Medical billing… biggest scam ever

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We can't keep track of every mf'ing insurance available.

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Why charge upfront at all then? The system is awful, nowhere else do you pay for services rendered then receive a bill a month later for some random additional amount. It’s ridiculous. No one deserves to have to sit a month waiting to see it they are going to be billed additional or not. Doing it a month after the fact also lessens the likelihood the person getting billed will even try to contest a bill if something looks out of whack.

Medical billing is a scam and I know because I have worked in private practice since 2011. Insurers randomly deny claims and hospitals can almost never give an actual price quote for procedures. Small clinics are better but everyone knows they inflate their prices because insurance is only going to pay a percentage so the end effect is that non insured patients get screwed and pay more than insurance companies. I know what I got paid for the same evaluation varied wildly by insurer. My typical evaluation was usually reimbursed between $800-1200 by insurance but the company charged $2500 for cash payment if you weren’t insured. It’s a scam.

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When people figure out their insurer is up to this and it adds significant costs to care, maybe they’ll insist on change instead of screaming at the sky.

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I can’t imagine the current system is much better for the doctors/insurance companies. The only person making bank when these derelict charges lapse are the collection agencies. I’m sure if all payment was collected at time of rendered services that would add to your bottom line.

Your attitude towards this is a very arrogant one. I don’t think it’s wrong for consumers to be displeased with the current state of affairs. Another angle that hasn’t even been mentioned is that some procedures will net you a bill from multiple entities, some with names that may not even connect with what you had done….adding the layer of having to filter out scams.
I.e. I had a procedure done, got a bill from doctors group of Texas…..(I’m in Louisiana), so now I’m attempting to figure that out as well.

Why though? So you can overcharge the insurance companies and drive prices up for everyone else?

Over charge insurance companies Insurance companies set the prices. They artificially depress the real cost of care while putting the majority of the cost on the patient. So the Dr and the patient bear the majority of the liability while the insurance company controls the game. It is a brilliant business model. Look at the share price of the big 5 if you don't believe me.

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Why though? So you can overcharge the insurance companies and drive prices up for everyone else?

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It really is amazing how they've convinced people of this. I can charge them a million dollars a visit. They are only going to pay their "contracted" rate that they can change without notifying us. I haven't gotten a fee schedule from an insurance for over a decade. We have to get rates code by code, item by item. There are well over 100,000 different diagnosis codes to choose from. Then there are modifiers and codes for tests, procedures , imaging. Etc. We usually set our base charges at 5-10% over BCBS. The reason is that if we start collecting 100% of the charge, they went up. Also in case another insurer pays better for a particular code. If you don't "overbill" you're leaving money on the table. The insurance company adjusts this to their contracted rate when they pay, minus co-pays and deductibles. If I ever charge a patient the full rate, it's because I down coded to help them or their assholes. Don't be an a-hole and sometimes we'll even do shite for free. At least those of us that own our businesses, the others can't do much about it. If you doc works for someone else, they'll milk you for all they can legally and illegally. It's a complicated and confusing system and it's that way by design. Remember Physicians are just contracted with your insurance to provide care for you. You got a problem? Take it up with your insurance.

We need to go back to a time where patients paid at the time of service and then they battle their insurance for payment. You're having to pay us to battle them and it's not cheap and they don't play fair. Do your part and always bring you current insurance card/cards. They change them all the time for a reason and there is a reason every damn office on the planet wants your newest card. NO...it's not the "same insurance". They'll change one little number on some shite and we don't know until they deny your claim. They may take a year or two to do this. Then we find out you card or insurance changed and you failed to notify us. Then you have to correct it and you will get a bill.

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I.e. I had a procedure done, got a bill from doctors group of Texas…..(I’m in Louisiana), so now I’m attempting to figure that out as well.

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Always check but it could be a path lab (as we have to send ours out of state now) lab group, hospitalist, ER, or anesthesia group contracting with the facility or radiology. They may even be in LA but using a billing service in Texas. Or it could be a mistake. I don't mind looking at a patients EOB to help them sort through it.

Medical billing is a total scam. People want to complain about health insurance which certainly has its faults, but medical facilities get away with straight extortion. I deal with cases all the time where doctors or hospitals etc bill for exorbitant amounts of money they just pull out of the air. Attorneys also use these billing practices to file suit against business owners for minor accidents or just fraudulent ones. The entire medical industry gets a pass because “they save lives”. bullshite. I bet they kill as many as they save.

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I can’t believe people still pay medical bills. It does not affect credit score, they can’t take your house, nothing. The healthcare system always eats the cost and you just have to ignore a few malty threats from debt collection.

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People like this add to the cost and make offices, facilities more predatory in collections. We used to make enough to let some slide, but we haven't had a raise (as providers) in 20 years.

Don't be shocked if you end up in small claims court or have your wages garnished. I've never sent a single patient to collections, but times are changes and people like you think it's fine to steal from others. Don't be shocked when this doesn't work out as planned.