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I can tell you that one part of "Obamacare" is working quite well. After a major medical problem I encountered in 2010, I can't get insurance due to a pre-existing condition I never knew I had. PCIP insurance was mandated by Obamacare and I signed up for it. The monthly cost was about $260 when I first signed up. Within 6 months, that cost was reduced to $230 due to having large numbers in the pool of people driving costs down. The healthcare is excellent and I don't know what I would do without it.
And also we DO need to move to a single-payer plan in the US. I had emergency brain surgery that really messed up my thinking and memory for months afterwards. I had no insurance and nobody to help me out, I kept getting bill after bill after bill and had to negotiate all these down to a reasonable amount I could pay. I did it, but there were days when I didn't know up from down, left from right, I really shouldn't have had to deal with all of that while recuperating. And now I'm being sued for $215k that I couldn't pay. The hospital demanded $60,000 from me while I was in ICU before my surgery, threatening me and saying they wouldn't let me get the surgery without paying!! Um, I wasn't in there voluntarily, the doctors said I would die if I didn't have the surgery!!!!!! They estimated the cost of my surgery at $120k, but strangely would never give that to me in writing. In the end that estimate was so far off what they actually charged me. It ballooned to over $300k. How is the current system any better than "socialist medicine"?????? Give me socialist medicine any day!
And if you were an illegal immigrant you could get all the health care you needed for free without damaging your credit.
I don't know if Obamacare is going to make things better or worse, but I have a small rant about how ridiculous healthcare in this country is. In October 2010, I got bit by something(spider?) at work. I was feeling dizzy and went to whatever was nearest. Unfortunately, that was a Kaiser nearby. They did some motor skill tests that consisted of me doing things like raising my hands lol. Then they gave me a Benadryll. After Insurance covered some, I was left with a 550.00 bill. I was upset, but hey, it's the ER, what do I expect. So, I take my lump, pay it off. A year later, today, I get a bill for a balance of 150.00 for the same thing. What's wrong with healthcare in this country? It's sad that you have to think about financial ruin when you should be worried about what is ailing you. Luckily, this is more of a major annoyance than financial ruin. But unfortunately, it makes people think twice before getting care. That's the sad part.
You have a few different issues at work here;
Was the Kaiser Hospital in your insurance carrier's Network? Unless you have Kaiser Insurance I would think not, so your Co-pay is going to be higher.
Years ago I had Kaiser and the only thing I paid was the ER co-pay($50) or an Office call($10).
Most Insurance companies have a different deductible when it comes to the ER unless you are admitted to slow down unnecessary trips to the ER and Urgicare places have NO co-pay.
Did you investigate what the $150 charge was for? Did the bill come from a provider or a collection agency?
You should have received a statement from your carrier listing the original charges, what was covered, what they paid, and what you are responsible for.
The problem isn't Health Care but how we pay for it, Doctor's offices need multiple persons to take care of the billing due to different insurance companies and plans, this increases the cost of doing business and why most doctors are part of a group sharing employees.
Last edited by Trackwatch; 02-19-2012 at 10:40 AM..
I don't know if Obamacare is going to make things better or worse, but I have a small rant about how ridiculous healthcare in this country is. In October 2010, I got bit by something(spider?) at work
go back to that last word of yours. It happened at work. You should have said that at the beginning of your treatment. It may have been covered by worker comp.
Quote:
. I was feeling dizzy and went to whatever was nearest. Unfortunately, that was a Kaiser nearby. They did some motor skill tests that consisted of me doing things like raising my hands lol. Then they gave me a Benadryll. After Insurance covered some, I was left with a 550.00 bill. I was upset, but hey, it's the ER, what do I expect. So, I take my lump, pay it off. A year later, today, I get a bill for a balance of 150.00 for the same thing. What's wrong with healthcare in this country? It's sad that you have to think about financial ruin when you should be worried about what is ailing you. Luckily, this is more of a major annoyance than financial ruin. But unfortunately, it makes people think twice before getting care. That's the sad part.
Administrators, it's exactly why health care costs so much in this country. They offer college degrees now in medical billing.
Exactly, when the private insurance company bureaucrats get out of the process of delivering medical care the costs fall and treatment is focused on the patient's need and not jumping thru hoops the insurance companies create.
Yes, many providers will negotiate as it's better to get something than nothing. However, the government does not reimburse the full difference. There may be some subsidy, but it's pennys on the dollar. Same for Medicaid, depending on the state, the government reimbursement is generally 20 cents on the dollar, the difference being absorbed by the provider. This is why some providers will not accept Medicaid patients.
Yep, my wife worked for over 6 years in processing claims and the BULK of the claims that had issues of payment were government ones. Many people get later bills from the doctor because the government lied about what it stated it would compensate and then refused to pay after the fact leaving either the doctor or the patient with the tab.
Her experience with the government services left her with an extreme distrust with them. She believes them to be the most corrupt and incompetent agencies she has ever dealt with.
Because, as you say the government programs end up only paying extremely small amounts for a service, many in the medical industry raise the costs of those services to ridiculous amounts in order to be properly compensated for them and so it is a vicious circle creating an industry of service with costs that are absurd and impractical and this is simply one area of government involvement in the system to which effects this.
Unfortunately, most are unaware of the politics in the system and continue to ignorantly fall for the line that "government is the solution to those big evil companies".
Exactly, when the private insurance company bureaucrats get out of the process of delivering medical care the costs fall and treatment is focused on the patient's need and not jumping thru hoops the insurance companies create.
Bingo! Here's where the dominoes start to fall. Get rid of this and then the excessive administration on the provider side becomes unnecessary. Staff resources can then be redirected to delivering affordable quality care.
Yep, my wife worked for over 6 years in processing claims and the BULK of the claims that had issues of payment were government ones. Many people get later bills from the doctor because the government lied about what it stated it would compensate and then refused to pay after the fact leaving either the doctor or the patient with the tab.
Her experience with the government services left her with an extreme distrust with them. She believes them to be the most corrupt and incompetent agencies she has ever dealt with.
Because, as you say the government programs end up only paying extremely small amounts for a service, many in the medical industry raise the costs of those services to ridiculous amounts in order to be properly compensated for them and so it is a vicious circle creating an industry of service with costs that are absurd and impractical and this is simply one area of government involvement in the system to which effects this.
Unfortunately, most are unaware of the politics in the system and continue to ignorantly fall for the line that "government is the solution to those big evil companies".
Yes indeed, lot's of waste from the government side. However, my experience tells me there's plenty of blame to go around on the private side. Many private payers will also pay, say "whups", and then readjudicate usually to the detriment of the provider. It's often due to pricing algorithms not properly uploaded at the insurer...this happens frequently. When we have thousands of procedure codes that need to be maintained across thousands of entities, it's no wonder it's a mess.
Most emergency type billing is two separate maybe more. Ceretainly the hopital and then the physicans group . Sometimes other providers of tecting bill seprately.If I got a bill 11/2 year later I would certanly question it.
Yes indeed, lot's of waste from the government side. However, my experience tells me there's plenty of blame to go around on the private side. Many private payers will also pay, say "whups", and then readjudicate usually to the detriment of the provider. It's often due to pricing algorithms not properly uploaded at the insurer...this happens frequently. When we have thousands of procedure codes that need to be maintained across thousands of entities, it's no wonder it's a mess.
One little known provision of ACA requires private insurance companies to process billing instead of rejecting the paperwork if they find a technical error anywhere. Typo's by a file clerk cannot be used to reject claims. A simple misspelling could get a claim rejected in the past.
Anytime one gets a bill that old...question it. Even if it's legit, many organizations will have a policy of writing it off as "too old to bill". We do that regularly, usually before flipping it to the patient's responsibility. It's just the right thing to do.
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