Working in healthcare and managing their billing systems... Yes. That sounds about right. Dealing with insurance if there is no contract in place (out of network) is a giant PITA. It can literally cost hundreds of dollars for a business (in labor hours, cost for billing system, IT, etc) to file a claim and run through the various appeals to get what they want. So they'll ask for $2k from the insurance company. Insurance company comes back with $500. Appeals get filed, and the insurance company finally cops out $1k. On the other hand, charging you less than what they're expecting is cheaper for them and probably cheaper for you if you haven't met your deductible yet. Thus your $725 bill. They save money, and you spend less. Problem averted. Note that the numbers I threw out are arbitrary. I have no clue how much your procedure is supposed cost.flechero wrote: ↑Thu Jan 30, 2020 9:45 amSounds familiar, but what about my Dr., can I keep my Dr.?
Oh how about premiums... can I go back to my pre-obamacare premiums, or are the almost 400% rate hikes we experienced still the cost?
Speaking of the wonders of obamacare, I had to get an MRI and it was cheaper to private pay than it was to go through my "insurance" and pay the co-pay + XX%.
I paid $725 private pay but my portion and copay for it would have been just shy of $1800....
how is it that an MRI cost $725 but my "portion of costs" with insurance is over $1000 MORE than the full cost of the procedure?
If there is a contract, it is a lot simpler to file the claim, and the healthcare provider will know exactly how much they're going to get paid. Call it $800. They may still throw out a private pay bill to you just to save from the headache of insurance claims if they determine that your out of pocket costs will be higher. Whether you really want to take it or not depends on how much you expect to get billed for healthcare procedures this year.
Trump recently signed into law a price transparency bill that requires health care providers to publicize their negotiated contract price for each billable procedure and medication. This will theoretically be the first step in driving down healthcare costs to the consumer. It does not solve the issue with the current way insurance companies operate, nor does it solve the actual high cost of healthcare at the provider level. It will still cost your hospital $700 to run that MRI machine.
Welcome to the confusopoly known as "healthcare insurance". It's terrible.