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Thread: What a difference having health insurance makes

  1. #1
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    Default What a difference having health insurance makes

    health care capital 2.jpg

    This is an actual statement of benefits behind a brief visit to a local ER. They took two x-rays of my back, and sent me home with a prescription for some pain meds.

    Note what was billed. Then note what the insurance allowed. The provider accepts the amount the insurance allows BECAUSE THEY MAKE MONEY being paid that amount.

    If I had no insurance, I would have been billed the entire charged amount, which I would not have been able to pay. The facility would not 'eat' that loss, but it would be passed on, probably to taxpayers.

    Even if I had a deductible, or a threshold before the insurance kicked in, my responsibility would be limited to whatever those amounts were. but way short of the $9 thousand plus charged.

    The charged amount, according to TIME magazine (Mart 5, 2015 or 16, I believe) the actual charged amount is a number made up: pulled out of the air by someone called the "chargemaster". Meanwhile, the amount Medicare (in this case) allows is a figure that takes into account the cost of living in the area, the overhead of the facility, the actual cost of the services rendered, and some extra so the facility makes some money.

    The facility accepts the amount allowed, because they do make money over and above their costs.

    This is something everyone should realize.
    How do we form a mutiny? Our new captain is navigating poorly.

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    Default Re: What a difference having health insurance makes

    I’m surprised by how steep the negotiated pay was. Hospitals have the most leverage; small clinics and primary care, least. A hospital owned practice is allowed to charge much more than an independent; they really don’t want independents!
    There's a lot of things they didn't tell me when I signed on with this outfit....

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    Default Re: What a difference having health insurance makes

    Those costs are outlandish. Makes me very glad to live in socialist Canada.

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    Default Re: What a difference having health insurance makes

    This is an actual statement of benefits behind a brief visit to a local ER. They took two x-rays of my back, and sent me home with a prescription for some pain meds.

    So you really expect anyone to believe that you was billed $9300. for a x-ray ..That visit would have been about $300 at most with x-rays here.

    It would take an idiot to agree to pay that price .

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    Default Re: What a difference having health insurance makes

    Yes, Ron. It’s real.
    There's a lot of things they didn't tell me when I signed on with this outfit....

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    Default Re: What a difference having health insurance makes

    Friend of mine is from Germany. He lives here in the States now with his family. When he was younger he needed to have a catscan, the price came to about $1500 in Germany. Later, he hurt himself swimming in the med while in Egypt and the catscan there, with the same machine.. $750.

    A couple of years ago his son here in the states needed on. Same machine, same level of skill needed, over $6500
    "If you think you are too small to make a difference, try sleeping with a mosquito"

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    Default Re: What a difference having health insurance makes

    Quote Originally Posted by George Jung View Post
    Yes, Ron. It’s real.
    No it's not ..

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    Default Re: What a difference having health insurance makes

    Quote Originally Posted by RonW View Post
    So you really expect anyone to believe that you was billed $9300. for a x-ray ..That visit would have been about $300 at most with x-rays here.

    It would take an idiot to agree to pay that price .
    considering a visit to your GP about $75, I can believe that an X-ray and ER visit equals several thousand dollars. You do need to remember that hospitals always overbill insurance companies because they know the ins will negotiate it down a good percentage.
    "If you think you are too small to make a difference, try sleeping with a mosquito"

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    Default Re: What a difference having health insurance makes

    [QUOTE=John Smith;5809019]If I had no insurance, I would have been billed the entire charged amount, which I would not have been able to pay. The facility would not 'eat' that loss, but it would be passed on, probably to taxpayers.[/QUOTE]
    Your misunderstanding of the bill is typical.

    The submitted charges are the list prices. Those without insurance have the ability to negotiate a better price.

    Since the ACA, government payments for non compensated medical care have gone away.
    Life is complex.

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    Default Re: What a difference having health insurance makes

    [QUOTE=Too Little Time;5809101]
    Quote Originally Posted by John Smith View Post
    [/QUOTE] Those without insurance have the ability to negotiate a better price.
    What planet do you live on? entering an ER without insurance, you have exactly NO leverage to negotiate.

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    Default Re: What a difference having health insurance makes

    Hehe... it’s like arguing with a three year old...
    There's a lot of things they didn't tell me when I signed on with this outfit....

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    Default Re: What a difference having health insurance makes

    I think most hospitals would accept a reasonable offer over the option of getting nothing. No?

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    Default Re: What a difference having health insurance makes

    I just got back from the gas station and getting a fill up, it was a little over $1800. boy am I glad that I had my gas rewards card with me.

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    Default Re: What a difference having health insurance makes

    Quote Originally Posted by sarnella View Post
    I think most hospitals would accept a reasonable offer over the option of getting nothing. No?
    Go on, give it a try.
    It really is quite difficult to build an ugly wooden boat.

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    Default Re: What a difference having health insurance makes

    [QUOTE=Greg Nolan;5809141]
    Quote Originally Posted by Too Little Time View Post

    What planet do you live on? entering an ER without insurance, you have exactly NO leverage to negotiate.
    Quote Originally Posted by George Jung View Post
    Hehe... it’s like arguing with a three year old...
    Just shows how important upper/lower case can be. TLT or TlT
    It really is quite difficult to build an ugly wooden boat.

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    Default Re: What a difference having health insurance makes

    Quote Originally Posted by sarnella View Post
    I think most hospitals would accept a reasonable offer over the option of getting nothing. No?
    Collections
    There's a lot of things they didn't tell me when I signed on with this outfit....

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    Default Re: What a difference having health insurance makes

    [QUOTE=Greg Nolan;5809141]
    Quote Originally Posted by Too Little Time View Post

    What planet do you live on? entering an ER without insurance, you have exactly NO leverage to negotiate.
    Quote Originally Posted by George Jung View Post
    Hehe... itís like arguing with a three year old...
    Just shows how important upper/lower case can be. TLT or TlT
    It really is quite difficult to build an ugly wooden boat.

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  18. #18
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    Default Re: What a difference having health insurance makes

    Quote Originally Posted by RonW View Post
    It would take an idiot to agree to pay that price .
    No, it would only take someone without health insurance, to be billed that much... and then hit with a lien if they can't pay.
    "Reason and facts are sacrificed to opinion and myth. Demonstrable falsehoods are circulated and recycled as fact. Narrow minded opinion refuses to be subjected to thought and analysis. Too many now subject events to a prefabricated set of interpretations, usually provided by a biased media source. The myth is more comfortable than the often difficult search for truth."







  19. #19
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    Default Re: What a difference having health insurance makes

    Quote Originally Posted by Norman Bernstein View Post
    No, it would only take someone without health insurance, to be billed that much... and then hit with a lien if they can't pay.
    That's a joke and this whole thread is a joke. Let's recap, hospital bills individual $9340. but accepts payment from insurance company of $167 as payment in full. Really? Why ?

    That's inflating the bill by 56 times. A hospital wouldn't have the nerve or stupidity to sue you or file a lien. In fact you would have a very good lawsuit against the hospital for fraud just for starters.

    That would be like someone mowing your lawn and you expecting them to charge $30 and then 45 minutes later they hand you a bill for 56 times a fair amount or $1680. Now what are you going to do pay it, because you are afraid they will lien your property . Get real.

  20. #20
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    Default Re: What a difference having health insurance makes

    Quote Originally Posted by RonW View Post
    So you really expect anyone to believe that you was billed $9300. for a x-ray ..That visit would have been about $300 at most with x-rays here.

    It would take an idiot to agree to pay that price .
    There are a lot of idiots out there...
    Privatized health care at it's finest, find a way to bilk the taxpayer.

  21. #21

    Default Re: What a difference having health insurance makes

    https://www.consumerreports.org/heal...y-negotiating/

    Sure, negotiate away. But I'm pretty sure you are not going to get them down to $167.
    But, you should not have to negotiate at all. The fact is that our system doesn't work for most people.

  22. #22
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    Default Re: What a difference having health insurance makes

    Quote Originally Posted by RonW View Post
    That's a joke and this whole thread is a joke. Let's recap, hospital bills individual $9340. but accepts payment from insurance company of $167 as payment in full. Really? Why ?
    The reason is obvious: some percentage of people treated, will not have health insurance. The hospital knows that thy won't get the full amount of the ridiculous charge, from these people, but by billing an absurdly high price, they can then 'settle' for an amount WELL OVER the $167 they'll accept from an insurance company. So, maybe the patient settles the bill for $1,000, which is a fraction of the $9340 billed amount.... and the hospital is delighted, since they got $8340 MORE from the patient, than they would have gotten from an insurance company for the same procedure.
    "Reason and facts are sacrificed to opinion and myth. Demonstrable falsehoods are circulated and recycled as fact. Narrow minded opinion refuses to be subjected to thought and analysis. Too many now subject events to a prefabricated set of interpretations, usually provided by a biased media source. The myth is more comfortable than the often difficult search for truth."







  23. #23
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    Default Re: What a difference having health insurance makes

    Yer maths are way out!

  24. #24
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    Default Re: What a difference having health insurance makes

    Except when you go to the wrong hospital or want to go outside your network.
    A large nose is the mark of a witty, courteous, affable, generous and liberal man. My feature suggests an excellent side kick of good index.

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    Default Re: What a difference having health insurance makes

    Quote Originally Posted by Norman Bernstein View Post
    The reason is obvious: some percentage of people treated, will not have health insurance. The hospital knows that thy won't get the full amount of the ridiculous charge, from these people, but by billing an absurdly high price, they can then 'settle' for an amount WELL OVER the $167 they'll accept from an insurance company. So, maybe the patient settles the bill for $1,000, which is a fraction of the $9340 billed amount.... and the hospital is delighted, since they got $8340 MORE from the patient, than they would have gotten from an insurance company for the same procedure.
    And the US of A are happy with this?
    Quote Originally Posted by John of Phoenix View Post
    Sweet Mother of God Americans are Stupid.
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  26. #26
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    Default Re: What a difference having health insurance makes

    Quote Originally Posted by Greg Nolan View Post
    What planet do you live on? entering an ER without insurance, you have exactly NO leverage to negotiate.
    It seems to work for a lot of people. You ask what they charge Medicare or insurers. They are kind enough to tell you. There are even people who find it profitable to negotiate for patients without insurance.

    I hope your health is good enough that you do not need to use your insurance.
    Life is complex.

  27. #27
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    Default Re: What a difference having health insurance makes

    Check your decimal points Norman before Ron offers it as proof that all liberals lie.

  28. #28
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    Default Re: What a difference having health insurance makes

    Quote Originally Posted by Norman Bernstein View Post
    The reason is obvious: some percentage of people treated, will not have health insurance. The hospital knows that thy won't get the full amount of the ridiculous charge, from these people, but by billing an absurdly high price, they can then 'settle' for an amount WELL OVER the $167 they'll accept from an insurance company. So, maybe the patient settles the bill for $1,000, which is a fraction of the $9340 billed amount.... and the hospital is delighted, since they got $8340 MORE from the patient, than they would have gotten from an insurance company for the same procedure.
    Better check your math, you are off by about $7500, or so.

    I go back to my original post #4, the same service here would cost about $300. not the absurd of price of $9300, unless people in new jersey are that gullible.

    I would expect the hospital to take cash of no more then twice the amount of what they would receive from insurance company.

    And as for this silliness of the hospital putting a lien of $9300 for services that they accept $167 for doesn't fly. If they was to lien, your lawyer gives them 30 days to file suit and prove the services as

    well as the legitimacy of the charges or the lien is cancelled. Period. And they would probably get a judgement and lien for about $300. But this would be settled early as they don't want to look like fools.

    And the judge could punish them thru a counter suit very easily for their attempt at Extortion

  29. #29
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    Default Re: What a difference having health insurance makes

    Quote Originally Posted by RonW View Post
    I would expect the hospital to take cash of no more then twice the amount of what they would receive from insurance company.
    You might 'expect' it... but you'd be wrong. The hospital sets its own prices, and there is nothing to preclude them from charging what they want. Will they settle for a lower amount? Sure. Will they settle for what an insurance company would have paid? Highly unlikely, except in circumstances where a patient is judgement-proof due to lack of assets.

    You don't seem the have ANY experience with this. Neither do I, but I DO have doctor friends who have confirmed what I've said; uninsured patients pay FAR more for a given procedure.

    But it doesn't matter. you seem to be fully accepting of the practice of charging uninsured patients far more than what they accept from insurance companies... and in fact, you even said that TWICE the charge would be reasonable.

    Is THAT the kind of medical care system this country ought to have?
    "Reason and facts are sacrificed to opinion and myth. Demonstrable falsehoods are circulated and recycled as fact. Narrow minded opinion refuses to be subjected to thought and analysis. Too many now subject events to a prefabricated set of interpretations, usually provided by a biased media source. The myth is more comfortable than the often difficult search for truth."







  30. #30
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    Default Re: What a difference having health insurance makes

    Creating Alternative Reality would be a hot IPO...

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    Default Re: What a difference having health insurance makes

    Is this really the process and legal expense you want to go thru every time you go to your doctor?

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    Default Re: What a difference having health insurance makes

    Quote Originally Posted by RonW View Post
    So you really expect anyone to believe that you was billed $9300. for a x-ray ..That visit would have been about $300 at most with x-rays here.

    It would take an idiot to agree to pay that price .
    That WAS the billed amount. I didn't make that up. That's my actual Explanation of benefits Here's another .healthcare 2.jpg
    How do we form a mutiny? Our new captain is navigating poorly.

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    Default Re: What a difference having health insurance makes

    ] health care capital 2.jpg


    .healthcare 2.jpg


    Problem with things matching up ?

  34. #34
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    Default Re: What a difference having health insurance makes

    [QUOTE=Too Little Time;5809101]
    Quote Originally Posted by John Smith View Post
    If I had no insurance, I would have been billed the entire charged amount, which I would not have been able to pay. The facility would not 'eat' that loss, but it would be passed on, probably to taxpayers.[/QUOTE]
    Your misunderstanding of the bill is typical.

    The submitted charges are the list prices. Those without insurance have the ability to negotiate a better price.

    Since the ACA, government payments for non compensated medical care have gone away.
    Have you ever tried, as an individual, to negotiate with a hospital?

    YOU ALL REALLY NEED TO FIND A COPY OF TIME FROM MARCH 5, '15, i BELIEVE It goes into all of this with great detail.
    How do we form a mutiny? Our new captain is navigating poorly.

  35. #35
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    Default Re: What a difference having health insurance makes

    Quote Originally Posted by Norman Bernstein View Post
    No, it would only take someone without health insurance, to be billed that much... and then hit with a lien if they can't pay.
    The point is, in the real world, people cannot pay these bills, but the hospital can pass them on to others.

    One way or another, they get paid. It costs ALL of us.
    How do we form a mutiny? Our new captain is navigating poorly.

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