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Old 01-13-2020, 09:18 PM   #1
Spoiled_TN_boy
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Default Ever wonder why Insurance is stupid expensive?

Because of crooks like ATI.
Was quoted "about $40 per visit" when I inquired with receptionist.
Ok, that's reasonable after Insurance payment.
After the rushing to keep scheduling visits I started to become wary. After 4 visits and still not receiving a bill I stopped going. Last service was in early July. I did not get the first bill until November! Imagine if I had kept going... Had I known these ****ers were going to charge my insurance company $350/visit I would have told them where to stick it. I mean, lawyers don't even charge that much.

For what the lady did I could have looked up the exercises on the internet. The first 30 minutes of each visit was spent massaging my next to loosen the muscles. Should have went to the thai massage. At least there I would have gotten a handy.

After fighting this for over a year, ATI is still sticking to their guns and refusing to honor the $40 verbal stating that they already filed on insurance and I am liable for remaining balance.
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Old 01-13-2020, 09:31 PM   #2
txoutdoorsman24
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Insurance is definitely a scam. Some of the cases my wife tells me about would make your head explode.
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Old 01-13-2020, 09:36 PM   #3
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Our leader is trying to do something about the lack of disclosing medical costs before they are incurred.

Hospital groups file lawsuit to block Trump's price transparency rule:

https://www.reuters.com/article/us-u..._0dtncc6SMvi9U
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Old 01-13-2020, 10:08 PM   #4
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same thing with X-Rays and MRI. If you have no insurance they will do it for a couple hundred dollars. If you have insurance, its a couple grand
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Old 01-13-2020, 10:08 PM   #5
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Pay $3.00 a month and they'll make a deal with you
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Old 01-13-2020, 10:19 PM   #6
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Yep, wuda been 40 cash, since u filed insurance it was 389... and they still balanced billed you (illegal in most states, but nooottttt texas).
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Old 01-13-2020, 10:30 PM   #7
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Or/and because people use the ER as their PCP and are uninsured or do not pay their bill and the costs gets inflated to cover all the no pays so the companies that own the hospitals can continue to make **** loads of money....
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Old 01-13-2020, 10:30 PM   #8
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You didnt do your homework
We charge tens of thousands to the insurance companies bc they will deny most of the claims. We dont balance bill the pt but some facilities do... that is your responsibility as a patient to ask those questions before you go in for treatment.
If you only knew how much our electricity and maintenance bill is every month to keep our MR machine on you would understand. ... try 25 grand just to break even. But I dont expect you to know that or anyone else that is upset about billing practices.. I understand both sides but you should really know what you are signing or dont sign it
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Old 01-13-2020, 10:35 PM   #9
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Also if you need an MRI or CT just let me know I'll help you out get your scan zero cost to you and promise you wont get a balance bill but we will try to hammer your insurance with one
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Old 01-13-2020, 10:37 PM   #10
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Got dehydrated drank a big coffee, heart started racing.
Family started freaking and made me go to the ER
1 ekg and a bag of fluid heart rate went back down. Bill came for the dr that never touched me and Two hour Er visit. $7,000.
When I went in I told them my deductible was $6000. So I was cash pay.
They rang it up as insurance. When I called about the bill the girl said it would have been 40% less as cash pay.
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Old 01-13-2020, 10:44 PM   #11
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I’m working on a 500k bill at Texas Children’s

Worth every penny though
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Old 01-13-2020, 10:53 PM   #12
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I keep getting calls from a collection agency, from a ER visit from a doctor that charged me $1000 to read my chart and tell me to drink more water to get my blood sugar down and prescribed seeing my PCP about changing my diabetes medicine, he was out of my insurance network so I was deemed at fault
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Old 01-13-2020, 11:02 PM   #13
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Does anybody disagree that our healthcare system is broken!
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Old 01-13-2020, 11:03 PM   #14
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Quote:
Originally Posted by Burnadell View Post
Our leader is trying to do something about the lack of disclosing medical costs before they are incurred.

Hospital groups file lawsuit to block Trump's price transparency rule:

https://www.reuters.com/article/us-u..._0dtncc6SMvi9U
Itís amazing how under the radar and how huge this passing would be! Liberals should be thrilled for it also since it will expose expensive healthcare but itís been very quite.
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Old 01-13-2020, 11:06 PM   #15
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Originally Posted by Burnadell View Post
Does anybody disagree that our healthcare system is broken!
It's almost like it was set up to fail!
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Old 01-14-2020, 12:20 AM   #16
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*
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Old 01-14-2020, 02:00 AM   #17
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Originally Posted by Burnadell View Post
Does anybody disagree that our healthcare system is broken!

Just imagine what it it'll be like when the government runs it.
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Old 01-14-2020, 06:31 AM   #18
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Originally Posted by Burnadell View Post
Does anybody disagree that our healthcare system is broken!


Thatís putting it mildly


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Old 01-14-2020, 06:43 AM   #19
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My wife had a ruptured disk in her lower back. We went to a specialist in Houston. He did the normal x-rays and the talk about everything. He then told me it was going to cost about 20,000 dollars. I said well you are going to have to bill me as I didn't have insurance at the time. Working for a contractor at the time. He said oh you have no insurance you didn't tell me that hang on. He went back to his office and came back and told me the cost would be 6500 for everything payment up front.
Then I was thinking to myself that's why insurance cost so much.
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Old 01-14-2020, 06:47 AM   #20
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I though it was because everyone has to pay for the ones that don't?
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Old 01-14-2020, 06:54 AM   #21
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Man I was fired up about this yesterday! My developmentally delayed (born early) 2 year old needs speech therapy. To file with insurance is $260 a visit, recommend twice per week.
Cash payment without insurance is $60.
We have a high deductible plan before 90/10 kicks in. So this is just a bull**** deterrent to keep us from filing anything towards that deductible.

Last edited by JLivi1224; 01-14-2020 at 07:05 AM.
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Old 01-14-2020, 07:17 AM   #22
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Before they even have a chance to "cover their costs", the poor person billing it must have to go through calculus to figure how to code the stuff. Went to a PCP. Should be $25 copay. Sir it's gonna be $120. Uhh no it ain't. ER used to be just a $100 copay. Now it's $300 plus whatever else they add. I get it, this stuff is expensive, but they obviously make it where you can't understand so there's no way to keep them from overcharging.
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Old 01-14-2020, 07:28 AM   #23
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Here’s another doozie - the twins mentioned above were on the NICU for 36 days.
Anyone want to take a guess at total cost per child before insurance??









1.1M per child! Really!? People were great, but that’s asinine!
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Old 01-14-2020, 07:41 AM   #24
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Thats crazy..
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Old 01-14-2020, 07:56 AM   #25
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My wife’s PT is $400 per session. I know your pain. We’re about to pull the plug on it again.
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Old 01-14-2020, 08:26 AM   #26
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Default Big medicine

Quote:
Originally Posted by Traildust View Post
I though it was because everyone has to pay for the ones that don't?
Insurance makes for big medical job base
Example
Our pcp doctor had a small practice 3 people in the past
Now they have 15+ people sole jobs are to deal with and file insurance paperwork, another group that shuffled around the x ray ,ct mri , then they have a office manager to keep it all running and organized. Crazy it now takes over a dozen people to run one office
Same with our dentist, and eye doctor,ect
Huge job base
And the equipment in all the offices x-ray , ct ,ect have to have specific technical issues and operations
Horrible
Sometimes we get bills from 3-8 months before that has been in the paper shuffle
Between insurance company and care providers

Last edited by pilar; 01-14-2020 at 08:37 AM.
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Old 01-14-2020, 08:34 AM   #27
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I dropped my normal healthcare when Obamacare kicked in. $1500/ month plus a $6850 per person deductible. I was 39, wife 37, and 3 small kids. I got catastrophic insurance and now operate on the monthly as a cash patient.

The reason in my opinion healthcare is so expensive, is due to the staff required to chase insurance payments. Since they have to chase the payments, they overcharge them, and the ruthless cycle continues.

We recently needed basic vaccinations for school. My wife shopped for best pricing as a gringa. It was $760 at Walmart. I work in construction and see that most of my guys get the same stuff as every other kid at a fraction of the cost, so I started looking. Within 5 minutes I found a clinic with free vaccinations, the same ones. But the line was going to be long and no guarantee we could get them that day if they ran out of their allocation. I called another place and they said they had plenty, $20/shot, if 2 could be combined, it was $30/ shot, cash or credit card only, no insurance allowed. Showed up, place was clean, staff friendly, wait wasnt very long, went in and they were very efficient. Paid our $40 or $60,and left. Absolutely zero unnecessary office staff chasing payments and having to file and code things 4 different ways to maximize their accounts receivable.
Yes we were the only non-Hispanic people in the joint, but that doesn't bother me a lick. In fact it verified to me I wasn't being wasteful and I had figured out the system.

We now do this every single time we go to any medical place. Tell them, no insurance, cash. They help us with the bill, and if it is prescription related, they write it as generic, not name brand, and inform us where to get a coupon to get the best price offered as many pharmacies will price match. The price gap is HUGE!!!!.

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Old 01-14-2020, 08:37 AM   #28
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Quote:
Originally Posted by eaglegolfj View Post
My wife had a ruptured disk in her lower back. We went to a specialist in Houston. He did the normal x-rays and the talk about everything. He then told me it was going to cost about 20,000 dollars. I said well you are going to have to bill me as I didn't have insurance at the time. Working for a contractor at the time. He said oh you have no insurance you didn't tell me that hang on. He went back to his office and came back and told me the cost would be 6500 for everything payment up front.
Then I was thinking to myself that's why insurance cost so much.
Stories like this are 100% true..

But this was happening long ago. My daughter just turned 18 and we didn't have insurance when she was born. "Normal" price was over 6k but cash up front price was about half that.

I think now it's just magnified with lots of confusion. Everyone is basically trying to scam as much money as they can from the system. It's become a big game.
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Old 01-14-2020, 08:38 AM   #29
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Here is the scary thought, at least to me...

Where does it go from here??
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Old 01-14-2020, 08:43 AM   #30
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Quote:
Originally Posted by Sticks&Strings View Post
I dropped my normal healthcare when Obamacare kicked in. $1500/ month plus a $6850 per person deductible. I was 39, wife 37, and 3 small kids. I got catastrophic insurance and now operate on the monthly as a cash patient.

The reason in my opinion healthcare is so expensive, is due to the staff required to chase insurance payments. Since they have to chase the payments, they overcharge them, and the ruthless cycle continues.

We recently needed basic vaccinations for school. My wife shopped for best pricing as a gringa. It was $760 at Walmart. I work in construction and see that most of my guys get the same stuff as every other kid at a fraction of the cost, so I started looking. Within 5 minutes I found a clinic with free vaccinations, the same ones. But the line was going to be long and no guarantee we could get them that day if they ran out of their allocation. I called another place and they said they had plenty, $20/shot, if 2 could be combined, it was $30/ shot, cash or credit card only, no insurance allowed. Showed up, place was clean, staff friendly, wait wasnt very long, went in and they were very efficient. Paid our $40 or $60,and left. Absolutely zero unnecessary office staff chasing payments and having to file and code things 4 different ways to maximize their accounts receivable.
Yes we were the only non-Hispanic people in the joint, but that doesn't bother me a lick. In fact it verified to me I wasn't being wasteful and I had figured out the system.

We now do this every single time we go to any medical place. Tell them, no insurance, cash. They help us with the bill, and if it is prescription related, they write it as generic, not name brand, and inform us where to get a coupon to get the best price offered as many pharmacies will price match. The price gap is HUGE!!!!.

Sent from my SM-N950U using Tapatalk
Lots of truth....

It's a self perpetrating bureaucracy that's spiraling out of control...as are many other things....
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Old 01-14-2020, 08:46 AM   #31
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Quote:
Originally Posted by 150class View Post
It’s amazing how under the radar and how huge this passing would be! Liberals should be thrilled for it also since it will expose expensive healthcare but it’s been very quite.
Liberals will never be thrilled with anything Trump does. No exceptions. Period!

Quote:
Originally Posted by JLivi1224 View Post
Man I was fired up about this yesterday! My developmentally delayed (born early) 2 year old needs speech therapy. To file with insurance is $260 a visit, recommend twice per week.
Cash payment without insurance is $60.
We have a high deductible plan before 90/10 kicks in. So this is just a bull**** deterrent to keep us from filing anything towards that deductible.
Yep. It's at the point where I wonder why any of us pay for healthcare at all. Just go get done whatever you need and pay $50 per month (total) for the rest of your life.

At some point working people will have to call BS10 and stop paying while everyone else is free (while still having all luxuries).

Quote:
Originally Posted by JLivi1224 View Post
Here’s another doozie - the twins mentioned above were on the NICU for 36 days.
Anyone want to take a guess at total cost per child before insurance??

1.1M per child! Really!? People were great, but that’s asinine!
Did you get an itemized invoice? That would blow your mind. My sister had brain surgery. We figured the doctors pattern. They go room to room and say "How are you doing today" Each 15 second to 2 minute stop they charge stupid money for like $130-250. The extra kickers are they have all sorts of "doctors" so it's a constant stream of them poking their head in.



Also I still can't figure out what my insurance covers. Does anyone? I think it's completely random what I get charged.

Last edited by RiverRat1; 01-14-2020 at 08:50 AM.
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Old 01-14-2020, 09:25 AM   #32
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Back in 2016 I had to have 2 stents put in my heart. Went to Presbyterian and they tried a procedure that didn't work. Wound up at Baylor Heart Hospital. After it was all said and done, Presby billed insurance $90k just to use the OR. No doctors or anything. just to use the room. Baylor billed for the same only they billed for $40k. Less than half of what Presby billed!
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Old 01-14-2020, 09:37 AM   #33
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I got bloodwork done last summer. I was told there would be no bill. I knew this not to be true because they said the same thing the year prior. Got a bill for like $500 or something from the bloodwork people. I call the bloodwork people, they tell me since it's not preventative, it's not covered. I ask how much the bill would be if paying cash. They have no answer.

So I call my Dr, explain to her my family has a history of Type II Diabetes and high blood pressure/high cholesterol. All of a sudden my $500 bill goes to $0, and the amount charged to insurance goes to ~$50.

Our system is absolutely broken.
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Old 01-14-2020, 09:42 AM   #34
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I got a bill from a stand alone emergency room in Livingston, TX for $5k to remove a treble hook from my daughters foot. The Dr wasn't even strong enough to cut the barb off the hook and my Brother did it. Insurance paid them $3800 and they sent me a bill for the rest. I told them to go to hell.
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Old 01-14-2020, 09:46 AM   #35
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Two years back we went on pay as you go. Had my PCP change the account to cash. Yes we do have BC/BS insurance. We have not turned in a penny to insurance so far, and the Dr gives us super cheep prices.
We will use BC/BS for only serious stuff........
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Old 01-14-2020, 09:58 AM   #36
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Quote:
Originally Posted by SwampRanger View Post
Iím working on a 500k bill at Texas Childrenís

Worth every penny though
Bingo
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Old 01-14-2020, 10:09 AM   #37
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This is precisely why I have never had insurance. It is an absolute racket and to say that the system is broken is an understatement. With the current average deductibles and monthly payments for a family, it is not worth the cost for me. We will pay cash for the small stuff (just like the folks with insurance do) and negotiate and pay out any major thing should it happen. I am very thankful that my family is healthy thus far and I pray it stays that way. I understand why some older folks or folks with pre-existing conditions have to have it. It's sad that such a high percentage of one's income has to go to health insurance each month and then you still have to meet a very high deductible while not even being clear on what will be covered and how much it might be.
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Old 01-14-2020, 10:19 AM   #38
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Quote:
Originally Posted by WItoTX View Post
I got bloodwork done last summer. I was told there would be no bill. I knew this not to be true because they said the same thing the year prior. Got a bill for like $500 or something from the bloodwork people. I call the bloodwork people, they tell me since it's not preventative, it's not covered. I ask how much the bill would be if paying cash. They have no answer.

So I call my Dr, explain to her my family has a history of Type II Diabetes and high blood pressure/high cholesterol. All of a sudden my $500 bill goes to $0, and the amount charged to insurance goes to ~$50.

Our system is absolutely broken.
When I had blood work done they have this new program where you can pay up front set prices. It was like $50..I asked how much I'd be charged if going through insurance and they had zero clue. Zero clue what the lab would even charge insurance. Zero clue what my insurance would cover or what they covered in the past... LOL It's freaking stupid.

Quote:
Originally Posted by Hoggslayer View Post
I got a bill from a stand alone emergency room in Livingston, TX for $5k to remove a treble hook from my daughters foot. The Dr wasn't even strong enough to cut the barb off the hook and my Brother did it. Insurance paid them $3800 and they sent me a bill for the rest. I told them to go to hell.
How much went to your brother? Sounds like he was an independent contractor

Last hook I got in myself I just cut out myself. Made my brother hold my finger steady so I could cut. Figured it not only saved money but I'd have more fishing time....And they'd have cut it out the same way!
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Old 01-14-2020, 10:44 AM   #39
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Originally Posted by kingranch View Post
You didnt do your homework
We charge tens of thousands to the insurance companies bc they will deny most of the claims. We dont balance bill the pt but some facilities do... that is your responsibility as a patient to ask those questions before you go in for treatment.
If you only knew how much our electricity and maintenance bill is every month to keep our MR machine on you would understand. ... try 25 grand just to break even. But I dont expect you to know that or anyone else that is upset about billing practices.. I understand both sides but you should really know what you are signing or dont sign it
Every single business has expenses, and every single business pays a ton to keep the lights on. To me, it's a simple solution: Have a price list available. Like EVERY other business that's out there. You look at the price list, decide what you can/cannot afford and select it. It would at least create free enterprise between hospitals. An individual could "shop" a bit and decide whats best for their situation. This would drive lower cost. Instead you go into a medical office tell them you want the OUT THE DOOR COST, they CANNOT CANNOT tell you what that will be. It's unbelievable the amount of bills I have received AFTER I've "paid in full".
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Old 01-14-2020, 12:18 PM   #40
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My wife went to an Urgent Care/ER for what she thought was appendicitis. They did a CT scan, gave her an IV and pain meds but never diagnosed her with anything other than saying it wasnít her appendix. I was new to my job so we didnít have our ID number yet and went with self pay. The bill was $11k, but they reduced it to $2400. I gave them the insurance info once I got it, they were paid $4500 from insurance and sent a bill to us for $6500. I talked to a supervisor and she ďloweredĒ it to $1500. I told them they were paid for their services and wonít see a dime from us. They sent several past due invoices and then havenít heard a word from them and they didnít turn it over to collections.
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Old 01-14-2020, 12:42 PM   #41
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Originally Posted by Burnadell View Post
Does anybody disagree that our healthcare system is broken!
The service side of the system is fine, it is the billing side that has past our ability to pay. People complain that insurance is high, but it cost most people $100-300K just to die in a hospital, unless they are DOA. And we ARE ALL GOING TO DIE.
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Old 01-14-2020, 01:07 PM   #42
John Paul
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My wife Is a medical biller for a Ped's office. Long ago insurance companies decided they would only pay 40-60% of the cost of a procedure and or a visit, then some Docs just increased the price of the visit to get the amount they would of originally charged. Then the cycle began, insurance companies payed less, docs charged more and got less. Every month her AR for one practice is 45%-55% of what was billed and most of the time insurance companies just deny a claim hoping it will be missed or it will be denied over 90 days then provider can't collect. And that practice has not over inflated its pricing but has had to decide not to see certain children with certain insurance because they were going out of business from not getting paid at all. It is super jacked up, this is one place I think the government should regulate the insurance companies some how. I know intervention rarely works.
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Old 01-14-2020, 01:34 PM   #43
BrianL
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Quote:
Originally Posted by John Paul View Post
My wife Is a medical biller for a Ped's office. Long ago insurance companies decided they would only pay 40-60% of the cost of a procedure and or a visit, then some Docs just increased the price of the visit to get the amount they would of originally charged. Then the cycle began, insurance companies payed less, docs charged more and got less. Every month her AR for one practice is 45%-55% of what was billed and most of the time insurance companies just deny a claim hoping it will be missed or it will be denied over 90 days then provider can't collect. And that practice has not over inflated its pricing but has had to decide not to see certain children with certain insurance because they were going out of business from not getting paid at all. It is super jacked up, this is one place I think the government should regulate the insurance companies some how. I know intervention rarely works.
They would have to regulate both sides. Overbilling and underpaying is the game and the patients get caught in the middle. There needs to be standardized upfront pricing.
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Old 01-14-2020, 01:54 PM   #44
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Totally agree, patients get the shaft for sure, but if pricing is standardized you would have to standardize Insurance reimbursements. If you didn't the care you would get would be substandard because Docs would have to see 2 to 3 times the amount of patients in a day to keep the practice going.
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Old 01-14-2020, 01:56 PM   #45
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Originally Posted by SwampRanger View Post
Iím working on a 500k bill at Texas Childrenís

Worth every penny though
No insurance?
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Old 01-14-2020, 01:57 PM   #46
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Originally Posted by BrianL View Post
They would have to regulate both sides. Overbilling and underpaying is the game and the patients get caught in the middle. There needs to be standardized upfront pricing.
Amen! Its a load of crap.
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Old 01-14-2020, 01:59 PM   #47
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Last year I needed a particular script and the insurance kept rejecting it. They were wanting me to go to a lab and have several tests run before approving me for the medication I needed. I finally asked the pharmacist how much the medication was and it was only $20. I paid it myself and went on. It would have easily been another $500 bill for a $20 bottle of pills to the insurance had I not just paid for the medicine myself. I thinks its mismanagement all the way around.

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Old 01-14-2020, 01:59 PM   #48
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It’s a simple fix, but there’s trillions of dollars lobbying against it. Make no mistake. The way you fix the entire system is you make them compete. You open up the state lines and have transparency pricing. The rest will naturally sort itself out through the free market system. That is capitalism, fellas! And the insurance industry should not be exempt from what all of us are subject to. It’s a racket, and it’s bull****.
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Old 01-14-2020, 02:00 PM   #49
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Originally Posted by Burnadell View Post
Our leader is trying to do something about the lack of disclosing medical costs before they are incurred.

Hospital groups file lawsuit to block Trump's price transparency rule:

https://www.reuters.com/article/us-u..._0dtncc6SMvi9U
Lawyers+Corupt Politicians+Big Pharma+Hospitals+Health Insurance co's=One of the largest criminal operations on the planet!!!!! They all get rich and we supply the money!!

IF there is any hope Trump is it.. They fight him at every turn though.. It will probably never be fixed..

Last edited by ttaxidermy; 01-14-2020 at 02:03 PM.
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Old 01-14-2020, 02:02 PM   #50
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It is also intentionally convoluted, and difficult. As someone who has had an extreme amount of medical debt in the past, sometimes it will take me an hour on the phone just to iron out a small issue. At one point it was literally a full-time job for my wife to address and pay bills.
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