Someone please explain to me how this works. Hospital bills $11,000, insurcance only pays $950. - Page 2

[ARCHIVED THREAD] - Someone please explain to me how this works. Hospital bills $11,000, insurcance only pays $950. (Page 2 of 4)

Posted: 1/9/2006 3:44:14 PM EDT

[#1]

Quoted:
Quoted:

I agree. I'm still amazed at the number of Libtards (including my brainwashed mother) who keep pointing to Canada and the UK and saying "look how good socialized medicine works there."

I spent three years living in England. It doesn't work there!

Yep it damn well does NOT work in Canada - what major hospital in the US that serves a population of 100k + people does not have an MRI machine?

You want socialized medicine Canadian style? Talk to my nurse wife and she'll give you pointers on how to have a Canadian style BAKE SALE to raise money for hospital equipment that is standard in even small US hospitals.

You forgot what happens when they DO have an MRI, my grandmother in law ties up the machine every 6 months or so with vague "dizziness" comments. She's a hypochondriac, and nobody cares, to humor her, she gets to give the equipment a workout.

Posted: 1/9/2006 3:44:56 PM EDT

[#2]

Quoted:
Quoted:

Absolutely, but since the profession is being taken over by women it isn't ever going to happen.

Doc....I believe you are a brilliant doctor......but where in the hell does this come from?

Ignorance

Posted: 1/9/2006 3:45:45 PM EDT

[#3]

Quoted:
Quoted:

Absolutely, but since the profession is being taken over by women it isn't ever going to happen.

Doc....I believe you are a brilliant doctor......but where in the hell does this come from?

Oh for crying out loud, why don't all you PC police take a break already. Geez, I really don't see why I should have to clarify everything I say. Maybe you guys and gals could just operate under the assumption that everything isn't racist, sexist, etc.

When I said that it referred to XX and XY karyotypes.
When I was a kid, docs seemed like they had balls. Not so much anymore.
And clearly the influx of women into profession has interjected a more socialist element.

Posted: 1/9/2006 3:48:01 PM EDT

[#4]

Quoted:
Hospitals suck, doctors suck and insurance companies suck the most.

Doctors suck?

Please don't come see any of us. Ever. Okay?

Posted: 1/9/2006 3:49:04 PM EDT

[#5]

Quoted:
Quoted:
Quoted:

Absolutely, but since the profession is being taken over by women it isn't ever going to happen.

Doc....I believe you are a brilliant doctor......but where in the hell does this come from?

Ignorance

Fuck you.

Posted: 1/9/2006 3:52:01 PM EDT

[#6]

As part of my practice, I often review medical bills and insurance payment records. Insurance payment records usually have a column that lists the amount charged and a separate column listing the amount they will pay for that particular procedure or item. The amount they ins. co will pay is usually less than 1/2 the amount charged; and it's not uncommon for the ins. co to pay less than 1/10th the amount charged for some things.

Health insurance companies pay for medical services at a contract rate that is much lower than what "cash basis" patients are charged. The discount described by the original poster is not unheard of. The contract rates are sometimes so low, and insurance companies are so unwilling to raise their rates, that doctors sometimes pad their bill to try to get more money from the insurance company. The arrangement has also resulted in overinflated charges for procedures and supplies.

Like someone else said, about the worst position to be in is a cash basis patient (uninsured) with money. You will be billed (or required to pay up front) the full amount of overinflated charges. And, unless you can negotiate a reduced rate on your own, you'll be on the hook for all of it.

Posted: 1/9/2006 3:54:19 PM EDT

[#7]

Quoted:
Oh for crying out loud, why don't all you PC police take a break already. Geez, I really don't see why I should have to clarify everything I say. Maybe you guys and gals could just operate under the assumption that everything isn't racist, sexist, etc.

When I said that it referred to XX and XY karyotypes.
When I was a kid, docs seemed like they had balls. Not so much anymore.
And clearly the influx of women into profession has interjected a more socialist element.

PC police my ass......I simply don't believe that gender is the problem with what is broken in the "business" of medicine.

There are plenty of male doctors with no "balls".

Posted: 1/9/2006 3:55:04 PM EDT

[#8]

Adding some backround here:

1)doctors don't really get to set their fees, with some exceptions such as cosmetic surgery. A physician who tries to charge a patient less than what they charge medicare patients will be fined and possibly arrested for medicare fraud (under the auspice that we are overcharging the govt by doing so). We can do it for free, but we cannot cdo it for a fee less than medicare.

2)The bill from the hospital is separate from the bill from the doctor. The hospital bill is always much bigger. The hospital also cannot charge less than they charge medicare because of possible medicare fraud charges.

3)many insurance companies allow their adjusters to pay out a maximum amount per day, say $2500 when paying claims. Most will reach that tally before noon, and spend the rest of the day denying claims based on a flowsheet of excuses to use. If they cannot find a suitable excuse, the claim goes to a supervisor who has another sheet of excuses/disqualifiers.

4)United Healthcare spent some $100 million in 2002 in costs to deny claims that they ended up later approving at a rate of over 93%. Think about it - wasting $100 million in paperwork and employee costs instead of paying that for actual care of their subscribers.

5)medicare basically sets all the guidelines for fees and reimbursement. Insurance companies pay at a rate multiplyer of medicare - 1.x of medicare fees. When medicare changes, everyone else follows. Medicare changes their reimbursement rates, diagnosis and procedure codes many times over each year - and they do so without informing the doctors. This practice is even more confusing than the IRS tax codes. Most people in the medical and insurance business have no idea of what is the correct current protocol at any given time.

6)medicare, malpractice, and insurance companies are what have screwed up healthcare. Very little of each healthcare dollars is for care anymore. 1 doctor probably needs at a minimum 4-6 employees to keep in practice- 1 nurse, 1 receptionist, and 2-4 people in billing and collections.

Posted: 1/9/2006 4:01:12 PM EDT

[#9]

Quoted:
4)United Healthcare spent some $100 million in 2002 in costs to deny claims that they ended up later approving at a rate of over 93%.

Do you have proof of that?

Posted: 1/9/2006 4:01:38 PM EDT

[#10]

Quoted:
Quoted:
Oh for crying out loud, why don't all you PC police take a break already. Geez, I really don't see why I should have to clarify everything I say. Maybe you guys and gals could just operate under the assumption that everything isn't racist, sexist, etc.

When I said that it referred to XX and XY karyotypes.
When I was a kid, docs seemed like they had balls. Not so much anymore.
And clearly the influx of women into profession has interjected a more socialist element.

PC police my ass......I simply don't believe that gender is the problem with what is broken in the "business" of medicine.

There are plenty of male doctors with no "balls".

And didn't I say that you stupid fuck?

Posted: 1/9/2006 4:04:31 PM EDT

[#11]

Quoted:
The Mrs had to have some surgery a few months back. The hospital part of the bill was just short of $11,000, insurcance only paid $950 and said we had to pay about $500.

Now if we did not have insurance we would be on the hook for $11,000. But yet the insurance only had to pay $950 and it's even. What's up with that?

And this is why the entire medical insurance/medical fee system is approaching a collapse point.

There is a stream of money for healthcare, and it used to go:


Patient----->Doctor/Hospital/Nurses

Now, the system is something more like this:

Patient----->Premiums to Insurance Company----->Partial Payment to Hospital/Doctorcorp
          \
            --->Copay----->Hospital/Doctorcorp----->Doctor/Nurse/Tech----->Insurance carriers (Malpr.)
             \                  /         \
               ---->Coinsurance/            --->In-house insurance filing experts/clerks
                                           \
                                              ->Insurance carriers (Malpractice)

And the doctor's office gets something like this:

Doctorcorp <-----Copay and Coinsurance (Partial payment)
                   \
                      Insurance Payment  (Partial payment)
                       \
                         Write off (MAJORITY of billed cost)

More and more people are establishing themselves as middlemen. Billed costs are rapidly inflating, because the medical professionals need to actually _receive_ enough to support their operations. The fat checks for premium medical care are in fact going mostly to fund legal and clerical careers, major write-offs are "saving" insurance companies money (but not reducing consumers' premiums) and people who pay cash are finding medical offices unwilling to negotiate much--because cash transactions are the only serious profit they can expect to make. The only major writeoffs I've seen on cash transactions were for people who clearly would never be able to pay at all.

A large portion of the problem is that insurance isn't used as insurance, it's used as a primary payment plan for normal medical expenses. I'd rather have medical insurance to pay or help pay when I have a car accident, or when I cut my thumb off with a band saw, or when I have a heart attack. I'd rather spend my own money for my office visit for a sinus infection, or for a broken toe, where the expenses should be (without the inflated insurance-based "cost" setting the price) perfectly reasonable--in much the same way that I'd prefer to replace two shingles myself rather than call in the homeowner's insurance.

The whole medical insurance system is a house of cards, and there's a stiff wind coming...

Posted: 1/9/2006 4:07:45 PM EDT

[#12]

Quoted:
Quoted:
The Mrs had to have some surgery a few months back. The hospital part of the bill was just short of $11,000, insurcance only paid $950 and said we had to pay about $500.

Now if we did not have insurance we would be on the hook for $11,000. But yet the insurance only had to pay $950 and it's even. What's up with that?

And this is why the entire medical insurance/medical fee system is approaching a collapse point.

There is a stream of money for healthcare, and it used to go:

Patient----->Doctor/Hospital/Nurses

Now, the system is something more like this:

Patient----->Premiums to Insurance Company----->Partial Payment to Hospital/Doctorcorp
\
--->Copay----->Hospital/Doctorcorp----->Doctor/Nurse/Tech----->Insurance carriers (Malpr.)
\ / \
---->Coinsurance/ --->In-house insurance filing experts/clerks
\
->Insurance carriers (Malpractice)

And the doctor's office gets something like this:

Doctorcorp <-----Copay and Coinsurance (Partial payment)
\
Insurance Payment (Partial payment)
\
Write off (MAJORITY of billed cost)

More and more people are establishing themselves as middlemen. Billed costs are rapidly inflating, because the medical professionals need to actually _receive_ enough to support their operations. The fat checks for premium medical care are in fact going mostly to fund legal and clerical careers, major write-offs are "saving" insurance companies money (but not reducing consumers' premiums) and people who pay cash are finding medical offices unwilling to negotiate much--because cash transactions are the only serious profit they can expect to make. The only major writeoffs I've seen on cash transactions were for people who clearly would never be able to pay at all.

A large portion of the problem is that insurance isn't used as insurance, it's used as a primary payment plan for normal medical expenses. I'd rather have medical insurance to pay or help pay when I have a car accident, or when I cut my thumb off with a band saw, or when I have a heart attack. I'd rather spend my own money for my office visit for a sinus infection, or for a broken toe, where the expenses should be (without the inflated insurance-based "cost" setting the price) perfectly reasonable--in much the same way that I'd prefer to replace two shingles myself rather than call in the homeowner's insurance.

The whole medical insurance system is a house of cards, and there's a stiff wind coming...

Yes it is and yes there is.

Posted: 1/9/2006 4:11:21 PM EDT

[#13]

Quoted:
Quoted:
4)United Healthcare spent some $100 million in 2002 in costs to deny claims that they ended up later approving at a rate of over 93%.

Do you have proof of that?

They even broadcast it as a commercial at one point. It may have been 1999, it was their utilization review policy.

Posted: 1/9/2006 4:13:20 PM EDT

[#14]

Quoted:
Quoted:
Quoted:
4)United Healthcare spent some $100 million in 2002 in costs to deny claims that they ended up later approving at a rate of over 93%.

Do you have proof of that?

They even broadcast it as a commercial at one point. It may have been 1999, it was their utilization review policy.

Smells like

.
Why on earth would they advertise that?

Posted: 1/9/2006 4:13:50 PM EDT

[#15]

Quoted:
Quoted:
Quoted:
Oh for crying out loud, why don't all you PC police take a break already. Geez, I really don't see why I should have to clarify everything I say. Maybe you guys and gals could just operate under the assumption that everything isn't racist, sexist, etc.

When I said that it referred to XX and XY karyotypes.
When I was a kid, docs seemed like they had balls. Not so much anymore.
And clearly the influx of women into profession has interjected a more socialist element.

PC police my ass......I simply don't believe that gender is the problem with what is broken in the "business" of medicine.

There are plenty of male doctors with no "balls".

And didn't I say that you stupid fuck?

Please provide the quote where you said something even remotely similar.........

Posted: 1/9/2006 4:16:49 PM EDT

[#16]

Quoted:
I can see this thread is spinning out of control.

NO ONE IS GOING TO PAY ONLY $1450 FOR AN $11,000 PROCEDURE. IT AIN'T GOING TO HAPPEN.

THE ONLY PEOPLE WHO WILL GET OFF THAT CHEAP ARE THE ONES WHO JUST DON'T PAY.

They might knock off 10-15% for a capitated contract but that's about it generally.

You know not of what you speak. Hostitals routinely obscenely overbill, and reductions of 75% or more are not at all uncommon.

I had exactly the same experience a couple months ago. I was taken to the hospital after a two story fall. They did some CT scans, took some x-rays, and kept me overnight. The bill came to about $22,000. Insurance paid $4500, I paid $1000, and the rest they wrote off as a contractual adjustment.

I've seen the same thing happen many times with all sorts of medical bills.

Posted: 1/9/2006 4:20:27 PM EDT

[#17]

Quoted:
Quoted:
Quoted:
Quoted:
Oh for crying out loud, why don't all you PC police take a break already. Geez, I really don't see why I should have to clarify everything I say. Maybe you guys and gals could just operate under the assumption that everything isn't racist, sexist, etc.

When I said that it referred to XX and XY karyotypes.
When I was a kid, docs seemed like they had balls. Not so much anymore.
And clearly the influx of women into profession has interjected a more socialist element.

PC police my ass......I simply don't believe that gender is the problem with what is broken in the "business" of medicine.

There are plenty of male doctors with no "balls".

And didn't I say that you stupid fuck?

Please provide the quote where you said something even remotely similar.........

You really are one dumb SOB. It is right above.
If it ain't good enough for you then fuck off. Hell, fuck off anyway. All you PC assholes that roam around here trying to tell everyone how to think or post need to be told to fuck off. Assholes, everyone of you.

Posted: 1/9/2006 4:25:51 PM EDT

[#18]

Quoted:

You know not of what you speak. Hostitals routinely obscenely overbill, and reductions of 75% or more are not at all uncommon.

News to me. I sure haven't seen anything like that around here with the exception of Medicare and Medical Assistance patients. Not with private insurance.

I have worked places where we had collections as low as 50% but that was, again, almost all govt sponsored healthcare. Needless to say it was impossible to ever meet the targets the administration set for you when they were only collecting 50%. I think the highest we ever got to at that clinic was approx 60%.

Posted: 1/9/2006 4:29:11 PM EDT

[#19]

Quoted:
Quoted:
Quoted:
Quoted:
Quoted:
Oh for crying out loud, why don't all you PC police take a break already. Geez, I really don't see why I should have to clarify everything I say. Maybe you guys and gals could just operate under the assumption that everything isn't racist, sexist, etc.

When I said that it referred to XX and XY karyotypes.
When I was a kid, docs seemed like they had balls. Not so much anymore.
And clearly the influx of women into profession has interjected a more socialist element.

PC police my ass......I simply don't believe that gender is the problem with what is broken in the "business" of medicine.

There are plenty of male doctors with no "balls".

And didn't I say that you stupid fuck?

Please provide the quote where you said something even remotely similar.........

You really are one dumb SOB. It is right above.
If it ain't good enough for you then fuck off. Hell, fuck off anyway. All you PC assholes that roam around here trying to tell everyone how to think or post need to be told to fuck off. Assholes, everyone of you.

Dude put down your crack pipe..............

You really need professional help.

Good Luck.

Posted: 1/9/2006 4:29:30 PM EDT

[#20]

Quoted:
Quoted:
Quoted:
Quoted:
Quoted:
Oh for crying out loud, why don't all you PC police take a break already. Geez, I really don't see why I should have to clarify everything I say. Maybe you guys and gals could just operate under the assumption that everything isn't racist, sexist, etc.

When I said that it referred to XX and XY karyotypes.
When I was a kid, docs seemed like they had balls. Not so much anymore.
And clearly the influx of women into profession has interjected a more socialist element.

PC police my ass......I simply don't believe that gender is the problem with what is broken in the "business" of medicine.

There are plenty of male doctors with no "balls".

And didn't I say that you stupid fuck?

Please provide the quote where you said something even remotely similar.........

You really are one dumb SOB. It is right above.
If it ain't good enough for you then fuck off. Hell, fuck off anyway. All you PC assholes that roam around here trying to tell everyone how to think or post need to be told to fuck off. Assholes, everyone of you.

+1.

Posted: 1/9/2006 4:35:30 PM EDT

[#21]

Quoted:
Quoted:
Quoted:
Quoted:
Quoted:
Quoted:
Oh for crying out loud, why don't all you PC police take a break already. Geez, I really don't see why I should have to clarify everything I say. Maybe you guys and gals could just operate under the assumption that everything isn't racist, sexist, etc.

When I said that it referred to XX and XY karyotypes.
When I was a kid, docs seemed like they had balls. Not so much anymore.
And clearly the influx of women into profession has interjected a more socialist element.

PC police my ass......I simply don't believe that gender is the problem with what is broken in the "business" of medicine.

There are plenty of male doctors with no "balls".

And didn't I say that you stupid fuck?

Please provide the quote where you said something even remotely similar.........

You really are one dumb SOB. It is right above.
If it ain't good enough for you then fuck off. Hell, fuck off anyway. All you PC assholes that roam around here trying to tell everyone how to think or post need to be told to fuck off. Assholes, everyone of you.

Dude put down your crack pipe..............

You really need professional help.

Good Luck.

I need help? LMAO.
You're the one who made something out of nothing, Then even when I clarified it for the braindead amongst you it was beyond your reading comprehension level. 4th Grade I see. Then I tried again. You still had to push it. And I need help?
FOAD.

Posted: 1/9/2006 4:42:28 PM EDT

[#22]

You're right my reading comprehesion is clearly lacking.......

Because you said "and Clearly the influx of women into (the) profession has interjected a more socialist element"

And I said I don't believe gender has anything to do with it.

And you said "That's what I said you stupid fuck"

Yep my comprehension is sorely lacking.

Posted: 1/9/2006 5:24:26 PM EDT

[#23]

Quoted:

Smells like .
Why on earth would they advertise that?

In November 1999 UnitedHealth announced plans to end its utilization review policy. This policy gave UnitedHealth employees, instead of doctors, the final say in treatment decisions. The tactic, which is practiced at many health maintenance organizations, has gained the ire of the public, doctors, and congress. As a result, United's move has produced a bevy of positive PR and placated many angry customers. Following the policy shift, The Wall Street Journal reported that the initiative was seen as an "industry watershed" that could spawn a wave of similar moves from other managed-care plans. Already Aetna/US Healthcare is discussing a similar move.

www1.iwon.com/home/careers/company_profile/0,15623,30,00.html

United Healthcare Tackles Utilization Review
In June 2000, UnitedHealthcare presented its new model of care coordination, being implemented following a review of its utilization review process. The plan found that utilization review efforts amounted to 3 percent of the services being denied.

www.massmed.org/AM/Template.cfm?Section=Your_Practice31&CONTENTID=8739&TEMPLATE=/CM/ContentDisplay.cfm

The public advertisement did not divulge the amount of money wasted of course. That was through some flyers physicians were mailed. It was a major ppolicy change at the time.

Posted: 1/9/2006 5:42:23 PM EDT

[#24]

Quoted:
Quoted:
Hospitals suck, doctors suck and insurance companies suck the most.

Doctors suck?

Please don't come see any of us. Ever. Okay?

+1 next time you are sick or break your arm, go fuck yourself and the horse you rode into town on. Believe us we wont miss you one bit.

Posted: 1/9/2006 5:44:27 PM EDT

[#25]

Quoted:
Quoted:
Quoted:
Quoted:

Absolutely, but since the profession is being taken over by women it isn't ever going to happen.

Doc....I believe you are a brilliant doctor......but where in the hell does this come from?

Ignorance

Fuck you.

No thanks, and PS you're still ignorant

Posted: 1/9/2006 5:50:07 PM EDT

[#26]

Man some people are having Pit withdrawal.

Posted: 1/9/2006 6:05:23 PM EDT

[#27]

Posted: 1/9/2006 6:11:40 PM EDT

[#28]

Quoted:
Quoted:
Quoted:

Absolutely, but since the profession is being taken over by women it isn't ever going to happen.

Doc....I believe you are a brilliant doctor......but where in the hell does this come from?

Oh for crying out loud, why don't all you PC police take a break already. Geez, I really don't see why I should have to clarify everything I say. Maybe you guys and gals could just operate under the assumption that everything isn't racist, sexist, etc.

When I said that it referred to XX and XY karyotypes.
When I was a kid, docs seemed like they had balls. Not so much anymore.
And clearly the influx of women into profession has interjected a more socialist element.

However, some comments clearly ARE racist/ sexist; do you not recognize that?

I think it would be more appropriate to blame the lawyers that affect all aspects of medicine.

I don't understand the guys who are so busy slamming women every chance you get; do you hide that aspect of your personalities from the women in your lives? Maybe thats why so many of you are having lousy relationships, with the anti-female attitudes I see so often here. Unrepentant troglodytes.

Posted: 1/9/2006 7:53:09 PM EDT

[#29]

First of all, DrJarhead is far from dumb or sexist. The truth is that ANY profession is which women have made inroads have suffered declining income. This is fact. Any economist will tell you this.

For example take my profession. More and more OB/GYNS are women. Since the influx of women into this field the nominal pay has dropped precipitously. My partner who is a female will tell you, its all the bitches that are making our pay go down. She was in practice with all the guys and can tell you when doctors made real money. She hates working with other women and says they are much more difficult to work with and have a real partnership with one. She considers me her little brother and takes care of me and watch my back and I do the same for her. We will go to the mat for each other. But in large female dominated groups the back stabbing and fighting is awesome.

There are several reasons for this. First female docs work about half the hours that male OB/GYNs do. This is due to children, choice and lifestyle options. Most men like me are workaholics and will work until we drop. Some of the females, like my partner are also like that. But there are several women docs that work half time. They work less and get paid more.

Obviously, HMOs and insurance have also cause a decline in the income.

Another good example is in Russia. Where most of the doctors are female. There is little respect and the pay is even less.

There is no sexism here, but only the pragmatic truth.

Posted: 1/9/2006 7:54:59 PM EDT

[#30]

Forgot to add, so more female doctors that work less. So they make less. When my contract came up for review the hospital wanted to pay me the average of the all the doctors pay. When you counted in the females that worked a lot less hours but were considered full time, the average pay plummeted.

ETA, You guys and gals should really know Kevin's credentials. He has more education and intelligence then several of you combined, me included. He is getting a little reiled up about a topic he feels strongly about, but always know its not the lack of intelligence or smarts.

Posted: 1/9/2006 7:58:28 PM EDT

[#31]

yep i got a bill for $4500
i always wait to pay as i have seen they bill me before insurance has a chance to get at it
got a statement of benifits about a month later my insurance paid $700 to settle the bill
just like anything else buy in bulk and on time and you get huge discounts

Posted: 1/9/2006 8:03:05 PM EDT

[#32]

Ok, here is a hint for some of you who get bills from the hospital. Never pay what they ask. Get your ass to the hospital and make an appointment with the hospital finance person. Tell them you want to pay medicaid rates or what an HMO would have paid to settle the bill. If they say no then tell them you will not pay and that they should call the collection agency now.

They will take what they can get.

This will not work with private doctors but will with hospitals.

A little information and education will go a long way towards saving money.

Posted: 1/9/2006 8:21:49 PM EDT

[#33]

Welcome to my world of the Totally Screwed. I was diagnosed with degenerative disc disease at 18. I had two surgeries to repair 2 herniated discs. Now, I cannot get insurance to cover my pre-existing back condition. So 2 years ago I blow out another disc. I had surgery. The total bill was $23,000. This was not a fusion, but a discetomy. I have been paying if of for the past two years. I only owe another $3,300 or so. I don't mind paying for the surgery, but give me a fucking break. Somewhere between the group rate and the full price would have been nice. When I'm done paying this bill, I'll finally have enough left over to pay for insurance. However, I'll have to pay for anything related to my back. Maybe next time I should just say "Fuck it !" and file for bankruptcy. Problem is, I'm not a deadbeat.

Posted: 1/9/2006 8:23:14 PM EDT

[#34]

Quoted:
Welcome to my world of the Totally Screwed. I was diagnosed with degenerative disc disease at 18. I had two surgeries to repair 2 herniated discs. Now, I cannot get insurance to cover my pre-existing back condition. So 2 years ago I blow out another disc. I had surgery. The total bill was $23,000. This was not a fusion, but a discetomy. I have been paying if of for the past two years. I only owe another $3,300 or so. I don't mind paying for the surgery, but give me a fucking break. Somewhere between the group rate and the full price would have been nice. When I'm done paying this bill, I'll finally have enough left over to pay for insurance. However, I'll have to pay for anything related to my back. Maybe next time I should just say "Fuck it !" and file for bankruptcy. Problem is, I'm not a deadbeat.

There are very few people like you that take personal responsibility. Most medicaid recipients bitch that they dont get everything free.

Posted: 1/9/2006 8:26:11 PM EDT

[#35]

Thanks ARDOC.

I'm a law school graduate. I know that I could never challenge the insurance company on my "pre-existing" condition. So, I'm just screwed for life.

Posted: 1/9/2006 8:44:07 PM EDT

[#36]

Quoted:
Thanks ARDOC.

I'm a law school graduate. I know that I could never challenge the insurance company on my "pre-existing" condition. So, I'm just screwed for life.

ahh never mind i was think of CHIP
I think you have to be under 18 to sign up

Posted: 1/9/2006 8:46:38 PM EDT

[#37]

Quoted:
Quoted:
Thanks ARDOC.

I'm a law school graduate. I know that I could never challenge the insurance company on my "pre-existing" condition. So, I'm just screwed for life.

is there not some sort of state sponsered "pool" health insurance for uninsurible people in IA?
nebraska has it you get enrolled in basiclly the same plan as state employees at about the same rate

Most states have this but is very expensive. Also, there are the health maintnance accounts that could save you some money. But with those back problems I think his problems are more severe then what he could save or pay.

Posted: 1/9/2006 8:48:51 PM EDT

[#38]

Quoted:
Thanks ARDOC.

I'm a law school graduate. I know that I could never challenge the insurance company on my "pre-existing" condition. So, I'm just screwed for life.

Its not too late to make a deal. Go to the hospital and talk to their finance person. You need ammo before you go. Get the quotes for what medicaid and other insurances would have paid for the surgeries. Then you go in and tell them thats what you want to pay. If they say no, tell them you are going to file for BK and that you would stop paying them at all.

I bet they will cooperate. But preparation is key and you need the numbers before you go in. Good luck but as a lawyer you should have no problems laying the ground work before you go.

Posted: 1/9/2006 8:51:24 PM EDT

[#39]

I just got an Explanation of Benefits from my Insurance Co. I had some labwork done and the billed amount was $178.50 and the amount paid was $22.58.

These things I find irritating, but what really irks me is my Doc prescribed medicine that we thought would benefit me and the insurance co refuses to cover it. I am glad somebody that is sitting behind a desk God knows where is able to determine what medication I should be taking. Because clearly my family doc is a quack.

Posted: 1/9/2006 8:53:58 PM EDT

[#40]

Quoted:
I just got an Explanation of Benefits from my Insurance Co. I had some labwork done and the billed amount was $178.50 and the amount paid was $22.58.

These things I find irritating, but what really irks me is my Doc prescribed medicine that we thought would benefit me and the insurance co refuses to cover it. I am glad somebody that is sitting behind a desk God knows where is able to determine what medication I should be taking. Because clearly my family doc is a quack.

The best part is that, some high school drop out is over-ruling your doctor for the correct course of treatment.

Posted: 1/9/2006 9:00:00 PM EDT

[#41]

Sounds to me like the original poster needs to thank his everluvin' lucky stars that his insurance carrier had a deal with the hospital.

...and that he didn't get a denial letter stating : " Payment DENIED due to charges being OVER AND ABOVE THE USUAL AND CUSTOMARY PRICES FOR YOUR AREA"

(Translation): Screw you, we ain't payin' your medical bills even though that's what you pay out the ass for us to do......oh yeah, your premium's going up next month too.

Posted: 1/9/2006 9:29:26 PM EDT

[#42]

Quoted:
Quoted:
I just got an Explanation of Benefits from my Insurance Co. I had some labwork done and the billed amount was $178.50 and the amount paid was $22.58.

These things I find irritating, but what really irks me is my Doc prescribed medicine that we thought would benefit me and the insurance co refuses to cover it. I am glad somebody that is sitting behind a desk God knows where is able to determine what medication I should be taking. Because clearly my family doc is a quack.

The best part is that, some high school drop out is over-ruling your doctor for the correct course of treatment.

That was my point exactly. But hey, there keeping my costs down.

Self insured, $1000/mo., Prescription meds, $200/mo., extemely high deductables, copays if I blow my nose. Do I sound like a fan of insurance companies. I am seriously thinking about a Health Savings Account and only carrying Insurance for hospitalization/catastrophic illness. I know I currently pay much more out of pocket per month than the insurance company reimburses.

ETA: The problem with doing a Health Savings Account is I am not sure if I could get the medicare negotiated fee structure or if I would be stuck paying those higher full fee costs that started this whole thread!!

Posted: 1/9/2006 10:39:41 PM EDT

[#43]

Quoted:
ETA, You guys and gals should really know Kevin's credentials. He has more education and intelligence then several of you combined, me included. He is getting a little reiled up about a topic he feels strongly about, but always know its not the lack of intelligence or smarts.

Know what, there is nothing wrong with passion....but Kevin has problems and to deny that is fantasy.

Not to admit that is just enableing him.......

Help him out.......you know he needs it.

Posted: 1/9/2006 11:05:14 PM EDT

[#44]

Quoted:
Quoted:
ETA, You guys and gals should really know Kevin's credentials. He has more education and intelligence then several of you combined, me included. He is getting a little reiled up about a topic he feels strongly about, but always know its not the lack of intelligence or smarts.

Know what, there is nothing wrong with passion....but Kevin has problems and to deny that is fantasy.

Not to admit that is just enableing him.......

Help him out.......you know he needs it.

Not really, I think he has strong opinions. But not more so then others here. But in this case he is correct. The infusion of females into this profession is one of the causes of the decline in income inaddition to all the other factors such as insurance and the use of technology. Long boring papers have been written that has compared our system and those of others that are dominated by women. In each case, the income is significantly lower.

Posted: 1/9/2006 11:19:33 PM EDT

[#45]

In a word: Contractuals.

We as a Healthcare organization are forced to accept whatever the Insurance assholes deem as "reasonable and customary" which is akin to allowing the car dealer to tell YOU what you're willing to pay.

For example, the "reasonable and customary" money that BCBS and Mediscare pay my department on a $3000.00 charge is not enough to cover the cost of the technicians that run it.

In short, You probably had a $500 copay for surgery, the Hospital was paid a "Reasonable and customary" fee of $950 of their $11,000 charge and wrote the rest off as contractual deductions.

You can thank Mediscare and Blue Cross of Alabama for the fact that ALL of the hospitals in Birmigham are going into the shitter financially, save UAB who exists on reasearch dollars the rest of us don't get, and for the EXACT rreasons above.

If the damn insurance companies and the governent would simply allow the market to drive what we cahrge, Healthcare costs would regulate to something resembling reasonable, nad hospitals could focus on caring for people instead of wondering how to keep the fucking doors open.

SG

Posted: 1/9/2006 11:22:24 PM EDT

[#46]

My wife works at a hospitol and after I had a surgery I needed some extra bandages. These were just normal gauze, about 8"x4". The hospitol billed my insurance $18 a piece for these. BC/BS paid $2 something and the hospitol wrote off the rest. If you don't have insurance you get screwed.

Posted: 1/9/2006 11:28:21 PM EDT

[#47]

Quoted:
My wife works at a hospitol and after I had a surgery I needed some extra bandages. These were just normal gauze, about 8"x4". The hospitol billed my insurance $18 a piece for these. BC/BS paid $2 something and the hospitol wrote off the rest. If you don't have insurance you get screwed.

If we DIDN'T charge $18 we'd end up giving you the bandage for free, because we wouldn't get paid for it at all at it's regular price.

Insurance companies are the minions of Satan.

SG

Posted: 1/9/2006 11:32:23 PM EDT

[#48]

Quoted:
Quoted:
My wife works at a hospitol and after I had a surgery I needed some extra bandages. These were just normal gauze, about 8"x4". The hospitol billed my insurance $18 a piece for these. BC/BS paid $2 something and the hospitol wrote off the rest. If you don't have insurance you get screwed.

If we DIDN'T charge $18 we'd end up giving you the bandage for free, because we wouldn't get paid for it at all at it's regular price.

Insurance companies are the minions of Satan.

SG

That's fine but what about the poor SOB with a family that for some reason can't or doesn't have insurance, should he get stuck paying $18 for a $2 bandage just because he is down on his luck.

Posted: 1/9/2006 11:34:09 PM EDT

[#49]

Quoted:

Not really, I think he has strong opinions. But not more so then others here. But in this case he is correct. The infusion of females into this profession is one of the causes of the decline in income inaddition to all the other factors such as insurance and the use of technology. Long boring papers have been written that has compared our system and those of others that are dominated by women. In each case, the income is significantly lower.

Where the hell does income of doctors come into this discussion?

I would like to see you post any credible links to support the fact that "an influx of women into the medical profession"( even if they are girly men) has in anyway caused a decline in the payment of insurance or especially the use of technology.

If you don't think that drjarhead has anger issues against women you are blind.

Posted: 1/9/2006 11:34:50 PM EDT

[#50]

Doesn't quite seem right....

[ARCHIVED THREAD] - Someone please explain to me how this works. Hospital bills $11,000, insurcance only pays $950. (Page 2 of 4)

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