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Old 07-19-2008, 02:15 PM
 
190 posts, read 781,140 times
Reputation: 75

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Quote:
Originally Posted by sterlinggirl View Post
I hate to burst your bubble, but the hospitals and doctors are as much to blame as the insurance companies. Each and every one of them is out to make a profit, and their standard operating practice is to put their needs ahead of the patient.
Sorry, Sgirl. This is not a blame inquiry, just a cold "how-to-save-$$$'s" one in a system we know is rotten to the core.

Quote:
Everybody wants a bonus, and you have to make good numbers to get one. In the case of the collections department, its more important to look like they're getting paid fast instead of getting the full amount.

Now....if you know that they're giving 40% off to insurance companies and you offer to make an immediate payment for 60% of the billed amount instead of making payments for three years, they'll take it. They want those numbers off their books so that their department looks like its working hard
Now if I could expect to successfully negotiate like that as an individual, then you're right. Why go through the hasssle of an LLC. But will the hospital treat me in subsequent visits if they know that each time I am going to argue the bill with them?
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Old 07-19-2008, 02:53 PM
 
523 posts, read 1,310,578 times
Reputation: 134
Quote:
Originally Posted by JoeyT View Post
Fact: Go to emergency as a private pay and the bill will be (hypothetical) $3000. Go as an insured and the ins. company will settle the bill w/ the hospital for $800. I know. I saw both figures for the same visit.
Now take a person who has a lot of savings but can't get reasonablly-priced health ins. because of, say a prior hangnail. He doesn't want to shell out $1500/mo. w/ high deductibles just to have a medical event and then have the ins. co. refuse to pay for treatment because he neglected to report on his ins. coverage application a headache he visited the Dr. for about 5 years ago.
So, instead, he forms his own health ins. LLC for himself and family members, if he has any. Then he has the legal right to have an ins. card printed up. Now, if and when he has to go to emegency he just whips out his "Super-Duper Consolidated Health Ins." card, gets the treatment, and then puts on his other hat when the bill for $3000 arrives and negotiates it down to $800 like Blue Cross and Blue Shield do. Could this scenario work?
Hospitals don't accept insurance cards based on how they look. They have a list of insurance providers that they accept based on contractual agreements that they have made with the insurance companies. If your so-called insurance company does not have an agreement in place with the hospital, then they will not accept your insurance and will bill you as a private party.
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Old 07-19-2008, 04:23 PM
 
3,460 posts, read 5,075,710 times
Reputation: 6677
Quote:
Originally Posted by JoeyT View Post
Now if I could expect to successfully negotiate like that as an individual, then you're right. Why go through the hasssle of an LLC. But will the hospital treat me in subsequent visits if they know that each time I am going to argue the bill with them?
They expect someone to argue the bill, and they're still making the same money off of you as if you had insurance.

Of course they'll treat you...
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Old 07-19-2008, 04:27 PM
 
190 posts, read 781,140 times
Reputation: 75
okay, thanks Sgirl and especially mojo for that helpful info. Now I know it wouldn't work. Thanks to all who responded.
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Old 07-19-2008, 06:42 PM
 
Location: State of Being
35,885 posts, read 68,747,356 times
Reputation: 22477
Quote:
Originally Posted by sterlinggirl View Post
I hate to burst your bubble, but the hospitals and doctors are as much to blame as the insurance companies. Each and every one of them is out to make a profit, and their standard operating practice is to put their needs ahead of the patient.

Everybody wants a bonus, and you have to make good numbers to get one. In the case of the collections department, its more important to look like they're getting paid fast instead of getting the full amount.

Now....if you know that they're giving 40% off to insurance companies and you offer to make an immediate payment for 60% of the billed amount instead of making payments for three years, they'll take it. They want those numbers off their books so that their department looks like its working hard.
You are 100% correct, Sterlinggirl. Most people have no clue that they can negotiate. I do it all the time. Even after the insurance has paid. I will tell them - if I pay this in full today (put it on credit card), will you discount it 25%? I am talking AFTER insurance has paid their part. Hospitals want to show less days in A/R so they will usually accept it. Some hospitals can't b/c their billing is not inflated, but most will. Have had to do it 2 x already this year - one w/ my bill for outpatient services, one w/ my son's visit to ED.

Also if you have not met your deductible, tell them you want a discount. Don't get jerked around by docs and hospitals.

Anyone who still believes that your doctor is there just b/c he loves humanity and wants to heal the sick is naive. Sorry. They may have started out w/ that in mind but I work w/ docs, and the first question they always ask a consultant is not "How can I better serve my patients?" but rather "What are the latest procedures/equipment that will maximize my reimbursement?"

And to the OP - NO, you cannot just decide to call yourself an insurance company. You have to be licensed by your state insurance commission. And that is not a simple matter, LOL. So sorry . . . your idea won't work and would, indeed, be fraud if all you did was form a company and print off a card, LOL!!!!! But I admire your ingenuity.
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Old 07-20-2008, 09:53 AM
 
190 posts, read 781,140 times
Reputation: 75
Quote:
Originally Posted by anifani821 View Post
But I admire your ingenuity.
Well, I'm nothing if not ingenius at cooking up half-baked schemes!
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Old 07-21-2008, 01:38 PM
 
55,257 posts, read 44,015,757 times
Reputation: 34537
Quote:
Originally Posted by JoeyT View Post
Yes, but that's the issue. Read the thousands of horror stories from the link below of people who paid their high premiums faithfully for 20 years--until they needed a liver transplant, or cancer treatment and then watched their ins. co duck out of sight w/ some feeble excuse about them not reading the fine print, or they withheld pertinent info like a headache or some other lame-ass excuse so the co. could say it is not responsible for their bills.

In the Heart of the Health Care Hustle (http://www.workingamerica.org/healthcarehustle/ - broken link)

I listened to testimony from workers about how health ins. co's don't utter a peep when you submit the app and as long as you pay your premium they are happy. The moment you submit a substantial claim they immediately put a dozen workers on the case to go over your whole health history looking for the slightest discrepency in your app that they can use as a reason to deny your claim. The truth is ugly and it hurts but that's the reality we live in. But I digress; we're off the topic.
Question: are there laws that prevent a person from forming his own private health care LLC? If there are no laws, and if a person could save thousands of dollars off medical bills by doing this, would it be feasible to do?
A lot of blather and a link to a hillariously biased site doesn't hold much water.

I paid my premiums, my wife got sick. After about 4 years or so she died and in that time we probably paid 20k or more in deductibles and uncovered items and the health insurer probably paid 200k or more.

People that have been paying premiums for twenty years don't get denied coverage due to their application unless something seriously messed up was going on (like they said they were 30 and were actually 60). What a load.
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Old 07-21-2008, 01:40 PM
 
Location: Lake Arlington Heights, IL
5,479 posts, read 10,678,877 times
Reputation: 2808
Quote:
Look into a high deductible plan. They're cheap and they do all the haggling to get the discounted rates. Then you've also got catastrophic coverage in case something major happens to you.

If you combine the high deductible plan with an HSA, you get some tax benefits too.
What if you have pre-exisitng conditions? My problem with buying my own insurance is thay jack the rates up for pre-exiisting. If I do ith through employer, they cannot deny and do not inquire about pre-exisitng. Heard part of a series on NPR about socialized medicine in other countries. Netherlands requires all citizrns to buy health insurance. The country negotiates rates and stipulate no one can pay more or be excluded due to pre-exisitng conditions. (Warning: The following is a rant.) Too bad we can't vote to take away Congress's nice health plan until they develop a system of universal coverage that works. We are the richest country in the world and if you lose your job and get ill, it can bankrupt you? Yes it's OK to have government involved in retirement (social security) yet it's taboo for them to socialize medical care? OK, I don't feel so "verklempt" now. Thanks.
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Old 07-21-2008, 03:34 PM
 
3,460 posts, read 5,075,710 times
Reputation: 6677
Quote:
Originally Posted by cubssoxfan View Post
Too bad we can't vote to take away Congress's nice health plan until they develop a system of universal coverage that works.
We can, but it would probably require a constitutional amendment. An amendment like that would be very popular if it was drafted to simply put them on par with Medicare benefits. I'd also like to see them get retirement benefits equal to the rest of us as well. If they were put on an equal playing field with the average person, I'm sure they could find some ways to make the system better.

The trick would be keeping out the various agendas that would complicate it, and make it less likely to pass.
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Old 07-22-2008, 05:06 AM
 
3,269 posts, read 9,080,872 times
Reputation: 2011
Quote:
Originally Posted by JoeyT View Post
So, instead, he forms his own health ins. LLC for himself and family members, if he has any. Then he has the legal right to have an ins. card printed up. Now, if and when he has to go to emegency he just whips out his "Super-Duper Consolidated Health Ins." card, gets the treatment, and then puts on his other hat when the bill for $3000 arrives and negotiates it down to $800 like Blue Cross and Blue Shield do. Could this scenario work?
Nice idea but probably won't work. Hospitals give preferential rates to insurance companies they have contracted with not every insurance company in the world. You will likely do just as well negotiating down the bill as an individual.
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