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re: Big price difference between 2 medical service providers for same procedure - acceptable?
Posted on 9/20/22 at 12:56 pm to Turf Taint
Posted on 9/20/22 at 12:56 pm to Turf Taint
you get what you pay for
Posted on 9/20/22 at 12:57 pm to WaWaWeeWa
quote:
TLDR point is that we don’t need to tear the system down. The billing issues just need to be reworked.
The billing issues create tremendous inefficency up and down the system. The costs of operating such a billing system... even with docs trying to be efficent... are simply staggering.
That's money that can be put into better care, or returned to the patient.
I understand the concept of overhead beter than most... but that is overhead that provides absolutely ZERO value to the doctor or the patient. It is actually lighting cash on fire.
Posted on 9/20/22 at 12:57 pm to LSUfan4444
quote:
Is it opposite day?
No, it’s not. We have the best medical training and best medical professionals. It just obviously isn’t the most affordable.
Posted on 9/20/22 at 1:00 pm to Turf Taint
quote:
Both on same exact insurance plan using same annual deductible at nearly the same time, etc
Do they work together at the same company, if not I find this very unlikely that it's the same plan.
Posted on 9/20/22 at 1:06 pm to WaWaWeeWa
quote:
TLDR point is that we don’t need to tear the system down. The billing issues just need to be reworked.
I agree somewhat. The billing aspect of insurance is just 1 part of the strife I think insurance companies cause. Another point is deciding what the provider can order for the patient like when a provider wants to order an MRI or CT, but the insurance requires the patient to do therapy first.
I think the system has to change at least a little bit which includes billing and letting the provider order what they think is medically necessary for their patient.
It could be somewhat like fixing cars after wrecks. The provider submits cost to the insurance company with an open book detailing everything that was done to "fix" the patient. Insurance pays less the patient's deductible/copay.
I'll admit that may be over-simplifying a complex issue though.
Posted on 9/20/22 at 1:09 pm to LSUFanHouston
quote:
or returned to the patient
The consumer will never get anything back on a deal like this. The price will stay the same at best.
Posted on 9/20/22 at 1:46 pm to WaWaWeeWa
quote:
You will pay your same deductible in both situations
Incorrect, let’s say you have a high deductible, $3600 and you have met none of it , if facility A is contracted to do the mri for 1800 and facility B is contracted to do it at $2200 by going to B you will pay $400 more, notice I said contracted for , because the billed rate does not matter at all
Now if we are talking about co pays that is different and your out of pocket would be the same either way assuming they are both in network
Posted on 9/20/22 at 1:55 pm to Turf Taint
I've said for a while that since more of us are on high deductible health plans with hsa savings plans Physicians should be forced to have more transparent prices. Each practice should have a published cash price list for procedures.
They sold high deductible plans and health savings accounts as having more choice in your Healthcare but how the hell can you make choices with no prices.
They sold high deductible plans and health savings accounts as having more choice in your Healthcare but how the hell can you make choices with no prices.
This post was edited on 9/20/22 at 2:06 pm
Posted on 9/20/22 at 2:07 pm to Turf Taint
quote:
Ortho A (Clinic) MRI costs 3X more than Ortho B (Hospital) MRI costs
I'm actually surprised. When I have testing in hospitals it is always way more than if I can do it at freestanding clinics. Nowadays though, the freestanding clinics are owned by the hospital haha.
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