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Started By
Message
re: Blue Cross launches tool to let customers compare provider prices
Posted on 7/10/17 at 11:25 am to Will Cover
Posted on 7/10/17 at 11:25 am to Will Cover
They stole the price match tool from flow?
0
Posted on 7/10/17 at 11:27 am to Will Cover
There is a lot of misinformation in this thread.
The cost is the average allowed amount for those claims not the charges.
All providers are not paid the same amount.
How do consumers know the quality right now? Should they go by price?
The cost is the average allowed amount for those claims not the charges.
All providers are not paid the same amount.
How do consumers know the quality right now? Should they go by price?
Posted on 7/10/17 at 11:38 am to GEAUXT
quote:
You do realize that balanced billing (as it is called) is illegal in most states.
quote:
In 29 states and the District of Columbia, there are no state laws or regulations that explicitly protect consumers from unexpected balance billing by out-of-network providers in EDs or in-network hospitals. In some of these states, insurance regulators reported taking informal approaches.
Posted on 7/10/17 at 11:39 am to GEAUXT
quote:
You do realize that balanced billing (as it is called) is illegal in most states. the feds even made it totally illegal for medicare patients. The only time this is allowed is for out of network patients, and that's only because insurance companies will just flat out deny payment regardless of services rendered. Typical out of touch dumb arse.
Wait wait wait
Are you actually trying to say, Doctor, that all carriers hold to the same network discount? Simple yes or no.
Posted on 7/10/17 at 8:57 pm to Sao
quote:
Many reasons, especially if I were my younger male/single self again. Many of you between 20-30 should seriously rethink healthcare in a new way instead of wantonly clicking buttons during open enrollment. Coverage in a group, even with a low premium high DED isn't good coverage at all for you. Not if you're in relatively good health, young and single.
So-why do you care about buying insurance then?
I don't get it. Pay the insurance or pay the fine.
Posted on 7/10/17 at 9:12 pm to GEAUXT
I'm to the point I'd happily pay $3,500 for a single x-ray just to exhaust my deductible and put blue Cross on the 100% hook
Posted on 7/10/17 at 9:26 pm to SUB
quote:
Giving people an incentive to choose cost over quality of care? What could go wrong>?
End of socialist ideas? If that's wrong, I don't want to be right.
Posted on 7/10/17 at 9:35 pm to Sao
Is the doc's charge applied to the deductible or is the amount allowed to doc under the plan applied to the deductible?
Posted on 7/10/17 at 9:43 pm to Motorboat
quote:
the doc's charge applied to the deductible or is the amount allowed to doc under the plan applied to the deductible?
If it's filed to insurance, the amount is the allowable.
So the provider can charge $150, but BCBS only pays $100...in that case the EOB says, in one format or another:
$150 billed
$100 allowed
$50 CO-45 reduction
$100 PR-1 (deductible)
$0 paid to provider
Patient owes the network allowable of $100.
Posted on 7/10/17 at 9:54 pm to SUB
quote:
Giving people an incentive to choose cost over quality of care? What could go wrong>?
"Yes sir, let's see...ah here we go! A nice left kidney from a middle aged white lady who only used it during communion. All yours for a paltry $120K.
What? Oh well we do have a couple dozen right and left kidneys from multi racial homeless people for a couple hundred bucks apiece. But they have no warranty and you have to perform your install and removal.
Right this way to our admissions and pre-op sign in."
Posted on 7/10/17 at 9:55 pm to Bestbank Tiger
People demonize the insurance companies who clear 5% profit while the providers are clearing about 200%.
Price transparency is key to fixing healthcare in this country.
Price transparency is key to fixing healthcare in this country.
Posted on 7/10/17 at 10:16 pm to deeprig9
quote:
People demonize the insurance companies who clear 5% profit while the providers are clearing about 200%
Posted on 7/10/17 at 11:53 pm to deeprig9
If you cut provider pay by half, it would decrease health costs by like 5%. Providers aren't the reason healthcare in this country takes of so much of the GDP.
Posted on 7/10/17 at 11:54 pm to SUB
quote:
Giving people an incentive to choose cost over quality of care? What could go wrong>?
What most medical providers dont seem to understand is the market shift to high deductible plans and how that shift pushes patients to want to at least be able to price shop a little. What other industry then medical doesnt give a patient a cost structure they can compare.
My yearly deductible is 4000, so basically all my medical typical expenses come out pocket (im happy to have the insurance if something big happens)
Today, I needed to take my son to a dermatologist to get something looked at. Out of the 100 or so providers that pull up, I would love to at least be able to get an idea of what a particular Dr visit is going to cost me out of my pocket. Many consumers feel the same way.
The patient should get to decide if they are more cost conscious or quality focused. You get to make that decision as a consumer on every other purchase you make. For many reasons this hasnt been possible in medical, however as more and more patients are pushed into high ded plans, the desire for the consumer to be able to price shop Dr's and procedures is just going to continue to grow.
Posted on 7/11/17 at 12:02 am to GEAUXT
quote:
ome pissed off patients who think the doctor is trying to screw them or the insurance company because the difference is so great between the charges and the payment.
And, they will never understand.
Good times.
Posted on 7/11/17 at 12:04 am to deeprig9
quote:
People demonize the insurance companies who clear 5% profit while the providers are clearing about 200%. Price transparency is key to fixing healthcare in this country.
You sure about this, coach?
Posted on 7/11/17 at 12:29 am to Will Cover
does this so-called pricing tool matter to people on Obamacare? Do they ever have to make health care decisions at all based on pricing anymore?
Do they ever actually come out of pocket for care?
remember, the rest of us have had premiums that have doubled or tripled, well above $1,000 per month (while they have not), and we have an $8,000 family deductable.
Basically, I have to come out of pocket 1,200 per month x 12 months = 14,400 + 8,000 deductible = 22,400 out of pocket spending before insurance ever cuts a check on my behalf to the providers who have helped me.
22,400 dollars before I have "coverage."
What is the so-called "poor people's" buy in?
I'm not stomping on the necks of poor people, but at what point do people say "I can't spend 22,400 before insurance kicks in." What's their deductible? They had better have one, in order to have skin in this game.
Do they ever actually come out of pocket for care?
remember, the rest of us have had premiums that have doubled or tripled, well above $1,000 per month (while they have not), and we have an $8,000 family deductable.
Basically, I have to come out of pocket 1,200 per month x 12 months = 14,400 + 8,000 deductible = 22,400 out of pocket spending before insurance ever cuts a check on my behalf to the providers who have helped me.
22,400 dollars before I have "coverage."
What is the so-called "poor people's" buy in?
I'm not stomping on the necks of poor people, but at what point do people say "I can't spend 22,400 before insurance kicks in." What's their deductible? They had better have one, in order to have skin in this game.
Posted on 7/11/17 at 6:26 am to G Vice
Most of them have ridiculously low deductibles. That's why your deductible and premium are high. You're paying for your family, and at least one other family.
Posted on 7/11/17 at 6:22 pm to PoppaD
quote:
My yearly deductible is 4000, so basically all my medical typical expenses come out pocket (im happy to have the insurance if something big happens)
Today, I needed to take my son to a dermatologist to get something looked at. Out of the 100 or so providers that pull up, I would love to at least be able to get an idea of what a particular Dr visit is going to cost me out of my pocket. Many consumers feel the same way.
The patient should get to decide if they are more cost conscious or quality focused. You get to make that decision as a consumer on every other purchase you make. For many reasons this hasnt been possible in medical, however as more and more patients are pushed into high ded plans, the desire for the consumer to be able to price shop Dr's and procedures is just going to continue to grow.
Yep.
The best way to design the app is to let the user punch in the procedure code and BCBS tells them the allowable and what their out of pocket would be.
So you type on A1234 (made up code) and it says "Allowable will be $500. You have met $233 of your $6000 deductible. Your out of pocket cost is $500." Then you can call around and see if anyone has a cash price less than $500.
Posted on 7/11/17 at 6:26 pm to Patron Saint
quote:
If you cut provider pay by half, it would decrease health costs by like 5%. Providers aren't the reason healthcare in this country takes of so much of the GDP.
4%. Provider payments are approx. 8% of healthcare costs. Administration and pharmaceutical costs are the killers.
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