patient financial responsibility. new ways of handling it

so i was at the hospital lab(on premises but not in hospital) getting a drug screen done for a new job and i was reading all the crap hanging by the window about cards on file then i heard the tech explaining it to a guy in front of me.

their new deal is to have an insurance card on file AND a debit or credit card. they said if you do not put a card on file you can not get treatment or services. she said when you have treatment or services done they bill the insurance first and whatever they do not pay they charge to the credit card or debit card.

in my opinion, this sucks. very not cool.
i have had services done at docs/hospitals/pharmacies and the insurance would not pay x amount even though i was covered. i would have to get on the horn with insurance and finally get my services covered.
it would suck for someone to have the insurance not pay say a 500 dollar bill and then have the lab or doc slam the card for 500.

i mean, is a person supposed to keep x amount in their account just in case something maybe didnt go through the insurance?
what if their account is under 500 and when the card gets hit they get overdrawn?

i dont like this at all.

if the system actually worked where insurance paid what and when they were supposed to but these days they are not on the ball.

a reply to: Mugly

Yes because they should charge you $500 for a$6 bedpan $20 for a $0.05 aspirin and then rape the money out of you.

Didn't you know, for profit medicine is more about profit and less about medicine.

I hate this world, there is scant good left in it.

It just shocks me they fail to see the obvious problem.

If they charged what it actually cost, plus a little extra for them to make money on, then people would pay their now reasonable medical bills.

Instead they charge you for stitches, what heart sergury costs in most countries.

You can literally build and have a satellite launched into space, for the cost of some medical services.

a reply to: Mugly

Go to a different lab--I'm uncertain where you live, but within comfortable driving distance from me there are many labs that can do this kind of work.

Take your money elsewhere.

And if you can't, then, yes, start a medical savings account and give them that card number and go from there. You can still dispute the charge, because you'll still get a bill, and they'll refund anything that needs refunded when the dispute is resolved.

But I do agree--it's a sucky business practice, regardless.

originally posted by: johnwick
a reply to: Mugly

Yes because they should charge you $500 for a$6 bedpan $20 for a $0.05 aspirin and then rape the money out of you.

Didn't you know, for profit medicine is more about profit and less about medicine.

I hate this world, there is scant good left in it.

It just shocks me they fail to see the obvious problem.

If they charged what it actually cost, plus a little extra for them to make money on, then people would pay their now reasonable medical bills.

Instead they charge you for stitches, what heart sergury costs in most countries.

You can literally build and have a satellite launched into space, for the cost of some medical services.

It is quite well documented that a large portion of the ridiculously inflated costs for medical services is due in part to both frivolous lawsuits against doctors/hospitals and those who, without insurance, us the E.R. for everything from a headache to a cold and then don't pay the bills (and don't even get me started on the costs passed on by hospitals by those who are here illegally and don't even use real addresses when getting medical services and can't even be found in order to send them a bill).

I'm not saying that greed isn't a part of it, but there are quite a few legitimate reasons as to why those of us who are responsible in paying for both insurance and medical care pay so much.

a reply to: SlapMonkey

Yessir, people abusing the system screws all of us.

One plate and eight screws in my ankle was 64,000 dollars. They said I needed another surgery two weeks later to pin one of the other breaks. I opted out of that!

a reply to: KawRider9

Sounds like I had a similar surgery about a decade ago, cost under $30,000
sounds like either inflation has really hit the medical costs or you got slightly screwed. sure hope your insurance didn't pay for any of the bill and your bill was on top of that!!

For those who are saying that the cost of the lawsuits and those not paying their bills , well got to tell ya, it would take my over two years to earn that money and that is if I could work!! add to that the amount of money our dear gov'ts both state and federal along with local take from us in the form of taxes that go toward medicaid, medicare, grants to build hospitals, grants to develop drugs, grants for hospital equipment, I am sorry but well I think the taxpayers put plenty of money into the healthcare system without even ever visiting a danged doctor!!!

I didn't have insurance when I broke my ankle, didn't qualify for any kind of gov't assistance, but well everytime I turned on the news I was hearing how our state and local gov't was having to raise this tax or that fee to help pay for the danged medicaid! I didn't have insurance because I got danged tired of limping around the shop trying to work with feet that just weren't working right, tried to get the medical care I needed only to end up so danged broke I could afford the gas to get to work! I'm now over 50+ years old recently lost my husband and will soon run out of money with really not much in gov't assistance being offered me. I'm supposed to go find myself a job in a sick economy that is run with sick gov't officials that would prefer to import illegal aliens so businesses can have a cheaper labor force that probably has the gov't paying their rent thanks to the american taxpayer. Only I have a tendency of waking up in the morning and finding my feet so cramped up it takes me 10-15 minutes of using my hands trying to get my toes straightened out!!

I have no guilt feeling about not paying all of that $30,000, I figure my family paid it through taxes. And well who has $30,000 laying around in their bank account for a doctor or hospital to charge?

The healthcare in this country has been screwed up for quite awhile and our dear elected leaders have no intention of fixing it! After all we live in a country where corporate profits are GOD!

I have always been of the opinion, that the major expense and abuse happens at the ER. A lot of people who go to the ER do not need to be there, and could wait the 24 hour to see an urgent care clinic or family practitioner. Leave the ER for what our hospitals actually do better than anyone: Trauma. Life, limb, or eyesight. Snotnosed fussy brbritches, can wait to see the pediatrician on monday. The ER is also heavily used by the uninsured for non life threatening ailments.

Personaly, I love my local urgent care clinic. Having joined their 'perferred cash payers' club, yes, most have these unadvertised, I get substantially discounted costs, and none of the hastle of proving banking or insurance information. As an example, I raked the flesh down a knuckles length on two of my fingers building a storage annex for my shop, was in and out in an hour hour, and only paid $300 cash for wound irigation, ensuring no nerve and tendon damage, and sutures. Whereas a similar ER visit would have been close to $2500 cash.

On the other hand, I am running into brick walls trying to find a urologist who will do a vasectomy for cash... And that is strictly an elective out patient procedure. They want in network referrals, a physical, insurance info, blah blah, blah, blah... I just want to give them 10 crispy hundos for the snip and 2 followups to ensure it took.

Definitly a backasswards system.


ETA. Also the massive increase in 'Medical Administrator' hiring to navigate all the bureaucracy, which may be more than the ER abuse in retrospect.

originally posted by: SlapMonkey

originally posted by: johnwick
a reply to: Mugly

Yes because they should charge you $500 for a$6 bedpan $20 for a $0.05 aspirin and then rape the money out of you.

Didn't you know, for profit medicine is more about profit and less about medicine.

I hate this world, there is scant good left in it.

It just shocks me they fail to see the obvious problem.

If they charged what it actually cost, plus a little extra for them to make money on, then people would pay their now reasonable medical bills.

Instead they charge you for stitches, what heart sergury costs in most countries.

You can literally build and have a satellite launched into space, for the cost of some medical services.

It is quite well documented that a large portion of the ridiculously inflated costs for medical services is due in part to both frivolous lawsuits against doctors/hospitals and those who, without insurance, us the E.R. for everything from a headache to a cold and then don't pay the bills (and don't even get me started on the costs passed on by hospitals by those who are here illegally and don't even use real addresses when getting medical services and can't even be found in order to send them a bill).

I'm not saying that greed isn't a part of it, but there are quite a few legitimate reasons as to why those of us who are responsible in paying for both insurance and medical care pay so much.

No. It is not well documented that the high cost of health care is due to frivolous law suits. Law suits don't really contribute that much to increasing health care costs. All of that is propaganda perpetuated by corporate entities that were pushing Tort reform; which is complete and utter crap and simply a way to remove rights from the consumer. Even those in health care bought this load of horse pucky though too. It has become its own industry. Proponents for this myth like to throw around that "ten cents for every dollar spent on health care goes to medical malpractice insurance", and that is BS too. It's all a money making scheme for those who can afford the lobbyists and media campaigns.

The high cost of health care is due to the bureaucratic red tape dragon that is the regulatory mess that we are in.

It.

Is.

The.

Government

that is making health care so expensive. There are entire departments constructed and implemented in order to deal with just the billing side. Medicare regulations alone have 130,000 pages. All of these regulations are designed to be confusing because one mistake means that the hospital does not receive reimbursement from the government and in fact may have to pay a fine; because of a clerical error.

The only ones making consistent money are those selling and manufacturing medical equipment. I'm not even so sure the insurance companies are making that much but I could be wrong. While our local hospital was negotiating to buy a new CT machine (which they desperately need) they basically tacked on an additional 25 grand in order to DISABLE the software that kept the machine from running at full capacity. It's a racket.

No one understands this because they don't want to. It's easier to blame the hospitals. Which makes me angry; most health care professionals want to help people but they are hindered financially and even in terms of time available to spend on each patient thanks to towers of government mandated paper work. Go ahead though and blame the people that are actually trying to help you and are just as frustrated and scared as you are. Everyone who does this is just part of the problem and part of the reason why it is only going to get worse. The people providing the care are just the most visible and so the best scape goat.

originally posted by: J.B. Aloha
I have always been of the opinion, that the major expense and abuse happens at the ER. A lot of people who go to the ER do not need to be there, and could wait the 24 hour to see an urgent care clinic or family practitioner. Leave the ER for what our hospitals actually do better than anyone: Trauma. Life, limb, or eyesight. Snotnosed fussy brbritches, can wait to see the pediatrician on monday. The ER is also heavily used by the uninsured for non life threatening ailments.

Personaly, I love my local urgent care clinic. Having joined their 'perferred cash payers' club, yes, most have these unadvertised, I get substantially discounted costs, and none of the hastle of proving banking or insurance information. As an example, I raked the flesh down a knuckles length on two of my fingers building a storage annex for my shop, was in and out in an hour hour, and only paid $300 cash for wound irigation, ensuring no nerve and tendon damage, and sutures. Whereas a similar ER visit would have been close to $2500 cash.

On the other hand, I am running into brick walls trying to find a urologist who will do a vasectomy for cash... And that is strictly an elective out patient procedure. They want in network referrals, a physical, insurance info, blah blah, blah, blah... I just want to give them 10 crispy hundos for the snip and 2 followups to ensure it took.

Definitly a backasswards system.

ETA. Also the massive increase in 'Medical Administrator' hiring to navigate all the bureaucracy, which may be more than the ER abuse in retrospect.

It is getting harder and harder to find docs that will work for cash, still lots out there though.

I see the problem as you are not the customer. Insurance is the customer. You have no say in your care, or what you will pay for.

I had a problem, and was in hospital for a couple days. Every time a doc picked up my chart it cost me 200 dollars. My chart was in the hall by the door. I never saw 5 of the specialists that my insurance paid 400 and o paid 200 to. There is no argument, if insurance pays, you owe the difference. One even admitted to me all he did was read my chart.

Now these were all pulmonologists. I had a spontaneous pneumothorax, however the ER doctor botched the chest tube, so every one of those specialists who wrote that I was recovering fine, without ever laying eyes on me, was dead wrong.

My lung was still not inflated. For over 2 days. Finally I went off all meds, took my chart, and wouldn't let anyone give me anything until they could tell me what was still wrong with me.

The good doc comes in, tells me the tube is botched, yanks the tube out the side of my chest, and jabs a needle in the front.

I was fixes in 30 seconds.


The problem is you, as a patient, have no influence on the flow of money between doctors and insurance. You are not a customer, you are an asset being traded around.

Now I pay cash for everything I can. Helps me to only pay the people who actually provide a service.

a reply to: johnwick

while i was sitting there the guy said something like "this is how much the lab work costs"
and she said thats what they bill the insurance company and then the insurance company usually negotiates it down about 60%.

my bro was charged 8 bucks for an ibuprofin at the hospital.

originally posted by: SlapMonkey
a reply to: Mugly

Go to a different lab--I'm uncertain where you live, but within comfortable driving distance from me there are many labs that can do this kind of work.

Take your money elsewhere.

And if you can't, then, yes, start a medical savings account and give them that card number and go from there. You can still dispute the charge, because you'll still get a bill, and they'll refund anything that needs refunded when the dispute is resolved.

But I do agree--it's a sucky business practice, regardless.

i was just sent there for a drug screen. didnt cost me anything.
and i absolutely will not start any sort of medical savings account. so they can just clip my account when insurance does not pay and then i have to fight to get my money back 6 months later.
pass on that

if i ever lose my insurance it will be right back to the doctors at the not for profit hospital.
they write a LOT of that stuff off