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re: How much have your insurance premiums gone up this year?

Posted on 7/25/17 at 10:18 pm to
Posted by deeprig9
Unincorporated Ozora, Georgia
Member since Sep 2012
64225 posts
Posted on 7/25/17 at 10:18 pm to
quote:

well, since insurance is regulated by the government and premiums are directly affected by the claims that your insurance pays each year, it looks like what we are really looking for is some way to reduce health care costs.


Bingo!


Insurance companies are just a conduit for money flow between the patient and the doctor. They shave off between 3 and 5% for profit. Their involvement certainly adds complexity and cost to the whole system, but their profit margin is very small.

I'd like to know why an anesthesiologist charges $750 to administer laughing gas to an infant for ear tubes, and then charges $750 twice because there's two ears, even though only one gassing occurred.

I'd like to know why the surgical facility charges a surgery suite charge of $15,000, for a 30 minute out-patient procedure, for putting tube in an infants ears, and then charges the facility charge 2x because there are two ears.

This all happenned to me, and was ran through Cigna, I contacted Cigna to tell them the doctor was ripping them off, and Cigna assured me that this is customary....

The insurance companies aren't the enemy, it is the doctors. The insurance companies are complicit.
Posted by Sao
East Texas Piney Woods
Member since Jun 2009
65974 posts
Posted on 7/25/17 at 10:24 pm to
It's illegal. Ask for a rebill or like the site says, Blow Dat Whistle. I share this with everyone I know.



LINK
Posted by Sao
East Texas Piney Woods
Member since Jun 2009
65974 posts
Posted on 7/25/17 at 10:33 pm to

If your EOB shows what you have written, you have recourse. It's legwork but what you stated is illegal.

Posted by the_watcher
Jarule's House
Member since Nov 2005
3450 posts
Posted on 7/25/17 at 10:34 pm to
If you were the doctor performing a procedure with a total cost of $75 and you knew (and believe me they know precisely what the average dollar per patient is for every type of reimbursement possibility) insurance typically paid 10% of what you billed, how much would you charge?

Does the cost of that laughing gas cost $750? No. But they won't receive anywhere near that from the insurance carrier. Ever wonder why some dentist/doctors will offer discounts if you pay cash?

The entire system is messed up but it's not the doctor/hospitals fault they don't ever get anywhere near 100% of what they "charge" from third party insurance carriers. The amount of money my former company wrote off per month (staffed and managed ED's across the country) was staggering.
Posted by 756
Member since Sep 2004
14887 posts
Posted on 7/26/17 at 5:28 am to
quote:

The insurance companies aren't the enemy, it is the doctors


Nope Blame the attorney's. Lawsuits and rewards have driven the cost of malpractice insurance through the roof. I have two close friends who dropped private practice because the malpractice rates are sky rocketing

it is no longer about medical care, it is about who gets the money.

PI attorney takes 40% plus expenses- his client is lucky to get 30% of the award
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