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IF I had been given the cost, "If I had known( If the hospital posted charges), I most definitely would have driven the extra 10 miles."
Given that I still would not have known the Medicare allowance, sadly, probably would not have made me anymore informed.
If someone is going to be self pay, then it would help.
If you are self pay, you haggle. If you are self pay you call and get numbers first. If you are self pay you tell your hospital that you agree to pay X dollars because another facility charges much less. And then see what they say. Talk to the right people and you probably can get a discount. Even with Medicare you can bargain. If you were in my town, I'd send you to Billy in the billing dept. She gets my patients discounts all the time.
The ER balance billing scam is everywhere. The same with anesthesiologists.
No such thing as “ everywhere” in the US.
50 states. 50 different laws/ regulations. 5,500 hospitals in the US.
Hundreds of state and national healthcare systems that own/ operate multiple hospitals in and across states. What XYZ Healthcare System does in one state is not necessarily what they do in all states. What one hospital does in a given healthcare system is not necessarily what’s going on in all hospitals under the same management.
Same deal with insurance plans. Some states or regions within a state allow plans to have very narrow networks and presumably do so to make premiums more affordable.
Some states require providers to disclose in network plans upfront. And some do not.
Some healthcare consumers don’t grasp the diff between in and out of network providers.
ER docs are a racket here. In network hospitals are all staffed by ER docs that belong to NO networks. My wife got into the hospital at 1045P (Shift change is at 11P). We got a bill for $1300 from a doc we never saw but claims he looked at a chart. No place to dispute. NJ is a well oiled machine for them. Automatic garnishment at about 6 months. We also got a bill from the 11P doc for similar money but we did see him.
The doc oversees the mid levels who saw you. If they really didn't see you and you want to buck the system, complain to your state medical board. It will probably takes months, but you just might see some money returned.
Despite the ACA, each state retained primary regulatory and authority over hospitals and laws. No two states have the same regulations. So often what a consumer or politician declares bad Obamacare, is really a state issue. There are many reasons why the premiums for the same healthcare plan is highly variable , state to state and within state. State regulation is one of them.
For example, one state mandates insurers cover ABC medication, while an adjoining state does not.
Another of the endless state differences is insurer reimbursement for ER services provided by out of network providers. After years of negotiation, NJ made some progress on that front, in 2018 :
The ER balance billing scam is everywhere. The same with anesthesiologists.
The whole thing is BS. The docs should bill thru the hospital and be part of whatever networks the hospital is in. There should be a single line item on any ER bill, "ER doctor" for how many docs you use when in the ER, there should be 1 charge, not 2 or 3.
Oddly, I worked with a woman who had 2 doctor children. One was an ER doc actually employed by the hospital. (What an uber mom, 3 kids, 2 doctors and 1 engineer. Yes she was from India)
Naturally some on the left are having a fit about this, and trying to claim that it won't do any good, blah blah.
Back in the day, before I knew that hospitals charged ridiculous amounts, I had to go in for something. At the end, I was offered 2 Tylenol for the pain before I left.
Had I KNOWN that I was going to be charged 20 flipping dollars for that Tylenol, (ie: if there had been a price list there for me to see), I would never have accepted.
By making the price list available, upfront, for all to see, people won't get scammed for useless crap like that, or even worse.
Accept that it's a good thing and stop trashing on it just cause you hate Trump. We know, move on.
Naturally some on the left are having a fit about this, and trying to claim that it won't do any good, blah blah.
Back in the day, before I knew that hospitals charged ridiculous amounts, I had to go in for something. At the end, I was offered 2 Tylenol for the pain before I left.
Had I KNOWN that I was going to be charged 20 flipping dollars for that Tylenol, (ie: if there had been a price list there for me to see), I would never have accepted.
By making the price list available, upfront, for all to see, people won't get scammed for useless crap like that, or even worse.
Accept that it's a good thing and stop trashing on it just cause you hate Trump. We know, move on.
It is not about Trump other than the misleading thread title. The requirement for hospitals to publish prices is part of the Obamacare law.
If you are self pay, you haggle. If you are self pay you call and get numbers first. If you are self pay you tell your hospital that you agree to pay X dollars because another facility charges much less. And then see what they say. Talk to the right people and you probably can get a discount. Even with Medicare you can bargain. If you were in my town, I'd send you to Billy in the billing dept. She gets my patients discounts all the time.
This is true. Hospitals will often negotiate with self pay patients. Many factors, including the patient’s credit score and assets and employment status, matters. Self pay typically pay more than an in network insurer or Medicare will reimburse. The premium paid by self payers is offset by the very real risk to the hospital that the patient will not satisfy their end of the bargain- default.
Depending on the amount, it may or may not make sense for the hospital to aggressively pursue which may include liens on assets and/ or wage garnishment and/ or selling the bad debt for pennies on the $ to a collection agency.
A percentage of the uncompensated healthcare becomes a part of the provider’s overhead that gets baked into the price of services.
When too may patients default ( uncompensated care) or there is a disproportionate share of patients insured by Medicare, it i becomes a sjippery slope into financial distress.
The number of hospitals that close due to financial distress increases every year. This is especially apparent in rural areas in Southern states. Texas leads the way for hospital closures.
Naturally some on the left are having a fit about this, and trying to claim that it won't do any good, blah blah.
Back in the day, before I knew that hospitals charged ridiculous amounts, I had to go in for something. At the end, I was offered 2 Tylenol for the pain before I left.
Had I KNOWN that I was going to be charged 20 flipping dollars for that Tylenol, (ie: if there had been a price list there for me to see), I would never have accepted.
By making the price list available, upfront, for all to see, people won't get scammed for useless crap like that, or even worse.
Accept that it's a good thing and stop trashing on it just cause you hate Trump. We know, move on.
The disclosure law which is already in effect in the super majority of states will not show a price for Tylenol.
My husband has had numerous outpatient surgeries and admissions over the past few years. Never have I seen a line item for a Tylenol on a bill. The hospital’s contract with BCBS does not allow for it.
I appreciate mileage varies, state to state, hospital to hospital, insurance plan to insurance plan.
I also understand a hospital’s Chargemaster represents the unit cost of everything, including overhead.
The $10 per Tylenol includes a percentage of the cost of the physical plant, employee compensation/ benefits, general and medical insurance, utilities, housekeeping/ janitorial, kitchens, TVs, WIFI, bad dent write- offs, and thousands of other components of routine overhead.
There is a diff between defending a charge and understanding it.
The whole thing is BS. The docs should bill thru the hospital and be part of whatever networks the hospital is in. There should be a single line item on any ER bill, "ER doctor" for how many docs you use when in the ER, there should be 1 charge, not 2 or 3.
Oddly, I worked with a woman who had 2 doctor children. One was an ER doc actually employed by the hospital. (What an uber mom, 3 kids, 2 doctors and 1 engineer. Yes she was from India)
The nature of the ER and anesthesia beasts IME, is that the hospital hires an outside source to provide the staffing. And when the hospital admin and ER/anesth beasts meet, there will be hell to follow. And this happens on a perpetual hire/fire basis. So it is common to have these transient docs not in the network.
If it were me, and it has been, I would pizz and moan and not comply. I don't mind being taken to collection.
AZ recently passed some legislation providing for this sort of patient relief.
Naturally some on the left are having a fit about this, and trying to claim that it won't do any good, blah blah.
Back in the day, before I knew that hospitals charged ridiculous amounts, I had to go in for something. At the end, I was offered 2 Tylenol for the pain before I left.
Had I KNOWN that I was going to be charged 20 flipping dollars for that Tylenol, (ie: if there had been a price list there for me to see), I would never have accepted.
By making the price list available, upfront, for all to see, people won't get scammed for useless crap like that, or even worse.
Accept that it's a good thing and stop trashing on it just cause you hate Trump. We know, move on.
Why would you need a price list, if you could just ask the nurse giving you the tylenol about its cost?
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