OT - Health insurance and Local hospital discount...

MAD as HELL!
Go to Dr. for Bi-annual checkup. Got lots of aches and pains and we agree I should get a good amount of blood work done as I ain't getting any younger and a fair amount of the big C in my family tree.
Go to local hospital by my Dr. and they can't do the work because it requires the sample to be put on ice immediately and the testing by done ASAP.
So I go to the local "yuppy" hospital right by my house.
Get a bill less the 2 weeks after. Total bill over $1000, insurance covers over $700 leaves me to pay $300+. Ok, I can deal with that
UNTIL I read the invoice and it says they charge the UN-insured 15% less!
WTF, We both work, chose and PAY for premium health insurance plan and then are charged 15% more for being responsible insured customers?

Sorry, that's not right or fair. We do the right thing and get penalized for it.

Just like it is not fair or ethical for hospital to charge uninsured more, its not ethical for the insured to be charged more.

Geez, time for me to just shut down my biz and go WELFARE! Then medicare would pay my bill.


Rant over,

Pete

I pay 15000 a year for 5800 deductable,never had a serious health issues,but at 62 i guess i'm a risk.I send every bill through my insurance company,they don't pay but i always get a reduced rate on the bill.My last blood test was 900 bucks,but going through the insurance company it was reduced to 200.

Ray,
I hear your pain. Being self employed my whole adult life we have spent many times more then the average wage earners on health insurance that covered less.
My wife, God bless her, took a hard working job in a hospital for low pay so we could qualify to BUY insurance we have now.
Our insurance paid 70+% which I can fight with them but for provider to charge a sliding scale based on whether someone is insured or not is not fair or ethical in my opinion.
People complain when non-insured get charged more due to high non-payment rate. Our insurance paid withing 2 weeks of bill.
This hospital either gives me the same discount or loses the our family as a customer.
Pete

I'll bet the "negotiated" rate that your insurance company pays is cheaper than the "discounted" rate charged the uninsured.

The whole thing with insurance billing is a bit of a joke. Hospitals inflate their charges by 200 percent or more, knowing that insurance will only allow a third of their charges. When I had knee arthoscopy, the hospital charged for three operations on one knee. The insurance company disallowed two of the three. So did the hospital overbill, or did the insurance company underpay?

This is one reason why so many countries have single payer health care systems.
Zach

not to worry external_link care is going to solve all the problems

Mark & Ray got it right. Insurance compamies contracts allow them to discount down the hospital bill oftentimes way low. Just because they charge it doesn't meal it gets paid. At 15% off you are paying way more than any insurance pays.

You can cut that bill by 50% by going into the business office and asking for a discount, and pay cash on the spot.

Did your bill say uninsured or non-insurance billed?? The reason I asked is that my health insurance pays me not the hospital/doctor. I get so much for each procedure. If it costs more than that I have to pay the difference. If it is less then the surplus is mine. I have had this policy for almost thirty years. It was a real life saver when my first wife had cancer. Most of the time I could gain the deductible with the cash discounts I could get by paying the bill directly myself.

I had some surgery done late last year. The surgeon knocked two grand off the bill because I paid him before the operation. He told me it may take him six months to get paid by an insurance company.

When my youngest son had to have his wisdom teeth cut out. The oral surgeon charged me $2000 for a cash/check payment and $3000 if he had to bill the insurance company. Same reason. He told me that he had over $200,000 owed him by the public employee's health insurance. Said the time between the services and him receiving his payment was almost nine months. He had a lot of teachers that had things done. He said he wished he could refuse all insurance and just worry about treating patients. Not worrying about getting paid from some bureaucrat.

Thank you!!

My wife"s cancer was discovered just before she went on medicare, so it was on Blue Cross, first oncology appt was on Friday before Oct 1, when medicare started. Next Monday was the next appt, so we double-checked to make sure coverage was ok before we dropped Blue Cross. That worked ok. Shortly after her surgery, we received a hospital statement, saying that if we couldn"t pay the bill, we could talk to them about a discount of up to 40%! Yeah, the insured pay for slackers.

don't start with the external_linkcare crap ,before george Bush and the rest of the nnalert crooks came up with part d I had a good advantage plan that I paid with my medicare and because they came up with mandatory Insurance participation to get prescription coverage with the donut hole nonsense I now am going to be forced to sell my home of 35 yrs. and working all that time and move because I am in the donut hole 6 months of the year,my and my wife's healthcare cost us 10 thousand dollars a year so what caused the housing crisis and recession?

What insurance company do you have that does business this way? I'm possibly interested myself.

Pete, just wait till you actually get Cancer!! Iwas diagnosed with stage 2b mucenus adendo carcenoma of the appendix, very rare about 1 in 500.000, and I was statistically speaking too young (usually hits in the 50's, I was 37 in 2006). After surgery and before Chemo, I went for a second opinion to MD Anderson in Houston, TX (one of about 15 or so places in the US for that type of cancer at the time), got accepted and since it is an out-of-network provider, my Oklahoma HealthChoice State plan only pays 50% of allowable. Every time I go for lab, chest x-ray and CT, it runs me gross about 5500 -6000 a pop, just switched to annually, went every six months before. Insurance pays, depending if co-pay and deductable are met somewhere near 1200 or less, the rest is NOT discounted by MDA, but they let me pay it off without interest. No further discount, nothing, I tried. They politely tell me that my bill is already discounted by the share my insurance company pays...LOL (not really!!!) I asked what discount I would get paying cash upfront??: 5%! On the other hand, if I had in-network insurance with them, the bill billed to the insurance company would be about 3800. I offered to pay the difference between what my insurance co. pays and 3800, even 4000, no deal!!!!
In all fairness, they changed their re-payment plans to an accelerated payment schedule but I got grandfathered in and was able to add new charges to the old plan. I stopped adding new balances couple years ago because every time I did that, they would raise the monthly amount by another Benjamin. I was told that if your balances become old, 2-3 yrs old and older, they can negotiate deeper discounts, 15-30 %...so I am doing that for now and hope to "negotiate" once my plan charges are paid. Does not make sense!! I currently pay about 22% of my take home every month to MDA!
Talked to my Oncologist there last month, told him the situation and he lets me do the tests here in-network in the future, just reviews them at MDA. He was shocked when I confessed the $$ situation.
On the other hand, the local tiny county hospital, about 26 beds, still gives $$ discounts for the remaining balance that the insurance does not pay on any services, 10-30%, depending how quickly you pay them!!!
What a lot of folks here in the US don't find out is that health insurance companies in Germany and Europe are much, much heavier regulated and still make a profit!! I just hope that none of the folks that scream about the coming changes really get ill, yes, it sounds wonderful to shop for great rates in the open market, but what happens when your available dollars buy you absolutely no coverage? Sure they have a plan for you, but if you can't pay the rates, it's no advantage to be in a capitalistic market. I guess you'll get to move 6 feet under first! And the only one that counts is the winner! Right????? (sorry got a bit onto my soapbox here...).

I had a prostatectomy last August. Dealing with the insurance company was more stressful than anticipating the surgery. I've paid for health insurance for 40 years straight, and they act like they're giving me some kind of a gift. . .

I am not sure of the current company it is through. The Insurance company has changed over the years. I get it from NASE (National Association for the Self-Employed). They are who I pay my premium to. I have had good luck with it. I have attached a link to NASE web site.
National Association for the Self Employed

Will try to keep this brief. Had a minor incident on 3-10-11. First notice came around 12-20-11, said I still owed $4800. Had to send written request to get statement of what they were charging me for. That statement came on 2-16-12, with a note that they had sent bill to collection.
Had an inperson interview on 1-10-12, got billing head to admit that insurance companies get automatic 20% discount. With a little polite grumbling, I got her to admit that if patient pays direct, 20% discount also applies. That suggests to me that they start out by inflating bills by about 25%.
With a little more going over the itemized bill, got the amount cut to $2400, & with the 50% that collection agency charges, hospital ends up with $1200, which is reasonable for the service they actually performed.
End of rant.
Willie

Most insurance companies also get an automatic 20% discount, so you probably did too, recheck your statement or ask your insurance provider.

Many communities give out free prescription discount cards for 20% off.

Thanks for info I'm contacting them to see what they can do for me.

Just a general comment for those who may be interested:

I was curious how health was done in other countries compared to the US. I looked at several books and finally purchased, Healing of America by T. R. Reid. The author traveled to various countries, interviewing doctors etc. and explained/compared the systems currently used. It answered a lot of questions I had on how/why we do things the way we do and what we might change.

Half the value of health insurance is the discounted amount "allowed" by the insurance company. Look on your statement- I'll bet you already got a discount of more than 20%. So the 20% discount for cash just brings the cash customers a little more in line with what the insureds are paying.

Why not just price it lower in the first place? Because the guvment pays the list price when paying for the po' folks through various guvment programs.