Part I

As you can see, I don’t run a typical doctor’s office. More or less, it’s synonymous to those planned parenthood clinics where they pass out free birth control pills, condoms, and morning after pills.

I would’ve preferred running a fee-for-service business, but what can you do? For years the practice reaped very little from the miniscule amounts it sowed. Prior to Rich enrolling in those family health plus plans, he barely saw 10 people a day.

The insurance companies do not reimburse for the amounts billed; instead, they compensate the provider with a lump sum (known as capitation payments) based on the number of members registered under his/her panel. According to the contracted agreement, providers are paid a whopping $13 - $22.50 for each individual member. So, building up and maintaining these rosters are critical to financial security.

It sounds pretty hunky dory, but there’s a catch. Certain folks haunt the office as though there are frequent flyer miles to be earned. Since we are reimbursed by head count, there is no credit for follow-up visits. On a day-to-day basis, I’ll see a mix of those who come in a few times in a week, versus those who never even stepped foot into our door. Although we benefit from these cap payments, but I’m still wondering if it’s all worth it.

Remember the whole bit about collecting $5 co-payments? Well, there other doctors competing in Chinatown for headcount and have done away with these “trivial” payments. This obviously makes those abominably insane crackpots very happy to save those precious five dollars while waiting for hours.

Wait, isn’t time money?

This, of course, has a major impact on how Chinatown operates as a whole. First off, patients are under the premise that they’re not obligated to pay or they’re Medicaid recipients. Second, when they leave their doctor’s office to pick up their prescriptions, they initiate loud pissing matches with cashiers and pharmacists because they’ve just discovered their drugs cost moolah – a whopping 3 bucks for generic drugs and $6 brand-name drugs.

Gosh is life harsh.

Thirdly, they continue rioting at the specialist’s office because they can’t understand why filthy rich doctors want their measly $5.

It’s helluva domino effect.

Why my office needs to collect co-payments? I’m not gonna lie…money is damn good. Why shouldn’t I ask for it? Heck, it’s great to receive some chump change at the end of the day. But there’s one supremo reason why it must be paid…and it’s got nothing to do with earning revenue or any sort of remuneration.

Believe it or not, collection of such funds ENFORCES the PRINCIPLES of practicing medicine. Yessiree, it does.

Due to the high number of individuals exploiting these benefits, paying for each visit keeps them in check. Remember, not all folks are especially keen about having to pay $5 for a specialist referral. Furthermore, Rich will not give into many of their whims because he truly believes in following protocol.

So they leave us. I’m not worried ‘cuz it’s less crap from these folks.

Because of the enormous size of their member panels, competitive doctors have a different methodology of operationally managing their medical practice. In order to meet the high demands (and the influx of people), doctors generally succumb to the patient’s whims just so they can get them out. No questions asked.

Meanwhile, we’re here arguing with them about medical necessity. They could give less shit and they’ll try to negotiate as to why they don’t have to pay me.

No wonder I act like a constipated bitch.

I think the stars and moon were somehow misaligned last week. Something happened where vile and foul patients decided to appear in my office and amuse themselves by shitting on my receptionists.

Last Tuesday, I walked my ass in late since I wanted to spend time with my mum and Miki. I found poor Tina trembling in anger and was close to tears because some bitch verbally launched a vicious attack against her. At first, the woman was irritated having been placed on the waiting list (no appointment, of course), and was nasty because the girls asked for her insurance card. The girls paid her no mind and had forgotten to put her name down on our register.

In the waiting area, patients generally eyeball one another to determine who would be next in line. The bitching cow gauged around the room and realized the girls had “deliberately” skipped her when Tina called in one of the self-paid patients. In a matter of seconds, she blurted out malicious words to demean the receptionists and declared how little girls like Tina needed to be put in her place. In an attempt to shut this cow up, Tinny shouted back as well as the other patients who were waiting..

Okay, I’m not saying that this despicable behavior is acceptable, but we generally expect such incidences from the Neanderthals every so often.

BUT…I had no idea who this fecking cow was. Seeing how distraught Tina was, I made a point to ask Rich who the psychocunt was. I wanted to confront this individual and exact vengeance because I will NOT tolerate such a contemptible act against us.

When he told me who it was, I literally hit the roof - HARD. I was extremely LIVID.

You know how angry I was? Red zones, man, red zones. This bitch rivaled with Colleen Esposito, for those of you who know me, this is a BAD, BAD thing.

I could not sleep that night.

It turns out…this fecking cow was a so-called family friend. She was my mother’s mahjong buddy, someone who babysat Mikayla for a few weeks when mum suffered from macular degeneration, a neighbor who asked me to resolve her telephone and cable bills, and somebody close enough to invite us to her son’s wedding years ago.

You have no idea how revolted I was to find out my neighbor vocally defecating on my favorite receptionists. No, not by those crude illegals - but by an individual who’s been in the US for over 2 decades soaked from head to toe in our Americanized customs. From the surface, she didn’t appear to fall in the Socialist ranks of those who leech off the government dry or manipulate the system for her benefit. Aren’t looks deceiving.

Hell, she’s WORST than those Cro-Magnons I’ve been pissed off about.

The next day, I marched right up to my office, yanked her chart out, and dialed her home number. Apparently I roused her from deep slumber (at 12PM?) and demanded to know why she waged a war in my office. As she tried to explain, I abruptly cut her off, declared that she could no longer be seen in our office, and had no right to mouth off as though she owned the place. Of course, I didn’t put it so eloquently. My Chinese oozed out of me in large blotchy pieces thanks to my anger.

Then I clicked the phone off.

Both Tinny and Tina were surprised by my behavior. Although I’ve always told them how to exact revenge against those who wronged us (not in any spiteful way - delays, feigning forgetfulness, purposely unable to verify insurance information, etc.), they never conceived the notion of me screaming the fuck out of someone.

15 minutes later, the cow rang back and demanded to know why I yelled at her. WHY? Are you kidding me? I yelled about how I didn’t appreciate her snide remarks, how she picked a fight with a little 20-year-old girl, and so forth. As she bit back in defense, I hollered, “I DON’T CARE WHAT SHE SAID TO YOU, IT’S WHAT YOU SAID TO HER!” and clicked again.

Mum taught me how to hang up in mid-sentence.

I swore throughout the entire day and scared the living daylights outta the girls.

To be continued…