Originally created 09/17/97

Warns some doctors refuse `assignments'

I tried to see a new physician the other day. The physician's office secretary said "we don't accept assignments."

When I was in the Air Force, during the Korean War, I couldn't tell them "I don't accept assignments." When I was in the Army, during the Vietnam War, I couldn't tell them "I don't accept assignments."

Now that I'm retired from the military, I'm covered by a health insurance program called CHAMPUS (Civilian Health and Medical Program of the Uniformed Services). At the office of the last physician I tried to see, I was told they would not file a claim with CHAMPUS.

"Assignments." It must be an ugly word, right? It just means that the patient authorizes the insurance company to pay the physician directly. Is that bad? Sure, if the physician wants to overcharge the patient.

If the normal charge for a procedure is $100, CHAMPUS says a physician can charge up to $115. Some physicians are not satisfied with $115. They want to charge $150. If they file with CHAMPUS, it will pay them $75 ($80, if the patient is a dependent of an active duty person). The patient is responsible for the balance. CHAMPUS will tell the patient that the going rate is $100 and that they are responsible for paying only 115 percent of the going rate.

By not accepting "assignments," the physician gets $150 for a $100 procedure. CHAMPUS pays $75 and the patient pays $75. If they accepted "assignment," the patient would only have to pay $40.

What's the solution? Find another physician. When you are told "we don't accept assignment," walk to the nearest exit. There are good physicians in the area that do except "assignments" and do file claims with CHAMPUS.

Clyde Hooks, Belvedere


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