There is a certain screening test that is highly recommended for people of certain age. I had it done not very long ago.
With the co-pay, medical insurance paid 16% of the bill amount as a full settlement of the bill.
Think about that for a minute. If you were self-insured and wanted that test, you would have paid over six times what I paid. The reality is that if you didn't have insurance, you might have been able to afford the test if you got to pay what my insurance company paid. But you could not get that price and you'd probably be shit out of luck.
This health-care system is basically corrupt. It should be fixed.
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Thursday, February 25, 2010
9 comments:
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Some years back, when I was young and invicible, I had major medical but a large deductible. So I was in an auto accident and had to be hauled to the ER, x-rayed, all that, and was sent the bills after Blue Cross sent them (and me) notification that the billed amount was X, the amount Blue Cross would pay was X-n, and the amount Blue Cross was paying (because the deductible had not yet been met) was $0.
ReplyDeleteSo of course they sent me a bill for the full amount X. But I knew that a) they were a Blue Cross network provider, and b) they would have thus accepted X-n from Blue Cross. So I sent'em a check for X-n, along with a letter stating that I considered this the full payment for their services given that they were a Blue Cross provider, and... I never heard from them again.
Point being, X is just a starting point, and generally you can talk'em down by a pretty big percent even if you don't have an insurance company standing between you and the provider. Assuming you know what the insurance company would have paid, anyhow. If it comes down to a choice of accepting the same payment the insurer would give them or selling the bill to a bill collector for pennies on the dollar, they're not idiots... well, not usually, anyhow.
- Badtux the Unhealthy Penguin
Interesting. Somebody I know just went in for the same procedure, no insurance, and the hospital was completely at a loss when he offered to pay for the procedure when it was done. They had no idea how to even handle it. Took a while to figure out.
ReplyDeleteCurious as to what the insurance company actually paid. Pretty sure my guy said it was about $800 that he had to cough up.
Justin, the insurance company coughed up about $380 for mine. And this is not a low-cost area.
ReplyDeleteI'll double check with my guy but so far it seems like a scope wasn't the only thing they shoved up his behind. Still, $800 is way better than the $2400-ish that the insurance company said it really costs.
ReplyDeleteThat's one of the thing that chaps my ass about insurance and health coverage. I've never found any basis for their "original" price before they apply a discount. It's like they're just making it up to make themselves look better. Like the dental insurance we get through the wife. They show something like a $200 original cost for the visit which gets knocked down to $75, $70 paid by insurance and $5 by us. When I asked the no-insurance guy what he pays for a basic visit with no fillings it was $75. Different dentists but within 15 miles of each other.
This price manipulation thing is absurd. Hell, borders on fraud in my book.
So, I went in in December to have a procedure. Got the bill, shows $18,000+ for 1 night ER, 1 night bed, 20 min surgery. Insurance discount, $17,000. Paid to hosp:$990. My co-pay: $91.00.
ReplyDeleteWTF?
BY, but if you had no insurance, those fuckers would be after you for the full 18 large.
ReplyDeleteNot exactly. They'd sell the bill to a credit collection agency for $1,700, and then the credit collection agency would go after you for the 17 large. In short, the reason they mark up so much is because the majority of bills not paid by insurance end up being sold to collections for 10c on the dollar, so if they mark them up enough, they get the same as insurance would pay when they sell it to the credit collector. The collection agency then makes its nut trying to extract the $17K from at least two of the ten people whose $17K bills they bought for $17K, and apparently they're successful enough at scamming people into paying the full $17K that they make a tidy profit at it.
ReplyDeleteIf you instead offered to just pay the hospital what they'd get from selling the bill to a credit collector, most likely they'd accept your offer. After all, they have the same amount of money either way, with less work for them than selling it to collections. But you are decidedly correct that the $17,000 is a scam! The hospital doesn't ever expect to see that amount of money, ever.
- Badtux the Medical Penguin
BadTux, and if you settle with the credit agency for 30 cents on the dollar, the fuckers will issue you a 1099 so that you get to pay taxes on the 70% as a forgiven debt and the fucking hospital gets to write that off for taxes.
ReplyDeleteYep, you got it :-). That's why it's always a good idea to try to settle the debt *before* it gets to collections, if you have any intention to settle it at all, a question which is far more complex than appropriate for this space (depends on your assets, income level, etc. as to whether it makes sense to settle or not).
ReplyDelete