Quote:
Originally Posted by markf31
I know it was in jest.
Those examples aren’t really relevant to this argument. Here's a real life situation comparing more apples to apples as far as circumstances and level of service go. You have x-rays taken and sent to a specialist doctor. The specialist doctor examines the x-rays. The doctors says he'd like to see you in person for a more thorough and complete examination, to make some determinations he maybe can’t quite make just by looking at the x-ray. Guess what, he will be charging you for the x-ray evaluation, and additionally he will be charging you more for an in person office examination and visit. Do you expect the doctor to not charge you for the x-ray evaluation? Or do you expect him to discount the office visit because he already charged you for the x-ray evaluation? What if the doctor saw nothing wrong in the x-ray, but determines that you infact suffered a ligament strain or damage, something he determined with the office visit but was unable to determine in the x-ray? Do you expect him to offer you a partial refund because his first opinion was inaccurate?
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Mark,
I'm sorry this example doesn't happen in real life.
As a physician, I can clearly state that there is no situation where a doctor will look at an xray and offer an opinion, that he will get paid for, without seeing the patient first.
In your example, X-rays are "taken". Who ordered them? The ER, family doctor, or specialist. If the ER or Family Doc orders the x-ray, it is secondary to a visit where the patient has been examined first and has been determined to need the test. The family doc will charge you for the visit. In ER, the physician will charge you for their services and the hospital will also charge for use of the facility. The ER and Family docs will not charge to read the x-ray. Neither of them will charge you an "X-ray evaluation" fee. Now, in this example, a radiologist will charge you for the official interpretation of the x-ray. That doctor will not have seen you or offered any opinion as to the nature of your injury. He/She will only opine on what the picture shows.
Now, if the ER or family physicians still feel your injury is somehow unclear or requiring further care, they may send you to see a specialist. That specialist will examine you and review the x-rays previously taken. They will charge you for that evaluation, which includes reviewing all related data from tests done previously, but will not charge again to read the x-ray.
As your example doesn't fit, I do think Jim's two prior examples do exactly fit this situation. You are paying twice for the same service.
In my mind the auction LOAs are a money making scam. They increase the final auction prices realized by increasing bidder confidence, and then increase revenue for the TPA, by incentivising further payment for a "full" LOA.
IMHO,
Mark Vel@rde