Holy mackerel! I’ve had conventional insurance, low/no income insurance, and no insurance at all. After all that, I’ve learned that you’re screwed whichever way you go: you pay tons of money per month for something you hardly ever use, or you have to go through so much red tape that it’s not worth it, or you’re just screwed out right.
I’ve decided to just let my illnesses rack up until it’s one huge thing worth going to the doctor for.
I used to have health insurance through my husband’s job which rejected every single claim. I do not exaggerate. Every single claim.
Automatically, they would tell me that it was rejected because I had no referral from my primary care physician. I would call my doctor’s office, and ask them to fax it into them again. A week or so later, I would get another rejection notice-- for the same reason. Usually after about the third or fourth time, they would finally pay the claim, but it was always a struggle.
I started getting my PCP to give me a copy of the referral. I thought I was mighty clever. When they told me that I didn’t have a referral, I would smugly tell them that I had it here, in my hot little hand. I would fax it in myself, thinking that it would be taken care of. I would carefully note to whom I spoke, when, and what actions I took.
It didn’t matter. Every single time I would have to call again and again. They would always say they hadn’t gotten a referral. It was enraging. I was put into collections again and again. I was so embarassed when talking to them, feeling like a deadbeat even though I had done nothing wrong.
So, I was probably one of those people who looked like a scumbag to the OP for not paying her bills.
There are legitimate reasons, sometimes.
Through all of my mother’s final illness, I never had to file with Medicare. This hospital does the Medicare billing routinely, as they are required to do (you seem to be deeply confused on this point). They work with this HMO, the largest in the area, every day of the week. I never got a bill for the ambulances, for the hospital stay, or for the hospice care. In this one case, they simply screwed up. And screwed up again. And again.
On the other hand, the bill was grammatically correct in all respects. It must not have been written by you.
No, you don’t have to file it. You don’t have to get paid, either. And I would dearly love to see you try ruining my mother’s credit rating (hint - she died several months ago).
If you want to argue on moral grounds, that’s one thing. If you are arguing in regards to economics, it’s another.
Not trying to be dense, but how exactly does $5.00 a month, towards an $800,000 debt for example, not make it more expensive for everyone else? I mean, it’s great that some form of payment is being made, but to me it seems like it might as well not be paid - it probably costs the hospital more than $5 to have someone open the envelope and cash the check.
Every time I read one of these horror stories, I gasp, and then breathe a sigh of relief, as I live in that majestic, far-away tundra kingdom known as Canada, where patients are covered for nearly everything by the government in an extremely simple process.
You have my sympathy, o victims of hospital billing.
Harleen, thank you. I am in the process of getting ahold of what my “normal” portion woul dbe under my plan-I’ve never been told or given any sort of rate schedule. Once I have that information, I will demand to be charged at that predetermined rate, not at $375 per visit.
WHen you consider that a visit to a regular MD would probably cost the uninsured $75 or so, $375 is ludicrous.
Sam
No, the practice is discriminatory because the hospital won’t enter into a contract with an individual, thereby having two different pricing plans for the exact same services with some consumers completely unable to access the second plan.
Now you can argue for yourselves whether or not the practice is unfairly discriminatory – clearly I think it is, but I’m willing to agree to disagree on the matter - but it is discriminatory by definition, as it draws a distinction between two classes of consumers.
See, personally I’m of the opinion that the price that you or I pay for healthcare should be based on the actual cost of providing it, not how many of our friends we can convince to use the same health-care provider. If hospitals are truly operating on a “shoestring” then they shouldn’t be playing the same economics games as the owner of my favorite restaurant who routinely gives free appetizers or desserts to favorite customers or people who send a lot of business his way.
From what I’ve seen from statements I’ve received, my insurer is not living up to any such guarantee, if it ever made one to begin with. I just got a statement from my kids’ pediatrician showing that my insurer hasn’t paid for their checkups yet – they happened in April. But yes, I’m generally happy to pay for services when I receive them, and if I cannot pay the whole amount, I’m willing to make reasonable payment arrangements. Most people, if they have the money or can make an affordable arrangement, will gladly pay for their healthcare. They understand how crucial it is.
I never said that it was, and I’ll thank you to not try to put words in my mouth. Expecting that people will pay their bills is not discriminatory. Expecting that individuals will pay more than (multimillion dollar profit making) insurance companies, however, is.
[ul][li]Start with one cost for everyone, insured, covered by Medicare/Medicaid or self-pay, a true cost which legitimately covers the expense of your treatment and compensates those who provide it. Accept no less from insurers or the government, accept no more from private individuals.[/li][li]Move to streamlined, simplified billing. I don’t care if lab services are separated from doctors’ services which are separated from radiology services which are separated from the hospital charges. But have all of those bills generated from one place, generated once (or once each month, max) and have shared access to the database of the patients’ insurance/financial information so that the proper bills can be sent to the proper place the first time around.[/li][li]Make healthcare insurance coverage more accessible and affordable by eliminating the ability of insurance companies to create false standards for what constitutes a “group” which qualifies for reduced premiums. (Or eliminate the concept of “group” rates entirely.) There is no reason why a community, a house of worship, a social club, an extended family or a trade organization cannot be a “group” just as well as the arbitrary standard of “everyone who works for XYZ Company” if we must have groups, and making it possible for more people to qualify as a group member (especially in our growing entrepreneurial age) will give more people access to healthcare and in turn, make us all healthier.[/ul][/li]That’s my start, how about you? How would you improve things?
Ugh. We’ve got the option for redress of grievances in the court for any and all disputes between private parties, and the “it’ll drive costs up” canard applies everywhere. It’s not a legitimate reason to stop people from seeking the remedy of law in cases where they feel wronged. There’s no point in even bringing it up, it’s so useless an “argument.”
I’m not suggesting that there should be socialized medicine, not because I don’t want taxes to go up but because I have seen the inefficiency and ineptness of anything the government runs, I’ve seen how Medicare and Medicaid programs run and I don’t want that for everyone. I don’t want it for the elderly or poor now. All I ask is for a level playing field. We’re not talking about bills for liposuctions and face lifts, we’re talking about things that are not optional. If there’s one area where people shouldn’t be getting special deals or access to something others cannot get, it’s health care.
I had made more than one point. This whole thing is wrong on so many levels — the entitlement mentality, the fiscal irresponsibility, the disregard for others, the special pleading fallacy, the contorted ethics, the intention to deceive, the social immaturity. I just reeks.
I don’t know if it’s discrimination, but it has the net result of well-off people (who would be insured) health care being subsidized (if the amount paid by insurers are lower, their premiums are presumably lower too) by poorer (who would not be insured) people. Given that it’s already an enormous burden to foot a medical bill for someone who doesn’t have an insurance, I can imagine such a situation being infuriating.
Same here. Each of these threads make me think that the most fucked up public health care system one could come up with would be a blessing of the gods by comparison. Let’s praise the taxes which protect us from the plague of private insurers and the wrath of hospitals’ billing services.
I would suspect it’s true. I assume these costs vary widely from one company to another, but, in the totally different field of activity I work, our cost for billing and cashing a payment is indeed around 5-6 $ if I remember correctly.
I simply cannot imagine the utter, soul-crushing despair which must come from going into hospital for a serious operation or treatment and having to worry about financial position it will place you in. And we complain about waiting lists!
I don’t usually venture into the Pit, but want to provide accurate information on this point: the Health Care Financing Administration (HCFA) has not been HCFA since 2001. They are now the Centers for Medicare & Medicaid Services (CMS and, yes, it’s an inappropriate acronym with only one M). CMS is interested in fraud related to Medicare and Medicaid; see http://www.cms.hhs.gov/providers/fraud/ , but there are links to other agencies where you can report health care fraud near the bottom of that page.
I am torn here. There have been good arguments on every side of this thing.
As for me, well, I was raised that you pay what you owe, even if it takes a long time. I have never blown off any bill that I owed and I won’t be in the future. That’s not a money thing, that’s an ethics thing. Just because the money is owed to some big company that “probably doesn’t need it anyway and they’ll never miss it” doesn’t mean that I don’t owe it.
Having said that, I have an anecdote and a warning.
Anecdote- my grandfather died at home, but the paras were required by law to take him to the hospital (he hadn’t been dead that long). At the hospital, we explained that he was long gone and they were to attempt no revival. They indicated that they must at least try. We said it was stupid and did not give permission, but they tried to bring him back to life anyway. Didn’t work, of course.
A few weeks later, bills begin to arrive for my grandpa’s “treatment” at the hospital. We wrote the billing dept a nice letter, explaining that the treatment was NOT authorized. They didn’t get it and we went back and forth. Eventually they threatened to send it to collections and ruin my grandpa’s credit. We said “Go ahead, guys, he’s DEAD and won’t care!”
My warning- don’t be a dumbass, be an informed consumer. Always ask your hospital for an itemized bill, then go over it carefully. The data entry people are human beings and they make mistakes. You will often (well, always) see multiple or incorrect entries. Write a nice polite letter detailing what you think are errors and ask for an updated bill. Repeat these steps until you are satisfied that the bill is correct.
Then pay the damn thing.
TeaElle, with a couple of exceptions, it sounds like a good start.
First, this:
When I say they need to be billed separately, I don’t mean “itemized.” I mean, each service has to be billed by the entity which performs the service. What you are proposing is not possible. Interestingly enough, because of all the lawsuits by patients accusing hospitals of price gouging. So now, when a radiologist reads an x-ray in the hospital, he requests billing information be sent on to his office in order to bill for the reading of that MRI/CT/X-ray. Because the hospital is not allowed to bill it for him. He may or may not get that info, depending on how many times his biller requests it, usually from patients who call his office and screech “You people are fucking incompetent! I gave the hospital all that information! Get your shit together!” Instead of finding out why the radiologist does not, in fact, have copies of insurance cards. It certainly would streamline things. Too bad the insurance companies successfully lobbied to get it changed.
How would I change things? For starters, I’d force insurance companies to put a stop to capitation. It was a horrible idea whose time has passed. The cap rate is never enough to cover patients’ expenses.
Second: I’d get patients to care enough about their coverage to educate themselves and get them to read what is and what is NOT covered. Most people just think “I have insurance, isn’t that what matters?” You should know your in and out of network deductibles, your coverage rate, your copay amount, and DEFINITELY should know whether or not your employer is offering a self funded plan or an actual insurance policy. They are two different things. Also, if it’s a self funded plan…your HR department decides what benefits you are going to get. Not the insurance company. So, if you complain and say “I have crappy insurance…” taking it up with your HR dept. might actually do some good.
Third: I’d try my damnedest to make sure that outsourcing does not occur. HIPAA guidelines don’t seem to be enough to stop the industry from moving accounts to India, and all privacy goes out the window.
Unfortunately, these things are not headlines in news these days, and most people tend to tune it out, because it’s an unpleasant subject, and kinda boring, when you get right down to it.
As for the “useless argument”; it’s only useless because you don’t want to believe it. Doctors are leaving California in droves because malpractice insurance is through the roof. A million dollar policy costs approximately $100,000.00 a year. Yes, that decimal is in the right place. Hospitals pay more. And those costs go up with each incidence. But hey, as long as it’s not you that’s getting laid off, I guess it’s easy to call it a canard. Sue that doctor over the $75 you shouldn’t have been billed. Nothing like swatting a fly with a Sherman tank.
You ought to try living in the real world, Lib. There are people here who had perfect credit ratings until they lost their jobs and couldn’t find another one that replaced the income, and ended up charging such luxury items as rent, utilities, and, yes, medical expenses on their credit cards, while vainly searching for jobs that would pay well enough to pay off the debt.
About a year and a half ago, I landed myself in the emergency room and copped myself a $1700 bill, plus another $400 for the physician who spent a total of maybe five minutes attending to me. All this for a couple of quarts of intravenous fluid and some Demerol. Four days later, I lost my job. Ended up working at Wal-Mart.
I tried to make payment arrangements with the hospital for $10/month. They refused, saying that even if I made the payments, they would still turn me over to collections. They wanted the whole $1700 and they wanted it yesterday. They said they would write off $400 if I paid in full immediately, but I didn’t have the available balance on my credit cards to do it, what with maxing them paying rent and buying expensive prescription medications and all.
So, I just said, screw it. I knew that if I was insured my insurance company would have been billed maybe $800, if that. I also knew that the hospital’s “usual and customary fees” gave them a 400% profit- the chain they belonged to had been, along with other Las Vegas area hospitals, the subject of a rash of newspaper articles. So, even billing at the rate they charged insurance companies, I said, “screw 'em”.
Meanwhile, trying to work at Wal-Mart, I was just barely making my share of the rent and household expenses, let alone pay my credit card bills, so I ended up filing bankruptcy.
If hospitals would actually charge reasonable rates for their services, like, say, figure costs and add maybe a 10% or so profit margin over that, maybe more people would be able to pay their bills. Instead, they quadruple (or more) their costs and then “reduce” their rates for insurance companies.
I got five minutes of physician care, maybe ten minutes of nursing care, and some saline and demerol. Maybe a total of $300 worth of care. And was charged $2100 for it. And they refused to make payment arrangements with me.
:rolleyes:
Please provide a reputable cite demonstrating a corellation between an increase in malpractice suite payouts and an increase in malpractice premiums.
The only people whistling that tune seem to be the insurance companies–just about everything else I’ve read on the topic seems to indicate that the reasons for high malpractice premiums are a great deal more complex then that, and, not surprisingly, a bit more damning of the insurance companies.
Here’s a good overview, complete with cites and actual data(!!).
Yes indeed. Much like our generous laws allowing you to continue your medical insurance (for self and little kiddies) at a mere 5 times the price, when the reason you are no longer insured in the first place is that you are unemployed. No wonder they call it COBRA.
Metacom, This is the one I read most recently. If you can give me a bit, I’m trying to find the transcript from the hearings that were on CSPAN last year.
Oh, and so you know…it causes me no end of frustration and pain that I’m siding with GW on this.