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No wonder medical cost or so high...
Posted on 11/20/14 at 7:44 am
Posted on 11/20/14 at 7:44 am
My employer provided medical insurance requires no premium payment on my part for years. Beginning last year, in order to continue to be premium free, I and wife have to do a yearly preventative care visit. Here is the twist. These preventative care visits, including the required blood test are free. This year my doctor, at the world renowned Cleveland Clinic system, wants to do a follow up blood test. I ask if this follow up test would be coded as preventative care, so I wouldn't be charged. The answer was "no, you will be billed, this is a follow up diagnostic test". Fair enough. I ask " what are you going to charge me for this visit, lab work and consultation?" I need this info so I can reach out to my insurance company to determine how much they are going to cover so I know what my out of pocket cost will be. Their reply " you will have to contact insurance company to find out how much we will charge you." Genius. How much money does it cost for all the administrative "you bill me this, I'll discount that, we'll send multiple eob's and this is not a bill invoice from doctor and on and on.
On a related note, I try to keep up with the eob's and all the crap listed above and keep the doctors paid timely, but one bill from an allergy test for my son slipped thru my fingers. Lawyers office/collection firm, contracted by doctor, calls and informs me of this past due bill and ask if I can pay now. I ask if this has been reported to credit agency and rep says no and will not be unless it is unpaid in another 60 days. And then the reps says, "pay it now and I can take 20% off." Gladly. What a great business model.
I guess all I have do now is not pay the bill, what for collection to call, take the 20% discount and be on my way.
On a related note, I try to keep up with the eob's and all the crap listed above and keep the doctors paid timely, but one bill from an allergy test for my son slipped thru my fingers. Lawyers office/collection firm, contracted by doctor, calls and informs me of this past due bill and ask if I can pay now. I ask if this has been reported to credit agency and rep says no and will not be unless it is unpaid in another 60 days. And then the reps says, "pay it now and I can take 20% off." Gladly. What a great business model.
I guess all I have do now is not pay the bill, what for collection to call, take the 20% discount and be on my way.
7
Posted on 11/20/14 at 8:26 am to cuyahoga tiger
It is the only service or product I know of where you do not know the actual cost until after the service is performed. It is a total cluster.
With that said, because of that model, payment appears as optional/negotiable to some people. You can literally haggle on medical bills because payment rates are low.
Prime example of where centralization would create a huge benefit to the system, albeit at some security concern of wherever the information is being centrally located.
With that said, because of that model, payment appears as optional/negotiable to some people. You can literally haggle on medical bills because payment rates are low.
Prime example of where centralization would create a huge benefit to the system, albeit at some security concern of wherever the information is being centrally located.
Posted on 11/20/14 at 8:43 am to cuyahoga tiger
You are in the minority for even looking at your EOB statements. Most people don't even care what they are charged because "someone else" takes care of it.
Lack of a direct transaction between provider and consumer and lack of transparency on quality of care and pricing got us into this mess.
Lack of a direct transaction between provider and consumer and lack of transparency on quality of care and pricing got us into this mess.
Posted on 11/20/14 at 9:08 am to cuyahoga tiger
I remember a few years back when my wife's employer switched everyone to an HDHP. The talking point they said over and over was a variation of "When all you pay is a small co-pay, you don't know what the actual cost is, so you have no incentive to control costs. When you know what the actual cost is, and are responsible for it or a portion of it, you are more likely to take actions to control costs".
The issue is, as you saw, that's not how healthcare works. With the exception of some basic tests and shots, it's very hard to get an actual cost of something ahead of time. Because the "rack rate" listed by the doctor is so much bullshite. In reality, medicare decides what they will pay, the insurance companies use the medicare amounts to negotiate with the doctors as to what they will pay, and that's what they pay.
I mean, imagine if when you got in an accident, you went to get your car fixed, and you asked them for an estimate, and they told you, well, the price you are charged depends on what auto insurance company you have, or, if you are a cash payer. It's insane.
The issue is, as you saw, that's not how healthcare works. With the exception of some basic tests and shots, it's very hard to get an actual cost of something ahead of time. Because the "rack rate" listed by the doctor is so much bullshite. In reality, medicare decides what they will pay, the insurance companies use the medicare amounts to negotiate with the doctors as to what they will pay, and that's what they pay.
I mean, imagine if when you got in an accident, you went to get your car fixed, and you asked them for an estimate, and they told you, well, the price you are charged depends on what auto insurance company you have, or, if you are a cash payer. It's insane.
Posted on 11/20/14 at 12:40 pm to cuyahoga tiger
quote:
This year my doctor, at the world renowned Cleveland Clinic system, wants to do a follow up blood test.
Problem is you shouldn't be asking questions about the cost, but questions as to why a follow up is needed. People don't ask enough questions around this kind of thing and unnecessary costs to your insurance company are what drives up the cost.
This post was edited on 11/20/14 at 12:42 pm
Posted on 11/20/14 at 1:12 pm to cuyahoga tiger
When my wife had her gallbladder out a year ago, the "cost" was over $45,000. Insurance "discounted" $24K, paid $17K and left us with the other $4k. Then I'm sure I could have saved 20% by writing a check for it, but we just rolled it in with other medical bills and keep paying $100/month, interest free for forever.
It's absolutely ridiculous to be able to charge a price, then have someone else say- "That's too much, you can only charge half that- or we can just send our customer base somewhere else"
It's absolutely ridiculous to be able to charge a price, then have someone else say- "That's too much, you can only charge half that- or we can just send our customer base somewhere else"
Posted on 11/21/14 at 1:11 pm to cuyahoga tiger
quote:
No wonder medical cost or so high..
and the world thinks us Car Dealers are bad...
Posted on 11/23/14 at 7:58 am to cuyahoga tiger
Med costs are high because the market has been distorted by insurance and gov meddling.
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