Why do hospitals have their people send separate bills?

quote:

---

Why do I receive separate bills from the hospital and from the physician? When a physician specialist performs these services, he/she is generally required to submit their bill separate from the hospital's bill. For example, if you came to the emergency room and had an x-ray and laboratory tests, you may receive a bill from the hospital for technical resources, a bill from the emergency room physician for professional services, a bill from the radiologist for interpreting any x-rays, and a bill from the pathologist for analyzing any specimens taken.

---

Interestingly enough googling the above question gave a plethora of answers... who would have thought

It's always nice when you get hit with the out of network charges for the ER physician.

And... Hospital bills are generally total bullshite. I remember getting charged $300 from some Dr for observing. He didn't do shite.

quote:

---

Why are they all separate? Why not just one itemized bill? 

---

One bill would require all these individuals to submit their billing and receive their reimbursement through the hospital. That is not the way it works-many physicians are self employed or employed by a group that handles their billing. Not sure how to explain it other than "that's the way it is." It would definitely require vast increase in hospital billing staff and further increase overhead. It's also sort of preference. I bill for my services to you rather than having an uninvolved middle man do it based off what I tell them to do. And if I work multiple places, I don't have multiple middle men with different standards.

quote:

---

it seems to me that it would be far easier to just have the hospital do it. After all, that is the only place I was the entire time. 

---

Here's the thing- if they bill you separately,I can all but guarantee you they work some place other than the hospital. So to bill for outpatient services through their clinic, they already have a billing department because they need one. This way, they don't have to be burdened with the salary of the billing department at each facility where they bill, they just use their own ( or even their self).

quote:

---

Imagine if hotels did this: one bill from the front desk staff, one from the cleaning crew, one from the hotel owners, one from the pillow unit.... it would be crazy... yet with hospitals we just take it as normal.

---

While this is partially accurate, as above, these folks aren't providing high-value, high-dollar services with high regulatory burden at multiple locations. Perhaps you suggest that these groups only get paid through the hospital. This is actually somewhat the idea behind the "bundle payment" system that is being put into place by CMS. There are potential downfalls-namely a greedy hospital that forces out quality providers for budget-friendly poorly qualified folks.


The medical system is absurd. There are lots of things that are terrible about it. But the longer I work in it, the more I realize most of the solutions are worse.

Health care is a fricking racket in this country. Could you imagine if other places worked the way hospitals do?

What if you went to a restaurant where the meal on the menu was $20 but your bill was $100 because they brought in a gourmet chef from the restaurant down the street to make it.

A lot of them are self employed or employed by a firm that the hospital contracts out.

I was taken to an ER and subsequently admitted for a true emergency (not the flu) last year. While being worked up in the ER, I learned that the hospital I was in (OLOL) was out of network but the General was in network. I couldn't leave OLOL at that point since I was admitted and undergoing treatment.

I asked multiple times to see someone from billing or a case worker as I was worried about the insurance situation. No one ever came to see me. I got out of there as soon as I could.

I ended up receiving a massive bill and zero insurance coverage. Yay. So I call OLOL billing and relate my story with the hope of negotiating a cash payment within reason. The lady on the phone immediately says they will "submit my case for review" and gets off the phone. Since that time, I haven't received a call, a bill, an email or any other contact.

What gives? What is a reasonable time frame to hear from a hospital? It has been months.