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ethical question

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General fitness, health and nutrition
Published
21 April 2004
Last activity
22 April 2004
Original author
taurusrc
Posts
13
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  1. Today I went to a medical provider and they gave me some
    forms to sign including one titled

    "Acknowledgement of Receipt of Notice of Privacy Practices
    Advanced Beneficiary Notice"

    The notice included the following (in addition to the
    acknowledgement):

    " Dear Patient,

    Medicare and/or your insurance will only pay for
    services that they determine to be "reasonable nd
    necessary". These are examinations and treatments
    performed for specific illnesses, symptoms,
    complaints or injuries. Routine physical
    examinations, some screening procedures, some
    laboratory studies and some medical imaging are not
    covered by Medicare and may not be covered by your
    insurance.

    I have read the above statement and agree to pay for
    the services rendered to me that are "not covered"
    by Medicare or my insurance company, while I am a
    patient with............

    ____________________
    Patient Name (Please print)

    _________________
    Patient Signature
    _____________
    Date "

    I signed the top portion of the form acknowledging that I
    had received the Privacy Notice but did not sign the portion
    shown above. When I returned the form to the receptionist
    she asked me to sign the bottom portion also and I told her
    I would not sign it. She did not insist but I just wonder
    how many people sign things at the doctor's office without
    carefully reading them.

    I wonder if it is ethical to add such a thing to another
    document which they want signed.

    Ora

  2. Quoted message said:

    I wonder if it is ethical to add such a thing to another
    document which they want signed.

    Two pieces of paper or one.... What's the difference? It
    would only be unethical if the form was somehow misleading
    or deceptive, and I don't see how this one was.

  3. <[email hidden]> wrote in message
    "]news:[email hidden]...

    Quoted message said:

    Today I went to a medical provider and they gave me some
    forms to sign


    including

    Quoted message said:

    one titled

    "Acknowledgement of Receipt of Notice of Privacy Practices
    Advanced Beneficiary Notice"

    The notice included the following (in addition to the
    acknowledgement):

    " Dear Patient,

    Medicare and/or your insurance will only pay for services
    that they determine to be "reasonable nd necessary". These
    are examinations and treatments performed for specific
    illnesses, symptoms, complaints or injuries. Routine
    physical examinations, some screening procedures, some
    laboratory studies and some medical imaging are not
    covered by Medicare and may not be covered by your
    insurance.

    I have read the above statement and agree to pay for the
    services rendered to me that are "not covered" by Medicare
    or my insurance company, while I am a patient
    with............

    ____________________
    Patient Name (Please print)

    _________________
    Patient Signature
    _____________
    Date "

    I signed the top portion of the form acknowledging that I
    had received the Privacy Notice but did not sign the
    portion shown above. When I returned the form to the
    receptionist she asked me to sign the bottom portion also
    and I told her I would not sign it. She did not insist but
    I just wonder how many people sign things at the doctor's
    office without carefully reading them.

    I wonder if it is ethical to add such a thing to another
    document which


    they

    Quoted message said:

    want signed.

    The fact that you didn't sign it means nothing. If you don't
    agree to their billing practices, the clinic/doctor may very
    well decide to not provide you with the service.

    HMc

  4. Howard McCollister said:


    <[email hidden]> wrote in message
    "]news:[email hidden]...

    Quoted message said:

    Today I went to a medical provider and they gave me some
    forms to sign


    including

    Quoted message said:

    one titled

    "Acknowledgement of Receipt of Notice of Privacy
    Practices Advanced Beneficiary Notice"

    The notice included the following (in addition to the
    acknowledgement):

    " Dear Patient,

    Medicare and/or your insurance will only pay for services
    that they determine to be "reasonable nd necessary".
    These are examinations and treatments performed for
    specific illnesses, symptoms, complaints or injuries.
    Routine physical examinations, some screening procedures,
    some laboratory studies and some medical imaging are not
    covered by Medicare and may not be covered by your
    insurance.

    I have read the above statement and agree to pay for the
    services rendered to me that are "not covered" by
    Medicare or my insurance company, while I am a patient
    with............

    ____________________
    Patient Name (Please print)

    _________________
    Patient Signature
    _____________
    Date "

    I signed the top portion of the form acknowledging that I
    had received the Privacy Notice but did not sign the
    portion shown above. When I returned the form to the
    receptionist she asked me to sign the bottom portion also
    and I told her I would not sign it. She did not insist
    but I just wonder how many people sign things at the
    doctor's office without carefully reading them.

    I wonder if it is ethical to add such a thing to another
    document which


    they

    Quoted message said:

    want signed.

    The fact that you didn't sign it means nothing. If you
    don't agree to their billing practices, the clinic/doctor
    may very well decide to not provide you with the service.

    HMc

    What service? If I am going to agree to pay for a service
    I surely would want to know what service I am agreeing to
    pay for. That form was an open ended promise to pay for
    "whatever". That is the reason I am wondering whether it
    is ethical.

    Ora

  5. In article <[email hidden]>, [email hidden]

    Quoted message said:

    What service? If I am going to agree to pay for a service
    I surely would want to know what service I am agreeing to
    pay for. That form was an open ended promise to pay for
    "whatever". That is the reason I am wondering whether it
    is ethical.


    You are agreeing to pay for the services as outlined.
    You promised only to pay whatever your insurance did not
    pay for. I did the same thing a couple years ago with an
    auto body shop and a carpenter when I needed some storm
    damage repaired. Some principal.

    --------------------------------------------------------
    "Writers even write the silences"

    - J. Michael Straczynski

  6. <[email hidden]> wrote in message
    "]news:[email hidden]...

    Quoted message said:


    What service? If I am going to agree to pay for a service
    I surely would


    want

    Quoted message said:

    to know what service I am agreeing to pay for. That form
    was an open


    ended

    Quoted message said:

    promise to pay for "whatever". That is the reason I am
    wondering whether


    it is

    Quoted message said:

    ethical.

    Ethics has nothing to do with it. They want you to be aware
    that your insurance may not cover the cost of all of the
    services, *any* services, they render to you and they want
    your promise to pay for the parts your insurance doesn't
    cover. If you don't agree to that, they may decide not to
    provide you with the service, then or in the future. They
    can decide to not accept you as a patient if you don't pay
    your bills. As to your concern about "what" services, you
    have the right to find that out and get cost estimates at
    every step along the "service rendering" process. You can
    refuse to have any service that you don't want to pay for,
    and you can refuse it before the service is rendered. But if
    they do the work, they expect to be paid. Just like any
    other fee-for-service occupation.

    HMc

  7. In article <[email hidden]>, "Howard McCollister"

    Quoted message said:

    Ethics has nothing to do with it. They want you to be
    aware that your insurance may not cover the cost of all of
    the services, *any* services, they render to you and they
    want your promise to pay for the parts your insurance
    doesn't cover.

    If anything is unethical, it would be to NOT let you know
    that there may be these holes in coverage and then just
    surprise you with them.

    --------------------------------------------------------
    "Writers even write the silences"

    - J. Michael Straczynski

  8. Quoted message said:

    Today I went to a medical provider and they gave me some
    forms to sign including one titled

    "Acknowledgement of Receipt of Notice of Privacy Practices
    Advanced Beneficiary Notice"

    The notice included the following (in addition to the
    acknowledgement):

    " Dear Patient,

    Medicare and/or your insurance will only pay for
    services that they determine to be "reasonable nd
    necessary". These are examinations and treatments
    performed for specific illnesses, symptoms,
    complaints or injuries. Routine physical
    examinations, some screening procedures, some
    laboratory studies and some medical imaging are
    not covered by Medicare and may not be covered by
    your insurance.

    I have read the above statement and agree to pay
    for the services rendered to me that are "not
    covered" by Medicare or my insurance company,
    while I am a patient with............

    ____________________
    Patient Name (Please print)

    _________________
    Patient Signature
    _____________
    Date "

    I signed the top portion of the form acknowledging that I
    had received the Privacy Notice but did not sign the
    portion shown above. When I returned the form to the
    receptionist she asked me to sign the bottom portion also
    and I told her I would not sign it. She did not insist but
    I just wonder how many people sign things at the doctor's
    office without carefully reading them.

    I wonder if it is ethical to add such a thing to another
    document which they want signed.

    Ora

    There seems to be no ethical problem with the request.
    For that matter, I don't think it is unethical to ask a
    patient to pay for treatment that an insurance company
    or Medicare declines to pay for. OTOH, I don't know if
    there are any LEGAL problems with putting what is
    obviously office policy on a form otherwise mandated by
    federal law.

    Steve

    --
    Mark & Steven Bornfeld DDS
    Brooklyn, NY
    718-258-5001
    dentaltwins.comdentaltwins.com

  9. On 2004-04-21 12:58:35 -0400, [email hidden] said:

    There's no ethical dilemma here; however, I agree that two
    forms would be clearer than one.

    In my office, we have a general "financial responsibility"
    form that says basically that you (the patient) are
    responsible for the portion of your bill that may not be
    covered by your insurance carrier. In my opioion, that's a
    no-brainer. If you don't want to sign that one, I'd say find
    another doctor.

    The second form is what we call a "waiver" (technically
    called an Advance Beneficiary Notice (ABN)), and it's
    required by Medicare (and generally a good idea regardless
    of the insurance carrier you're dealing with). It is signed
    at the time a service is provided that we have reason to
    believe may not be covered by insurance (e.g., a physical,
    certain screening laboratory tests, a cosmetic procedure,
    etc.). An estimate of the cost is included on the form.
    Again, this form is *required* by Medicare...in fact, they
    have a specific form that you're supposed to use, and you
    aren't supposed to create your own.

    Quoted message said:

    Today I went to a medical provider and they gave me some
    forms to sign including one titled "Acknowledgement of
    Receipt of Notice of Privacy Practices Advanced
    Beneficiary Notice"

    The notice included the following (in addition to the
    acknowledgement):

    " Dear Patient,

    Medicare and/or your insurance will only pay for
    services that they determine to be "reasonable nd
    necessary". These are examinations and treatments
    performed for specific illnesses, symptoms,
    complaints or injuries. Routine physical
    examinations, some screening procedures, some
    laboratory studies and some medical imaging are not
    covered by Medicare and may not be covered by your
    insurance.

    I have read the above statement and agree to pay for
    the services rendered to me that are "not covered"
    by Medicare or my insurance company, while I am a
    patient with............

    ____________________
    Patient Name (Please print)

    _________________
    Patient Signature
    _____________
    Date "

    I signed the top portion of the form acknowledging that I
    had received the Privacy Notice but did not sign the
    portion shown above. When I returned the form to the
    receptionist she asked me to sign the bottom portion also
    and I told her I would not sign it. She did not insist but
    I just wonder how many people sign things at the doctor's
    office without carefully reading them.

    I wonder if it is ethical to add such a thing to another
    document which they want signed.

    Ora

  10. Mark & Steven Bornfeld DDS said:
    Quoted message said:

    Today I went to a medical provider and they gave me some
    forms to sign including one titled

    "Acknowledgement of Receipt of Notice of Privacy Practices
    Advanced Beneficiary Notice"

    The notice included the following (in addition to the
    acknowledgement):

    " Dear Patient,

    Medicare and/or your insurance will only pay for
    services that they determine to be "reasonable nd
    necessary". These are examinations and treatments
    performed for specific illnesses, symptoms,
    complaints or injuries. Routine physical
    examinations, some screening procedures, some
    laboratory studies and some medical imaging are
    not covered by Medicare and may not be covered by
    your insurance.

    I have read the above statement and agree to pay
    for the services rendered to me that are "not
    covered" by Medicare or my insurance company,
    while I am a patient with............

    ____________________
    Patient Name (Please print)

    _________________
    Patient Signature
    _____________
    Date "

    I signed the top portion of the form acknowledging that I
    had received the Privacy Notice but did not sign the
    portion shown above. When I returned the form to the
    receptionist she asked me to sign the bottom portion also
    and I told her I would not sign it. She did not insist
    but I just wonder how many people sign things at the
    doctor's office without carefully reading them.

    I wonder if it is ethical to add such a thing to another
    document which they want signed.

    Ora

    There seems to be no ethical problem with the request.
    For that matter, I don't think it is unethical to ask a
    patient to pay for treatment that an insurance company
    or Medicare declines to pay for. OTOH, I don't know if
    there are any LEGAL problems with putting what is
    obviously office policy on a form otherwise mandated by
    federal law.

    Steve

    That is what motivated me to ask my question. It seemed that
    there should be two forms, not one.

    Ora

  11. On 2004-04-21 18:52:55 -0400, anon <[email hidden]> said:

    Oh, and regarding the Medicare ABN...if a patient refuses to
    sign it, we can decline to provide the service.

    Quoted message said:

    On 2004-04-21 12:58:35 -0400, [email hidden] said:

    There's no ethical dilemma here; however, I agree that two
    forms would be clearer than one.

    In my office, we have a general "financial responsibility"
    form that says basically that you (the patient) are
    responsible for the portion of your bill that may not be
    covered by your insurance carrier. In my opioion, that's a
    no-brainer. If you don't want to sign that one, I'd say
    find another doctor.

    The second form is what we call a "waiver" (technically
    called an Advance Beneficiary Notice (ABN)), and it's
    required by Medicare (and generally a good idea regardless
    of the insurance carrier you're dealing with). It is
    signed at the time a service is provided that we have
    reason to believe may not be covered by insurance (e.g., a
    physical, certain screening laboratory tests, a cosmetic
    procedure, etc.). An estimate of the cost is included on
    the form. Again, this form is *required* by Medicare...in
    fact, they have a specific form that you're supposed to
    use, and you aren't supposed to create your own.

    Quoted message said:

    Today I went to a medical provider and they gave me some
    forms to sign including one titled "Acknowledgement of
    Receipt of Notice of Privacy Practices Advanced
    Beneficiary Notice"

    The notice included the following (in addition to the
    acknowledgement):

    " Dear Patient,

    Medicare and/or your insurance will only pay for
    services that they determine to be "reasonable nd
    necessary". These are examinations and treatments
    performed for specific illnesses, symptoms,
    complaints or injuries. Routine physical
    examinations, some screening procedures, some
    laboratory studies and some medical imaging are not
    covered by Medicare and may not be covered by your
    insurance.

    I have read the above statement and agree to pay for
    the services rendered to me that are "not covered"
    by Medicare or my insurance company, while I am a
    patient with............

    ____________________
    Patient Name (Please print)

    _________________
    Patient Signature
    _____________
    Date "

    I signed the top portion of the form acknowledging that I
    had received the Privacy Notice but did not sign the
    portion shown above. When I returned the form to the
    receptionist she asked me to sign the bottom portion also
    and I told her I would not sign it. She did not insist
    but I just wonder how many people sign things at the
    doctor's office without carefully reading them.

    I wonder if it is ethical to add such a thing to another
    document which they want signed.

    Ora

  12. <[email hidden]> wrote in message
    "]news:[email hidden]...

    Quoted message said:
    Quoted message said:

    There seems to be no ethical problem with the
    request. For that


    matter, I don't

    Quoted message said:
    Quoted message said:

    think it is unethical to ask a patient to pay for
    treatment that an


    insurance

    Quoted message said:
    Quoted message said:

    company or Medicare declines to pay for. OTOH, I don't
    know if there are any LEGAL problems with putting what


    is

    Quoted message said:
    Quoted message said:

    obviously office policy on a form otherwise mandated by
    federal law.

    Steve

    That is what motivated me to ask my question. It seemed
    that there should


    be

    Quoted message said:

    two forms, not one.

    I see your point. However, they may well have assumed that
    if you didn't agree to the second point, the first point
    would be moot since you wouldn't receive services anyway.
    Acknowledge/agree to both points or hit the road. Something
    like that.

    You obviously surprised the particular clerk and she didn't
    know what to do. Naturally, you are still obligated to pay
    your bill.

    HMc

  13. Quoted message said:


    That is what motivated me to ask my question. It seemed
    that there should be two forms, not one.

    Ora

    Point taken. If the patient sees the second question on
    the same page on a form required by federal law, it
    could be construed to have an element of coersion.

    Steve

    --
    Mark & Steven Bornfeld DDS
    Brooklyn, NY
    718-258-5001
    dentaltwins.comdentaltwins.com

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