Doctor's fees unbelievable

[unvme]

Originally Posted by wasel

I hear people say this sort of thing all the time. But look at it another way: The doctor is getting paid for his knowledge and expertise. While this might seem like a high fee when you are "well," it's not a high fee when, based on his training and experience, he is able to detect when something is wrong and can get you the correct treatment.

I mean, I spend $200 plus tip on a haircut and color. If my stylist can command those rates, shouldn't the physician who oversees my health command more than that?

But my question is... Why is the rate changing when I have insurance for the same service ? He charged $80.00 when I had no insurance and (he looked at my blood work and checked what my blood pressure was)

I have insurance $330.00 ( looked at blood work, checked blood pressure

[suzy_q2010]

Originally Posted by unvme

But my question is... Why is the rate changing when I have insurance for the same service ? He charged $80.00 when I had no insurance and (he looked at my blood work and checked what my blood pressure was)

I have insurance $330.00 ( looked at blood work, checked blood pressure

He gave you a discount when you had no insurance. He probably lost money on your visit.

[Travelassie]

Originally Posted by unvme

But my question is... Why is the rate changing when I have insurance for the same service ? He charged $80.00 when I had no insurance and (he looked at my blood work and checked what my blood pressure was)

I have insurance $330.00 ( looked at blood work, checked blood pressure

Have you considered that $80 you were charged when you didn't have insurance was a self-pay discount offered to you by the physician? That his rates for an office visit are normally higher?

While the $330 the physician's office billed your insurance company for that visit seems excessive, they know they will not be reimbursed anywhere near that amount. If you have an explanation of benefits (EOB) form from the insurance company for that visit you can see what they actually paid, as well as any copays you may owe. I'd bet the total for this would be somewhere around half of what was billed.

If the insurance company had been billed for $80 for that visit, the doctor would have received no more than that (or perhaps less), even if the charges allowed by the insurance company were more than that.

[toofache32]

Also, insurance increases the cost to provide care. Many people think the doctor just sends a bill to the insurance company and they pay it. The doctor has to hire staff to fill out all the paperwork for each and every claim. Then about 1 out of 5 claims are denied right off the bat for no given reason. So now the doctor has to pay someone to sit on the phone and argue about it and fill out more paperwork to appeal. Then they get paid to track the appeals, etc, etc.

Insurance increases the costs of getting paid.

[noodlecat]

In my experience, cash discount rates have always been cheaper than so-called "insurance negotiated" rates. Think about it: the doctor has a baseline of salary and overhead that he must cover, so therefore that becomes the base rate or cash discount rate. Once an insurance company enters the picture, now the doctor must increase overhead to deal with that, plus the ins. co. must cover their salaries and overhead as well. So the out-of-pocket price you pay will always be more in an insurance model, because you are paying the ins. co. premiums, deductibles, co-pays, co-insurance, etc etc, as well.

Luckily, there are more and more doctors who have stopped playing the insurance game. My previous doctor went fee-for-service only. He lowered his rates because he no longer needed office staff to deal with all the insurance nonsense. He said he was so much happier because now he could spend more time with each patient, which is what he truly loved to do, and with more freedom to treat them as well. An office visit with him costs $75.

See if you can find an independent doctor (one who doesn't take insurance) in your area. If not, most if not all health service providers (doctors, dentists, hospitals) will give a cash discount rate.

[GearHeadDave]

Originally Posted by TimAZ

Have you ever seen pigs feeding at a trough? Billing practices in our health care system makes that seem dainty and polite. Even ignoring the fraud and corruption, most bills are inflated 3X to 10X the cost of services. Why? Because nobody goes to jail for doing it.

Why? The reason why is that we decided as voters to elect representatives are are in the pockets of the health care industry and are perfectly willing to sell you out by ripping away every last bit of regulatory protection. We only have ourselves to blame.