Specialists charging discovery DOUBLE??

[marzbars]

Boils down to this, in hospital treatment does not come off from your MSP and there is no affect to you as a member of the medical aid if he charges what they are willing to pay him.

If he had charged you 300% and you were only on a 100% plan, sure you would have been in a disposition but this does not affect you.
You might find that he charges the 100% covered patients at 100% which in my eyes makes him more ethical than the doc who charges everyone at 217% regardless of their medical aid affiliation.

If you were in the same boat would you not maximise your income?

 

[Blu82]

Boils down to this, in hospital treatment does not come off from your MSP and there is no affect to you as a member of the medical aid if he charges what they are willing to pay him.

If he had charged you 300% and you were only on a 100% plan, sure you would have been in a disposition but this does not affect you.
You might find that he charges the 100% covered patients at 100% which in my eyes makes him more ethical than the doc who charges everyone at 217% regardless of their medical aid affiliation.

If you were in the same boat would you not maximise your income?

By even recommending to patients to switch to medical aids that pay for more expensive procedures even though the chances of success are not higher than the norm procedure?

 

[SilverNodashi]

Wow, what a good doctor.

One who doesn't love money :crylaugh:

 

[SilverNodashi]

Boils down to this, in hospital treatment does not come off from your MSP and there is no affect to you as a member of the medical aid if he charges what they are willing to pay him.

If he had charged you 300% and you were only on a 100% plan, sure you would have been in a disposition but this does not affect you.
You might find that he charges the 100% covered patients at 100% which in my eyes makes him more ethical than the doc who charges everyone at 217% regardless of their medical aid affiliation.

If you were in the same boat would you not maximise your income?

Quite interestingly, if you tell the hospital you gonna pay cash (and you can afford it) it's much much cheaper than what the medical aid pays. And it's generally not as you say above.

 

[reactor_sa]

Quite interestingly, if you tell the hospital you gonna pay cash (and you can afford it) it's much much cheaper than what the medical aid pays. And it's generally not as you say above.

You'd be lucky if a private hospital admits you without medical aid approval or a nice cash down payment upfront.

 

[SilverNodashi]

You'd be lucky if a private hospital admits you without medical aid approval or a nice cash down payment upfront.

For certain operations you have the option. But need the cash.

 

[EricsON]

Report them to Discovery. They will get kicked off the list of covered specialists if it is not in line the rest of the market.

And you think Discovery isn't in on this too?

 

[SaiyanZ]

And you think Discovery isn't in on this too?

How would this affect Discovery? Please enlighten. Don't hold anything back.

 

[EricsON]

How would this affect Discovery? Please enlighten. Don't hold anything back.

Medical Aids don't have the members' interests at heart. They are a business and they are established to make money. If the "cost" of medical care can be increased then the premiums of the entire pool of members can be increased to cover the expenses. Additionally the members feel more at risk and take out extra cover, increase their plans, etc. No wonder Discovery sells GAP cover as well.

 

[Sinbad]

Medical Aids don't have the members' interests at heart. They are a business and they are established to make money. If the "cost" of medical care can be increased then the premiums of the entire pool of members can be increased to cover the expenses. Additionally the members feel more at risk and take out extra cover, increase their plans, etc. No wonder Discovery sells GAP cover as well.

Medical aids are non-profit organisations.

 

[EricsON]

Medical aids are non-profit organisations.

Good point! But don't try tell me the Discovery group doesn't benefit from their GAP cover policies, etc.

 

[Kosmik]

You'd be lucky if a private hospital admits you without medical aid approval or a nice cash down payment upfront.

Hmmm wonder how this applies to elective surgeries......

 

[Sinbad]

Hmmm wonder how this applies to elective surgeries......

My neck surgery could have been considered elective, I guess? It wasn't life threatening, it was a planned admission.

Medical aid approval obtained in advance. Pretty sure that without an approval, they would not have booked me in, or would have wanted a LARGE deposit.

 

[hj007]

Quite interestingly, if you tell the hospital you gonna pay cash (and you can afford it) it's much much cheaper than what the medical aid pays. And it's generally not as you say above.

there's no incentive to do so, because you'd be the only one paying cash and be taking the risk that you don't get refunded the lower amount. Because everyone else is still just handing the higher payments off to the medical aid, your premiums will still go up. Tragedy of the Commons..

 

[Ockie]

Medical aids are non-profit organisations.

Really? But that is Discovery's main business not so? If not for profit, how the hell did they just build that massive new HQ?????

 

[Sinbad]

Really? But that is Discovery's main business not so? If not for profit, how the hell did they just build that massive new HQ?????

The medical scheme is not for profit. Retained earnings are invested on behalf of the membership, to cover claims etc.
They pay admin fees which I would guess go to the holding company, which together with the other companies in the brand, pays for the HQ... (think Vitality, Invest, Insure, Life, credit card, etc)

 

[Ockie]

The medical scheme is not for profit. Retained earnings are invested on behalf of the membership, to cover claims etc.
They pay admin fees which I would guess go to the holding company, which together with the other companies in the brand, pays for the HQ... (think Vitality, Invest, Insure, Life, credit card, etc)

Oh ok. So profit is made, but not directly from the scheme. Correct?

 

[Kosmik]

Oh ok. So profit is made, but not directly from the scheme. Correct?

And lets not mention interest on all that money.

 

[Sinbad]

And lets not mention interest on all that money.

Goes into the scheme. It's how they finance the risk portion of your cover.

 

[SaiyanZ]

Really? But that is Discovery's main business not so? If not for profit, how the hell did they just build that massive new HQ?????

The new building is not owned by Discovery. Even all buildings they're in now are leased. They are going to be renting in the new building for 10+ years or so. The main purpose of the new building is to have all the different divisions under one roof instead of spread out all over Sandton. Rent might be similar or even cheaper keeping everything consolidated in one place when you consider things like IT support.