Talked to my AME at length today

derg

derg

Apparently a "terse" writer
Staff member
She says there's a lot of the experienced Medical office people that she was able to work with the smoothen and hiccups in the certification process, but they're mostly been replaced by a bunch of young people without a true grasp of some of the realities of medicine in 2026.

Even I caught some things that shouldn't have been on my medical record that my soon-to-be former healthcare provider slapped on my record because now, everyone is reimbursed based on the number and severity of maladies you're being treated for. A couple I was never tested for but it showed up that I was diagnosed for them. Needless to say, i'm a little pissed because if it had gone to the FAA, it would make for a long certification process.

Check your records, stay frosty.


(And I just missed @MikeD by a couple hours)
 
I was gonna say, wait, did Dr Ross do something? Then I realized I have zero clue who you use for an AME.

And I'm afraid to log into UMR and see what they're claiming about me...
 
Karnage said:
I was gonna say, wait, did Dr Ross do something? Then I realized I have zero clue who you use for an AME.

And I'm afraid to log into UMR and see what they're claiming about me...
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I bounce back and forth!
 
derg said:
She says there's a lot of the experienced Medical office people that she was able to work with the smoothen and hiccups in the certification process, but they're mostly been replaced by a bunch of young people without a true grasp of some of the realities of medicine in 2026.

Even I caught some things that shouldn't have been on my medical record that my soon-to-be former healthcare provider slapped on my record because now, everyone is reimbursed based on the number and severity of maladies you're being treated for. A couple I was never tested for but it showed up that I was diagnosed for them. Needless to say, i'm a little pissed because if it had gone to the FAA, it would make for a long certification process.

Check your records, stay frosty.


(And I just missed @MikeD by a couple hours)
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Would’ve been awesome to have run into you!
 
The sheer incompetence I’ve encountered at my regular primary care office is staggering. Half the time I go to check in I might as well be talking to a brick wall. Doubly fun when there’s multiple lost blood samples or incorrect tests run.
 
JordanD said:
The sheer incompetence I’ve encountered at my regular primary care office is staggering. Half the time I go to check in I might as well be talking to a brick wall. Doubly fun when there’s multiple lost blood samples or incorrect tests run.
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It’s bad.

I had so many random diagnosis codes for sh— I’ve never been tested for on my chart that it appears that someone was trying to buy a boat.

They get paid per diagnosis code. Most people don’t care because it doesn’t cost them a dime and makes the doctor happy. But when you’re dealing with maintaining a medical clearance to perform a job, all that crap matters real quick.

I’m looking at concierge medicine/off insurance to disincentivize adding diagnosis codes to satisfy their business model.

I can’t tell you how pissed-off I am.
 
🦈💜 said:
How exactly does one do this?
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Explanation of Benefits will often list the codes your doctor is billing insurance for, some insurance will have it listed on your account profile. My doctor’s office has a patient portal that lists what I’m being treated for, and I compare that to what my insurance is billed for. It also helps that I get a full visit summary once a year for my SI that also includes all conditions my doc knows about and the treatment plans, if anything.
 
derg said:
I’m looking at concierge medicine/off insurance to disincentivize adding diagnosis codes to satisfy their business model.

I can’t tell you how pissed-off I am.
Click to expand...

I'm still trying to get a job. So, as much as I can relate and would like to share? Keeping my mouth shut on a public forum.

The system is thoroughly broken though.
 
Karnage said:
Explanation of Benefits will often list the codes your doctor is billing insurance for, some insurance will have it listed on your account profile.
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That's going to list what they paid for. So, what test was ordered, and whether it was paid or not. The codes to justify that? Maybe, maybe not.
 
True.
drunkenbeagle said:
That's going to list what they paid for. So, what test was ordered, and whether it was paid or not. The codes to justify that? Maybe, maybe not.
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True. It’s one of the reasons I’m glad that the FAA forces me to pull detailed notes from my doc that list all my diagnostic codes and I have detailed summaries of every thing my blood tests check for on my patient portal.

But I also make it explicitly clear to any doc I go to that random testing could mess with my ability to work so I need to know exactly what is being tested for or diagnosed.
 
Karnage said:
But I also make it explicitly clear to any doc I go to that random testing could mess with my ability to work so I need to know exactly what is being tested for or diagnosed.
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A very long day of my life. "Why do you want this test?" -- "The FAA said so." -- "But your insurance won't cover it." -- "Fine, I will." --- "BUT BUT BUT, no one ever asks for this, we have no idea how much to bill you?"

"$15 later."

5 hours of my life wasted.
 
derg said:
She says there's a lot of the experienced Medical office people that she was able to work with the smoothen and hiccups in the certification process, but they're mostly been replaced by a bunch of young people without a true grasp of some of the realities of medicine in 2026.

Even I caught some things that shouldn't have been on my medical record that my soon-to-be former healthcare provider slapped on my record because now, everyone is reimbursed based on the number and severity of maladies you're being treated for. A couple I was never tested for but it showed up that I was diagnosed for them. Needless to say, i'm a little pissed because if it had gone to the FAA, it would make for a long certification process.

Check your records, stay frosty.


(And I just missed @MikeD by a couple hours)
Click to expand...

“Insurance harvesting” is the new Olympic sport for the 2020s.

It is effing everywhere. At all levels, public and private.

Want to know where the money goes? It goes everywhere. The leakage is out of control.
 
Richman said:
“Insurance harvesting” is the new Olympic sport for the 2020s.

It is effing everywhere. At all levels, public and private.

Want to know where the money goes? It goes everywhere. The leakage is out of control.
Click to expand...

It is. I pretty much told the NP that loading all this crap onto my charts would surely jeopardize my medical status with the FAA and it was literally like telling a teenage girl that "No, you can't borrow the keys to the Porsche".

First problem: Me not being more proactive and knowing that I should be asking certain questions
Second problem: Dealing with a NP. You're not a doctor-doctor? Have a great day, no seriously, I'm gone
Third problem: The entitlement this business, dare I say medical office had with doing that. And they're so smug about it.
 
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derg said:
It is. I pretty much told the NP that loading all this crap onto my charts would surely jeopardize my medical status with the FAA and it was literally like telling a teenage girl that "No, you can't borrow the keys to the Porsche".

First problem: Me not being more proactive and knowing that I should be asking certain questions
Second problem: Dealing with a NP. You're not a doctor-doctor? Have a great day, no seriously, I'm gone
Third problem: The entitlement this business, dare I say medical office had with doing that. And they're so smug about it.
Click to expand...

Thankfully, my most recent experience was positive. “Get your blood sugar down and come back in a month.” He then balled up my exam sheet and tossed it in the trash. Move along, nothing to be seen here.
 
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derg said:
She says there's a lot of the experienced Medical office people that she was able to work with the smoothen and hiccups in the certification process, but they're mostly been replaced by a bunch of young people without a true grasp of some of the realities of medicine in 2026.

Even I caught some things that shouldn't have been on my medical record that my soon-to-be former healthcare provider slapped on my record because now, everyone is reimbursed based on the number and severity of maladies you're being treated for. A couple I was never tested for but it showed up that I was diagnosed for them. Needless to say, i'm a little pissed because if it had gone to the FAA, it would make for a long certification process.

Check your records, stay frosty.


(And I just missed @MikeD by a couple hours)
Click to expand...
It's pretty scary what some "providers" put in the records now. Litigation is to blame (at least that's my hypothesis as well as the aforementioned "code bloat" offices do for billing) but in the world of a flyer, it can be pretty egregious.

I went to a dermatologist last month for a routine skin check and the while the PA told me "it's all good, nothing to note!", the aftercare notes were replete with 3/4 of all maladies one might have in their 50's...and let me tell you youngins who spent a lot of time in the sun...it can be A LOT.

And the number of "chronic conditions" and "current medications" that pop up on MyChart? To the unsuspecting out-of-network provider, they will wonder how I am still alive even though I am actually in pretty decent shape for being 50-something. So yes, if you rely on a FAA medical...PAY ATTENTION to that shiznat.
 
mightynimbus said:
How did they know your blood sugar was elevated?
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Urine test. He knew I’ve been borderline and didn’t want to see a glucose test. I’ll do a glucose test when I return. I think the urine test is a screening tool and can’t actually be used. He might have wanted a fasting test.

Years ago, when my near-vision acuity was declining with middle age, he did the same thing, telling me to return with a fresh RX.

I think there is a window between exam start date and submission deadline. Maybe he’s using that window to my advantage.

My doc wants me to be healthy and wants me to meet FAA standards. He’s a doctor first, FAA cop second.
 
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