quote:
Most times for a single hospital visit with labs etc, you wind up with multiple items being billed. What most people don’t realize is that the lab may be contracted to a different company. The radiologist that reads images may be contracted. The cardiologist that reads the EKG may be contracted.

And that all should be illegal. I work at a hospital and have health insurance thru that hospital. I went to the ER at said hospital and was seen by a contracted ER physician. I got a $800 bill from the ER physicians group because they were “out of network”. So the hospital was “in network” but the group inside of the building is “out of network”. How is the public suppose to know that? The contract is between the hospital and er doctors. Not the patient.

This post was edited on 12/27/23 at 1:06 pm

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Posted by chawbaw

Member since Sep 2021

62 posts

Posted on 12/27/23 at 12:50 pm to dlambe5

I’m not saying I agree with every piece of it. I’m simply stating the nature of it all.

Pros and cons exist in each model.

If insurance payouts fully covered provider costs, the hospitals wouldn’t need to subsidize private groups. On the other side, it’s a well known piece of information that organizations that employ internally staff at higher patient:staff ratios to cut costs and maintain profitability.

The big hospitals that get away with all and remain profitable are typically religious-based and/or non-profit making them tax-exempt.

I think the individual also holds responsibility for understanding their health coverage and what physician they are seeing. There is a No Suprises Act for a reason. It’s not difficult information to find, if one looks for it.

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