Medical Clearance for GM BC/BS

HearWHAC hearwhac at netins.net
Sat Nov 1 01:44:33 EST 1997


Jeffrey Sirianni asked:

> Is this practice of the dealer paying for medical clearance accepted /
>
> legal / ethical / a conflict of interest?  I'm guessing that the
> dealer
> pays the physician fees as I know no physician who see patients for
> nothing.

What would be the difference between an audiologist/dealer paying for
the physician's clearance, and an optician paying for the optometrist's
examination? I believe this is done frequently.

I can't come up with a reason why this would be illegal. The insurance
company would not care. (Believe it or not, insurance companies are glad
to provide a new aid every three years. It makes them look good and
costs are really not that important to them.) Why would it be unethical?
Hey, the guy/gal is providing an "extra" service - paying the cost of
the doctor's visit. And what would be the conflict of interest?  Jeff,
this is an interesting question. I suspect the answer is, "It is okay to
do this because there is no rule or law prohibiting it." But I'm sure my
comments will generate other comments.

Now, if you asked, "Is this an intelligent business practice?" my answer
would be, "Absolutely not!" The insurance programs pay so little, I know
of no reason to a) solicit anybody or b) discount hearing aids (which is
what paying the doctor's fee is) more than what the insurance companies
are willing to pay. If somebody is stupid enough to do this, hey, it's a
free country. (I noticed a check came into our office today for a little
more than $600 from BC/BS of Michigan - for "Payment in Full" for a
hearing aid. Needless to say, if we were paid this amount for every
hearing aid we dispensed in our practice - and if we had to go through
all the paperwork, agony, sweat, waiting, lousy cash flow, etc. we would
have to greatly reduce the quality of our work. Insurance hearing aids
are not too good a deal, believe me. But not everybody gets the
"privilege" of writing the checks to pay the expenses in a hearing aid
practice.)

Paul ;-)






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