Social Security has decided to post a Freedom of Information Act response they've given showing the rates at which the Alabama Disability Determination Section (DDS) paid for medical examinations and some other things they ordered. This is from 2020 so it's a bit out of date but take a look. I'm only posting the first page here. The whole thing which runs to 20 pages is linked above. The last page may surprise you a bit.
Don't these rates seem a little low -- or maybe a lot low?
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I paid $65 for my most recent eye exam so I don't think its out of line. Doctors don't get paid as much as we think they do for basis services. My concern with CE providers is that they often don't do the thorough exams they are being paid to conduct.
ReplyDeleteHeadline says it all
ReplyDeleteWe've seen a lot of exams done by recently licensed residents. On one the doctor had his license less than a month. A couple of others less than 2 months. They are often dermatology residents for some reason. Reps need to be researching these doctors and putting this information in the record. DDS doesn't care about the doctor's qualifications as long as they have an M.D. For a long time DDS here had a reviewing doctor whose license had been revoked twice and could only work for SSA under a consent order that allowed her to only work for SSA.
ReplyDeleteI'm not sure the rates are that low compared to Medicare, Medicaid, and private insurance reimbursement rates. I was more surprised at the separate rate for some of the exams at the ALJ level. Can anyone explain that? Are they order different testing depending upon who is adjudicating the claim? Or is it only if it is an order for a succeeding test at the ALJ level after it was previously performed at initial or recon?
ReplyDeleteIs it possible that at the ALJ level, the ALJ's are also requesting the examining CE complete a mental or physical RFC form in addition to conducting the examination? Perhaps they are paid more to complete the form in addition to what they are paid for the exam?
DeleteAmerican: The government needs to pay for better quality services and labor to put an end to all this dysfunction!
ReplyDeleteSame American: I’ll not stand for giving the government one more red cent in tax money! Also, why is it spending so much money to begin with?! Outrageous!
Alabama has a lower cost of living (by FAR), I don't think those are too out-of-line with the Alabama economy. Though low, it's probably more (or even) to what medicare would pay.
ReplyDeleteThe data is from 2020. Curious if it has been adjusted in the last 4-years…
ReplyDeleteI have some concerns with these exams, so in some instances I will accompany my claimants if it's on a Saturday. Amazing how careful those exams are then. I can't complain too much since I'm in a state without Medicaid expansion, and we need medical evidence not paid for by my client.
ReplyDeleteFunny, given how shoddy the evaluations are, I am surprised they are paid this much. Most claimants call me after the evaluation to complain the doctor barely spent five minutes with them. The reports are checklist and generic and often contain contradicting information.
ReplyDeleteI see they "pscyhaitric exam" is 200 but the "psychiatric examination" is only $156. I was not aware of the price differential. Next time I schedul a physical for myself I'll be sure to specify that I want an "examination" rather than an "exam" so I can save 25%. Perhaps if we replace all medical abbreviations with the the complete word nationally, we can lower medical care by 25% nationally. If it works for SSA, why not for the nation?
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