face to face or over the phone. Go for the hospital, because I know a lot of MTs wished they could have that opportunity. Go luck to you!!!
hospital
security, benefits,local, communication, "real people" versus "phone people"
take less money and have these advantages, the days of making a lot by working on production are over
Good Luck!
Thank you both, will look into it and ask at the hospital too.
//
|
