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blktoptrvl is absolutely correct. You never know when all the bills have arrived as you have no idea who is going to send you a bill. If you go to a clinic you should get one bill. Period.
To use another example, if you get your car worked on, you don't get a bill from the dealership, the mechanic and the parts manufacturer. You get one bill.
A hospital is not a clinic.
Unless it’s an emergency or there are complications, there is no reason why you don’t know the cost before you are admitted. Physicians typically operate as independent or affiliated contractors, not hospital employees, and as such they bill independent of the hospital.
Unless it’s an emergency or there are complications, there is no reason why you don’t know the cost before you are admitted. Physicians typically operate as independent or affiliated contractors, not hospital employees, and as such they bill independent of the hospital.
Insurance companies demand discounts. Hospitals base their pricing structure in this fact. So, you have a procedure which costs them $500. The list price might be $1000. They offer the insurance a discount to bring the cost to $600. Everyone is now happy. The insurance company has an illusion of a discount and the hospital made money.
I don't think you understood what I said.
The hospital admin said it would be $5000 for cash. If I used my insurance they would charge $10,000. She couldn't actually say it, she wrote it on a piece of paper and slid it to me. I knew right then if was shady gouging.
My insurance company cut them a check for $5k and they came after me for another $5k. So they charged double for me using insurance because I didn't have $5k in cash. BTW, it was my auto insurance, not health insurance. She broke her ankle getting out of our truck.
This is an illegal practice that hospital administrators ignore.
ON TOP OF THAT, a doctor came in and asked her how she was doing and handed me a card. He didn't have anything to do with her surgery. He sent us a bill for a $300 consultation. $300 for a "hello, how are you"!
Quote:
Originally Posted by pknopp
One way. Consumer advocates.
You have posted $X for such and such service. Hospital B charges $X less than you. Can you explain the differences?
Many clinics and hospitals are doing it. It takes out the "bill whatever you think the victim can afford" mentality that is the current MO of administrators. They are as bad as any CEO when it comes to bilking their patients. That's what happens when a pencil pusher only cares about the bottom line. Hospitals should be managed by doctors as they once were. Heartless business administrators have no business being in the healthcare business if they only see a bottom line.
BTW, I don't know how the hospitals are where all of you live, but here... they have all poured literally billions into expanding. Even the worst hospital in the area (Gardena Memorial) spent tons on expanding. Torrance Memorial just spent nearly $500M. They certainly are making money hand over fist. Pain, suffering, and gouging have been bedy bedy gewd to them!
Its got to start somewhere. Get numbers out there, get at least the possibility of some form of competition between providers. Markets don't correct to the norm over night when new information becomes available, it takes time for market participants to interact and for providers to learn from those interactions so they can adjust accordingly.
It’s a tad more complicated than that.
Your MD schedules surgery at a hospital he/ she has privledges.
Guess it’s possible one could one day go online and comparison shop amongst hospitals. If your MD does not have privledges at the cheapest hospital, then what?
Now you have to find a surgeon who has privileges at your chosen hospital and start all over.
Who pays for that?
If one is in the midst of a medical emergency, are you going to waste time and perhaps your life looking for the cheapest hospital?
Who wouldn't support it?
That and require insurance companies to also post what they pay on a given procedure. I hate those hidden costs in the American system.
Sounds like something is amiss with your interpretation of the situation or you have non- standard insurance.
Does your insurance have negotiated Preferred Provider Rate with hospitals?
Hospital can bill the insurer any amount. They will be paid a predetermined amount they agreed to, less your deductible and/ or co-pay.
Why not make an appointment with the hospital’s billing office and sort it out.
Do you have a comprehension issue?
Please reread where I made it clear she broke her ankle in our truck, so my auto insurance paid the bill. As with any other accident they sent me copies of what they paid.
It's really that simple as you try, for whatever reason, to defend the actions of a hospital breaking the law.
Why would you do that?
Are you or someone close to you in the HC industry? That's about the only explanation I can come to.
Quote:
Originally Posted by boneyard1962
Who wouldn't support it?
That and require insurance companies to also post what they pay on a given procedure. I hate those hidden costs in the American system.
It's a circle jerk. Insurance companies say they need to raise premiums because costs are going up, healthcare service raise costs higher, rinse repeat, rinse repeat. Gee, I wonder why costs have gone through the roof.
Then they claim it has a lot to do with lawsuits, and if they could just reform tort laws so doctors are protected (from their victims) cost would go down. BS! It would just increase their bottom lines and a lot more people would die with them being protected (no fault) against legal action for surgeries gone bad. Over half the doctors go to work either drunk or on drugs as it is...
Your MD schedules surgery at a hospital he/ she has privledges.
Guess it’s possible one could one day go online and comparison shop amongst hospitals. If your MD does not have privledges at the cheapest hospital, then what?
Now you have to find a surgeon who has privileges at your chosen hospital and start all over.
Who pays for that?
If one is in the midst of a medical emergency, are you going to waste time and perhaps your life looking for the cheapest hospital?
Dont be ridiculous, nobody is talking about on the spot comparison shopping for emergency surgery....Although I could even make a case for that given the long term possibility of high level pricing becoming available, which would be that over time certain hospitals would become known for things like price and service levels with more transparency, so even in an emergency (as long as travel time/distance isn't an issue) then yes someone might be able to make a decision on the fly in an emergency to go to hospital X over hospital Y because they know it will save them some money and not take unnecessary risk in terms of quality or other factors.
Basic pricing transparency, especially for simple elective surgery or services is a huge step forward from where we are now. Making excuses against it is just covering up for the smoke and mirrors used to rip off customers and give insurance companies leverage to take advantage of people.
Regardless of complexities that might contribute to a pricing model, there can definitely be more transparency around it. There are definitely ways to factor in what you explain, a pricing model doesn't have to be static or black and white, it can have variables and different scenarios factored in. More information is ALWAYS better for the consumer, hiding it behind excuses and what ifs is NEVER better for the consumer.
Hospitals and insurance companies have prenegotiated rates for everything. Hospitals can bill any amount. Nothing illegal about it. What matters is what it agreed to accept as payment. A PPO discount of 50% is common.
Look at your insurer’s Summary of Benefits. The value of the PPO Discount is right there.
Uninsured patients may be offered a discount for a fee for service arrangement. That discount is not going to be greater than the rate the hospital agreed to accept from an insurer under contract.
Unions and insurance companies also negotiate rates. Hospitals can bill any amount they want but that doesn't mean they will get paid.
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