re: Hospital overcharging BS

Gotta love EMTALA

Gotta love Federal mandates with no federal funding to back it.

That is the submit price. You should get another statement from your insurance company once the reimbursement is complete. You’ll see that the reimbursement is much closer to the amazon price.

quote:

---

That is the submit price. You should get another statement from your insurance company once the reimbursement is complete. You’ll see that the reimbursement is much closer to the amazon price.

---

Exactly...if the hospital had charged $50 for the brace...insurance would have only reimbursed them like $5 for it.

quote:

---

It's ridiculous though. NPR did a story on a lady that went to the doctor for the flu or cold. The doctor gave here antibiotics but also ran a bunch of test on her blood samples. The doctor owned or worked for the test lab and rung up a $25000+ bill. Lady paid her out of network deductible and insurance had to pay for the $25k. We all end up paying that back in premiums.

---

You don't know the half of it, Aunt was an accountant at a Major Hospital, and she would show us and tell us all about the inflation of prices. It was sort of disgusting what they get away with, so much sliminess, all under the guise of NON Profit. LOL

quote:

---

I'm not sure what the solution is but it's definitely a broken system.

---

Part of the problem is most of the individuals and companies within the healthcare system are reasonably well compensated as are the insurance companies. Add to that that medical care as a whole has become highly politicized and like the ball in a balanced rugby scrum it never moves very far.

The fear of making things worse effectively paralyzes most any attempt at change.

quote:

---

Hospitals do make almost all of their profits from private insurance though.

---

Not where I work. Safety net hospital. I think like 80% of our reimbursements is from Medicaid(AHCCCS here in AZ) and Medicare.

When I was at the bedside I can remember being shocked when I realized a patient of mine had private insurance

quote:

---

The lack of price transparency is my biggest issue with the system. It's normally one of a family/individual's largest expenses and it's the only one where we don't know how much it's going to cost until after the service is rendered and you're responsible for payment. People can't make rational decisions about cost because the provider and insurance get together after the fact and figure out how much it's going to cost you.

---

This is the main thing the administration is going after. But again, the industry is fighting tooth and nail.

quote:

---

Like you alluded earlier, the hospital can charge the insurance company whatever it wants. It could charge $100000 for an aspirin but the insurance company will say “nah, here’s what you get”.

---

Exactly. And then the hospital will say "oh ok, thanks" and usually drop the rest of the charges.

For one of my outpatient surgeries I think the hospital charged my insurance company like 30K. The insurance company reimbursed less than half of that. Did I get a bill for the difference from the hospital? No. But I did pay my copay and outpatient surgery deductible prior to checking in for surgery. Got a separate bill later on from the anesthesiologist and surgeon.

ETA: Think I paid a total of 4k out of pocket for it

Next time OP, go to an urgent care and not the ED.