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A new rule going into effect January 1, 2019, will require hospitals to post a list of their standard prices online and make electronic medical records more readily available to patients.
Our family medical records have easily been accessed online for a couple of years. It's a great tool. We use one particular hospital for tests and surgeries whenever possible, so "shopping around" isn't for us, but it may be very important for others who have no medical insurance.
Hospitals are already required to disclose prices publicly, but this change will put that information online in a machine-readable format that can be easily processed by computers.
It may still prove to be confusing to consumers since standard rates are like list prices and don’t reflect what insurers and government programs pay.
Patients concerned about their potential out-of-pocket costs from a hospitalization would still be advised to consult with their insurance company.
How about the sneaky business of insurance not covering you if you are there for "observation" as opposed to "admitted"?
....
Actually what's bolded is the Hospitals or the group they belong to. Insurance companies call it the "23 hour rule". If a hospital is honest per se and have a staging area for the "23 hour rule" then a insurance company pays bills quickly as they come in. Bon Secours is known to be honest. On the other hand there is HCA who is known to be dishonest for numerous reasons, gets their billing rejected often which sometimes takes years to resolve.
Here's how it went for me in 2018. My husband and I pay $1000 a month for medical coverage, with a $5000 EACH deductible (went up to $6500 each for 2019). I needed an MRI. Here's the crazy thing - if I hadn't had insurance, I would have paid about $1000 for the MRI. But that $1000 wouldn't have gone toward my deductible. I was pretty sure I was going to need surgery, which would certainly max out my deductible. Anyway, so the hospital does the MRI, and charges my insurance company (aka me, because I had that huge deductible to pay) $3000. OK, me - patient off the street paying out of pocket - $1000. Insurance company - $3000. Which in actuality I pay anyway.
But screw it, because the bottom line is that I was going to pay $5000 NO MATTER WHAT. I don't care how they label it, it's still $5000 out of my own pocket, not including the other $12,000 we paid in premiums, and my husband's $5000 deductible.
It just seems like a big shell game to me.
A few years ago I had to have surgery on my Achilles tendon. I have no idea what it cost insurance, but it cost me my deductible and then 20 percent of the remaining costs, so it ended up being about $8000 out of pocket for me for this outpatient surgery with no complications. A few months later, my uninsured yard guy injured his Achilles tendon. He had THE SAME outpatient surgery that I had, and he paid out of pocket for it. $3500.
Hospitals are already required to disclose prices publicly, but this change will put that information online in a machine-readable format that can be easily processed by computers.
It may still prove to be confusing to consumers since standard rates are like list prices and don’t reflect what insurers and government programs pay.
Patients concerned about their potential out-of-pocket costs from a hospitalization would still be advised to consult with their insurance company.
Sounds pretty meaningless to me.
I on't know about """meaningless"--but could be data overload for many people--
It makes me concerned it could lead to price-shopping for services and results that are less than average...
Doctors usually require priviledges to function at specific hospitals/systems
What do people do if the hospital their doctor uses is 15K more expensive for a procedure?
Get another doctor???
Will hospitals also post their rate of negative incidents--or lawsuits?
patients that develop post-op issues because of contamination from poor sanitary proceedures,
patients who have to be re-admitted because of complications after being sent home too soon...
Will they post their nurse to aide to patient ratios for different departments?
This is one of those abstract decisions that government thinks should be more helpful--
Like calorie count in fast food--that some people might pay attention to but that others likely don't
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