Is there a consumer oriented version of ELAP for out of control health care billing

[Wesley_Clark]

I read about a group called ELAP today.

http://www.newsweek.com/how-keep-down-sky-high-hospital-bills-dont-pay-332271

Apparently when a health care bill which is (to them) radically inflated comes to one of their clients, they contest it in court on various grounds and seem like they usually win. However the group is just for self funded employers who pay their own health care bills. Does anything similar exist for individual consumers?

Normally, customers who don’t pay bills get hassled or sued. This sometimes happens to ELAP clients and their workers. Hospitals send patients huge invoices for what the employer refused to pay. They hire collection agents and threaten credit scores.

ELAP fights back with lawyers and several arguments: How can hospitals justifiably charge employers and their workers so much more than they accept from Medicare, the government program for seniors? How can hospitals bill $30 for a gauze pad? How can employee-patients consent to prices they will never see until after they’ve been discharged?

[GrumpyBunny]

Normally, self-insured plans work through an insurance company and uses their networks.

As such, unbundling (billing separately) for the mythical “$300 gauze pad” would probably be against the billing rules and guidelines of the insurance company, and would be considered abusive billing, and would be handled by the insurance company.

You can see this as your hospital sends bills to the insurance company and you, and you see things “fall off” the itemized bill as the insurance company says nope, A and B are included in the payment for C.

As for private individuals, do you mean those with or without insurance? Those with insurance should, again, fall under their insurer’s networks and billing guidelines. I have yet to run into any insurance company that allows a health care provider to unbundle services and bill for gauze pads or an emesis basin. That’s included in the reimbursement for certain charges. Pretty much everything comes under negotiated rates of what’s reasonable and customary.

For uninsured people, a healthcare provider can bill any goddamn thing they want. A patient can work with that provider to pay a lower amount, and if you can pay quickly you can get a good deal. There are also negotiation services that can be used. Google is your friend here.