US healthcare illustrated: The impossibility of getting a bill for five stitches
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I used them as baseline to consider local costs.
I was uninsured and asked the local hospitals and surgeon what the prices were going to be. I did qualify for assistance. I paid my surgeon pronto($2,600) and had to wait for the hospital to approve my assistance application.
The anesthesiologist(which I hadn't anticipated, thought that was going to be in the hospital bill) told me to pay $35 dollars to keep my $1,800 bill from going to collections. Once I showed them the approval from the hospital, they would accept that and reduce it to $180.
After calling the hospital constantly to get the bill reduced, 6 months later they told me they were waiting to see if I qualified for Medicaid, which I was no where near qualifying for and never requested. I just had their standard financial assistance reduction from about $18,000 to $6,000.
In the mean time, my anesthesia bill made it to collections for the full amount. Because.
I tried initially to get all my ducks in a row. I tried to pay everyone. Ultimately, I only paid the surgeon the full amount.
The medical groups will write off the difference between what they billed and what they sold my debt for. This will reduce their "revenue". I won't ever pay them. Bye bye credit.
Cash is King.
Edit: I knew going in what the prices were and two of the three parties fumbled the process of payment. Those two didn't get paid because I was frustrated.
Like WTF?!
> Much publicity has surrounded the use of gag clauses in contracts between insurance companies or their pharmacy benefit managers (PBMs) and pharmacies. These clauses prohibit pharmacists from voluntarily informing patients that their prescription medication may cost less if paid for directly by them instead of through their insurance.
> How often an insurance copayment exceeds the cash price for a prescription is not definitively known; however, Van Nuys and colleagues reported that such overpayments affected 2.2 million (23%) of 9.5 million prescription insurance claims from a single large insurer. Additionally, in a 2016 survey involving over 600 pharmacies, approximately 39% of respondents stated that a gag clause prevented them from informing patients about other payment options between 10 and 50 times in the last month.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6293384/
Antitrust action when?
What I meant is I've never seen a pharmacy that will refuse to bill to cash when directly asked.
Sounds to me like enforcing the current law is a pretty good start. Consistent enforcement could prevent many future occurrences.
https://www.naag.org/issues/consumer-protection/consumer-pro...
https://www.naag.org/issues/consumer-protection/consumer-pro...
I don’t understand how this abuse can be accepted.
Are we electing people? Or puppets? Mostly rhetorical.
For example, insurance companies will never tell you the "allowed coverage" of anything until you've already enrolled into their insurance in which case you're locked in for 1 year due to open enrollment.
Imagine if you go to the dentist and your insurance says it will cover 100% of preventative care such as a cleaning. There's always a * there which states they will only cover 100% up to their defined "allowed" or "covered" amount which is a value they get to define in secret.
It means if your cleaning costs $150 they might decide to only cover 100% up to $110 because they determined they won't pay more than that and there's no way to find this number out until you've already enrolled and either had the procedure done or have your medical provider submit a claim as a price check but at that point it doesn't matter because you've lost the ability to pick providers by price. The numbers change every year and every provider has different numbers.
Single-payer healthcare cannot come soon enough.
None of those are likely with (especially non-elective) healthcare.
Healthcare must be treated as a human right, not a profit center.
It takes one to now one. Health Insurance tells the hospital what they will pay for servicing their "client". Plus the Insurance Company will tell their Client "we will not pay for your life saving treatment" if they determine it is too expensive. I will not speak to the rates they charge for malpractice insurance.
There is a reason health care is too expensive. Plus I am sure the bonus an Insurance Company CEO gets dwarfs the total of all bonuses people in the non-profit hospital gets.
they appear to be fishing for additional management fees over and above the hospital bill.
I contacted the hospital and confirmed they're a contractor but couldn't provide anything else.
when contacted for itemized billing, the first time, they just lost the bill. the second time they offered a discount
when asked for the name of the doctor who they managed, they could not provide.
it's clearly some kind of hospital kickback scame.
You can't have a normal billing process when the buyer can't decide what they want.
The problem is: a person can't decide the best treatment for their disease. The extreme case: a person that goes through a surgery cannot decide what care they need or want (they are under anesthesia when that decision needs to be made).
So, someone else needs to manage the cost, not the end customer. Who? Insurance passes the cost to the customer, and companies buying health insurance can't really decide on the care needed by their employees.
That leaves the government to be an effective regulator of cost. The US decided they don't want that.
Fix that before anything else.