Whenever you’re evaluating your own or somebody else’s symptoms, rely on the instincts of the doctor inside you and put yourself behind the doctor’s desk: ask yourself what information you would need to know if you were the doctor.
Along with your Body Signals, your doctor needs your past medical history to make the correct diagnosis and offer the right treatment. An illness you had five years ago is important if it pertains to the symptoms you’re experiencing now or if it has affected your health since you were sick; you and your doctor can disregard it if it’s unrelated to your present symptoms. For example, if you’ve come in to see the doctor about your malaise, it’s not important for him to know that you fractured your foot in summer camp 25 years ago; however, you should let him know about the diabetes you’ve had for most of your life.
HEALTH CARE TODAY: FEE FOR SERVICE
Fee for service: With a fee-for-service arrangement, a health care provider is paid based on the particular service he or she performs. This service can be either an office visit or an ancillary service like a lab test or an X ray. The fee for service is usually paid to the health care provider by the patient or the patient’s insurance company, which is usually paid at a discounted rate if the provider participates with the insurance company. If the insurance company pays for less than the doctor’s actual fee, in most cases the patient is required to pay for the difference out of pocket if the provider does not participate. This is known as conventional insurance or indemnity insurance. Today, insurance companies frequently ask to preapprove a certain medical procedure before they will pay for it. Because some medical procedures will automatically drive up the cost of an insurance premium, or because a patient may have a lifetime cap on benefits he or she receives, a patient may prefer to pay the fee for service without prior approval from the insurance carrier and without submitting the claim to the insurance carrier.
Many specialists are on a fee-for-service basis at a discounted rate, whereas a primary care physician might be on a capitated payment plan if he participates with an insurance company where the doctor’s fee is in essence set by the insurance company.
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