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Message
2
Posted on 1/7/19 at 4:23 pm to Uncs
Semi related but why is there such a gap between what Doctors charge and what the insurance actually pays? If the visits cost what it is paid out I don't see why anyone wouldn't self insure. Got the EOB from my wife's 28 week checkup:
Exam: $130. Insurance paid: $17
Lab 1: $40. Insurance paid: $7
Lab 2: $30. Insurance paid: $6
Titty milker: $365. Insurance paid: $123
Total: $565. Insurance paid: $153
Those labs were pretty mild, I remember seeing some that were hundreds that insurance paid out tens on. Seems someone is getting ripped somewhere along the line
Exam: $130. Insurance paid: $17
Lab 1: $40. Insurance paid: $7
Lab 2: $30. Insurance paid: $6
Titty milker: $365. Insurance paid: $123
Total: $565. Insurance paid: $153
Those labs were pretty mild, I remember seeing some that were hundreds that insurance paid out tens on. Seems someone is getting ripped somewhere along the line
Posted on 1/7/19 at 4:23 pm to Mingo Was His NameO
I've never known any MD to have a stake in diagnostics other than being able to send people down an elevator due to proximity.
And I need to mention I hate I'm siding with you. Freak.
Posted on 1/7/19 at 4:24 pm to Uncs
quote:
It's a shell game. Bill insurance for $900.00 an hour, we will agree to $750.00 an hour with insurance and bill the patient the additional $150.00
It's called coinsurance.
Posted on 1/7/19 at 4:25 pm to Uncs
quote:
Why can't I tell these people you will get what insurance pays and nothing more including a co-pay?
You are correct. It’s a joke of a system. Only business in the world where you will buy a product before you know what it will cost you.
It’s doctors and insurance companies taking advantage of your willingness to do anything for your health.
Posted on 1/7/19 at 4:25 pm to Sao
quote:
And I need to mention I hate I'm siding with you. Freak.
thanks, just spit beer on my screen
Posted on 1/7/19 at 4:25 pm to SuperflyLSU
quote:
Semi related but why is there such a gap between what Doctors charge and what the insurance actually pays? If the visits cost what it is paid out I don't see why anyone wouldn't self insure. Got the EOB from my wife's 28 week checkup:
Exam: $130. Insurance paid: $17
Lab 1: $40. Insurance paid: $7
Lab 2: $30. Insurance paid: $6
Titty milker: $365. Insurance paid: $123
Total: $565. Insurance paid: $153
Those labs were pretty mild, I remember seeing some that were hundreds that insurance paid out tens on. Seems someone is getting ripped somewhere along the line
Noone is stopping you from getting a catastrophic plan that doesn't cover anything
Posted on 1/7/19 at 4:25 pm to Mingo Was His NameO
quote:
This is the case nearly 0% of the time
BR Clinic and Louisiana Womans (OB offices next to Womans) labs are both owned by the clinics (Physicians).
Posted on 1/7/19 at 4:26 pm to Uncs
quote:
All the while the doctors own the labs!
Sorry, man. If you're going to an out of network lab instead of quest or lab Corp, that's on you. Physician owned labs are nearly dead. They either remain out of network, which pisses off patients to the point of leaving the practice entirely. Or they take 2 years of financial losses to qualify for contract negotiations with payers for in network contracts. It just isn't financially feasible for physicians to buy into anymore. Quest and lab Corp have put all of them out of business, and have the barriers to entry too high to even consider.
Your physician can not prevent you from using the national labs. Tell them to print your lab order, and take it where you want.
This post was edited on 1/7/19 at 4:28 pm
Posted on 1/7/19 at 4:28 pm to dsides
quote:
Only business in the world where you will buy a product before you know what it will cost you.
False, you can know exactly what is costs. It just takes effort from the insured which most people don't want to give. The doctor has a rate, and your insurer covers part of it. They can't lie to you, that's against the law.
Most people just want doctors offices to have an expert for everyone of the thousands of policies that exist to tell them exactly what is going to be covered. That's not how it works, and I assure you all doctors don't want it to be complicated either, they get paid the same amount no matter how much comes from you or how much from the insurance company.
Posted on 1/7/19 at 4:29 pm to Golfer
quote:
BR Clinic and Louisiana Womans (OB offices next to Womans) labs are both owned by the clinics (Physicians).
quote:
This is the case nearly 0% of the time
This post was edited on 1/7/19 at 4:30 pm
Posted on 1/7/19 at 4:31 pm to Mingo Was His NameO
I'm giving you two examples of two of the largest outpatient physician facilities in Baton Rouge. If they're doing it, there's certainly more.
Posted on 1/7/19 at 4:32 pm to 777Tiger
Thattakid! What's your FBD on this F Bama and Clemson day? Having a Leinenkugels grapefruit shandy ATM. Was left in the fridge and I like a free found beer.
Posted on 1/7/19 at 4:33 pm to Sao
quote:
What's your FBD on this F Bama and Clemson day?
Shiner-thirty over here baby!
Posted on 1/7/19 at 4:40 pm to 777Tiger
to you, my budPosted on 1/7/19 at 4:42 pm to Golfer
quote:
If they're doing it, there's certainly more
They are trust me. And they are putting pharmacies in their offices that can fill about 80% of the prescriptions that they write.
Posted on 1/7/19 at 4:45 pm to Uncs
quote:
They are trust me. And they are putting pharmacies in their offices that can fill about 80% of the prescriptions that they write.
Labs are becoming more and more outsourced and pharmacies are nearly extinct outside of the national chains. Do you have one iota of data to back up a single claim youve made in this thread?
Posted on 1/7/19 at 4:45 pm to Sao
quote:
to you, my bud
back atcha, and frick bama and clempson
Posted on 1/7/19 at 4:47 pm to Golfer
quote:
he issue is the system. Doc orders lab work during visit. If you ask the Doc (or his office staff) what it will cost, they'll say "Not sure, talk to the lab."
You call the lab in the exam room, lab says "not sure, depends on what the doctor codes the visit as and what your insurance deems necessary with the codes"
So you call the insurance company and give them the codes. Insurance company says "not sure, can't give you a cost until the information is submitted and reviewed."
The coding is definitely a big issue and something that gets done wrong a lot. I went a while back for a physical and had some generic diagnostic lab work done for an issue, which is covered by my plan, paid my copay and moved on. Once everything posted like 4 months later, all of a sudden my insurer was saying I owed for half of the lab tests, for like $1000. Call the insurer and talk to them about it and they said the ones that were covered were coded as some type of diagnostic testing while the others were something else. I ask them how some could be coded different when it was all diagnostic for the same issue and they had no clue and told me to call the doctor's office. After multiple conversations with them, half the work got coded something different that was like 1-2 digits off or something. How that happened, no clue, but it was ridiculous.
This post was edited on 1/7/19 at 4:51 pm
Posted on 1/7/19 at 4:47 pm to Mingo Was His NameO
quote:
As hospitals face a squeeze on payment rates and margins, there are few types of clinical services, purchased services and medical-supply categories that aren't facing a ruthless bottom-line evaluation. Hospitals increasingly are outsourcing nonclinical services such as laundry and food to save money. Now, some are turning the cost spotlight on clinical services such as labs and diagnostic imaging.
Ratings agency Standard & Poor's said in a recent report that more hospitals are willing to sell their labs, create joint ventures and establish lab management agreements with lab services companies. “As hospitals strive to become more efficient, these types of lab transactions could be a way for some hospitals to redirect scarce capital away from labs to core activities,” S&P analysts wrote in the Aug. 4 report.
A hospital's “lab business is not a core asset,” said Bryan Brokmeier, an analyst for Maxim Group. “Historically, it's been looked at as a cost center, not a profit center.”
The trend has accelerated thanks to aggressive moves by major lab companies seeking hospital customers looking to outsource lab services. Publicly traded
Laboratory Corporation of America and Quest Diagnostics, two of the biggest lab services providers, are making a play to purchase hospital labs, contract with hospitals to manage their labs or form joint ventures with large health systems. They currently provide lab services to about half of U.S. hospitals.
LINK
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