Trump executive order now requires transparency up-front in hospital billing

[Czarcasm]

Here is a link to the Executive Order being discussed.

[Snowboarder_Bo]

I can’t wait for the 90 and 180 day mark to see what Secretary Azar puts in place; I’m sure they’ll be the very bestest regulations. Late September and late December; got it marked on my calendar now.

[iamthewalrus_3]

@doreen

Well, sometimes you can - I know exactly how much my primary doctor will charge for a visit, because he doesn’t accept my insurance. I could have called the lab to find out how much the blood work would cost if I was self-pay.

Yes, this is sometimes true, but it is often not. My own experience is that I was unable to find out the cash cost of an eye exam, which is a very simple sort of thing that basically always consists of the same steps. No insurance was involved. No price list was forthcoming.

Surely you’ve heard about people who did all their research, figured out insurance coverage, went to in-network facilities, and nevertheless got hit with huge bills because some medical worker who happened to not have a contract with insurance apparently wandered in and performed some part of the procedure.

cite.

[doreen]

@iamthewalrus_3

Yes, this is sometimes true, but it is often not. My own experience is that I was unable to find out the cash cost of an eye exam, which is a very simple sort of thing that basically always consists of the same steps. No insurance was involved. No price list was forthcoming.

No insurance was involved and yet they couldn’t tell you how much they were going to charge you ? I’d have found another doctor. Because someone is going to send you a bill and that person has to know how much they are going to bill you.

Surely you’ve heard about people who did all their research, figured out insurance coverage, went to in-network facilities, and nevertheless got hit with huge bills because some medical worker who happened to not have a contract with insurance apparently wandered in and performed some part of the procedure.

cite.

I have heard about that - which is why I said this

Most of that only applies to out-of-network doctors - you’ll almost always know how much you will end up paying a participating provider. The problems tend to come in when you go to a participating doctor/hospital and some doctor/lab there doesn’t participate. But states can regulate that and some do - I don’t actually know if the Federal government can regulate that.

[iamthewalrus_3]

@doreen

No insurance was involved and yet they couldn’t tell you how much they were going to charge you ? I’d have found another doctor. Because someone is going to send you a bill and that person has to know how much they are going to bill you.

Yes, that is what happened. I did find another doctor. But this experience, not being able to get actual information about prices, is not uncommon in medicine. It’s extremely uncommon in any other industry.

I have heard about that - which is why I said this

Sure, but the problem is that there’s often no way to effectively restrict a hospital to use in-network providers, or to reasonable determine whether all the providers involved in some service will be in-network.

Regulations about making sure that in-network providers are fine, I guess, but they’re not universal and they’re still quite complicated. A better regulation model would be one where you contract with a hospital/doctor for a service and they publish and are held to a price.

I shouldn’t have to care or try to figure out whether the lab that the hospital might use is covered by my insurance any more than I should have to determine the details of the labor union contract at the autoparts manufacturer that makes a part when I get my car fixed. I should get a legally binding statement of costs that I and the hospital and my insurance agree on, and then we’re done. They can sort out their supplier issues on their own.

This is a little more complicated than some agreements because there are three parties, but people manage to get their cars repaired with insurance footing the bill without surprise bills regularly. We can do it in healthcare too.