Hospitals slow to disclose prices

[Ingomike]

Yeah, let's completely ignore the fact that it's a business service you paid for. Not only that, it's one you are forced to have.

Weak nonsense

If one is not getting what they paid for sue them for breach of contract. Otherwise either pay for what you want or buy the insurance coverage you want…

 

[wtburnette]

I think it will dry up. Federal and state emergency dollars i think are gone and hospitals can't afford it.

Crazy incomes for these travelers. 20% of bedside nurses quit when COVID hit. Either left the industry, retired, or took non-clinical jobs The travelers are making 2-3X normal rates while my salary is down 15-20% since COVID hit. Staff nurses have been getting huge bonus incentives to work shifts. I mean, good for them, but their industry bailed and it is hurting patients, docs, and hospitals. Frustrating.

Yep, plus don't forget the members of the workforce who were on the COVID frontlines when there was no vaccine who suddenly weren't good enough to keep working when they didn't want to be forced to take it once it was available. Experienced men and women who were forced out of their livelihoods. That probably lead to some of those traveling nurse positions.

 

[Jaybird1980]

It is really simple, pay for your own healthcare. Then no one can tell you what to do. Until then, others are going to tell you what you get…

 

[hoosierdoc]

Yep, plus don't forget the members of the workforce who were on the COVID frontlines when there was no vaccine who suddenly weren't good enough to keep working when they didn't want to be forced to take it once it was available. Experienced men and women who were forced out of their livelihoods. That probably lead to some of those traveling nurse positions.

Federal mandate to be vaccinated if your facility accepted Medicare, but yes, i agree

 

[Cameramonkey]

Federal mandate to be vaccinated if your facility accepted Medicare, but yes, i agree

Yep. Because nothing says "Its a good idea" like "Do it or else".

If it was so good, people would line up willingly to do it, not walk away from a job over it.

 

[thelefthand]

That's mainly because the hospital has no idea what each procedure actually costs. They can look up what the negotiated rate is for a specific code for a specific insurance company, but they have no idea what it actually costs.

 

[HoughMade]

...If it was so good, people would line up willingly to do it, not walk away from a job over it.

Because everyone always make sound decisions. I'm not going down the vaccine debate path, but clearly this is not a sound argument as to pretty much anything. That people don't choose to do something is close to irrelevant to whether it is a positive thing or not.

 

[BehindBlueI's]

Because everyone always make sound decisions. I'm not going down the vaccine debate path, but clearly this is not a sound argument as to pretty much anything. That people don't choose to do something is close to irrelevant to whether it is a positive thing or not.

People always do what's best for their health. That's why there's no obesity in America.

 

[jamil]

Usually at least a 10X markup. Which is more expensive? A bag of fluid? Or the nurse taking time to get it, spike it, prime the line, ensure the IV is patent, hook it up, run it in, and assume liability if there's a problem?

Hospitals are sneaky at separating all these charges. Simply giving the fluids increases the level of service, then there's pharmacy charge on the fluid, nursing fee to admin it, etc etc etc.

We could do it like mexico where you don't get to leave until your bill is paid. And the longer it takes you to pay, the higher the bill goes.

Spokane woman says Mexican hospital held her hostage, extorted her family

A Spokane woman and her family say she was held hostage in a Mexican hospital this week after receiving a punctured lung while on vacation in Cabo San Lucas.

www.spokesman.com

If you have a laceration that's a bit skewed, I can repair it without revising the wound edge. I can try to stuff the extra fat back inside the cut. Or i can simply cut the lac to have better edges and cosmetic appearance. I can cut out the little bit of herniated fat and make it close easier and cleaner.

Each of these two interventions adds to the complexity of the laceration repair, and thus the cost. Should i get consent from the person before I trim the wound a bit if it adds $200 to the fee?

I usually just do it and don't tell anyone or document it because it seems ridiculous for minor things. The lac repair charge is enough. But technically when I do that I am signing a fraudulent medical chart.

Underbilling and undercoding is fraudulent. Waiving co-pays is fraudulent.

Charges are so complex. There is no easy answer.

Used to be easier. What if we just cut insurance companies and the government out of some of these decisions? What if we severed the link between insurance companies and providers? The patient isn’t the real customer now. It’s essentially the insurance company.

Patient comes in with a cut. You work out with the patient what it’ll cost. You fix the cut as agreed. You send the patient the bill. Patient files a claim. Insurance company sends patient a claim check. Patient pays you.

Insurance company only works out coverages with the patient. The patient is the insurance company’s only client in that transaction. You work out what you’re going to charge with the patient. The patient is your only client in that transaction. And of course, the government stays the **** out of it other than standards of care, fraud prevention, etcetera.

 

[Cameramonkey]

Used to be easier. What if we just cut insurance companies and the government out of some of these decisions? What if we severed the link between insurance companies and providers? The patient isn’t the real customer now. It’s essentially the insurance company.

Patient comes in with a cut. You work out with the patient what it’ll cost. You fix the cut as agreed. You send the patient the bill. Patient files a claim. Insurance company sends patient a claim check. Patient pays you.

Insurance company only works out coverages with the patient. The patient is the insurance company’s only client in that transaction. You work out what you’re going to charge with the patient. The patient is your only client in that transaction. And of course, the government stays the **** out of it other than standards of care, fraud prevention, etcetera.

But you assume the patient actually has the cash to float what the doc is charging while they wait for insurance reimbursement... assuming insurance even reimburses the patient fully. I can see the patients rebelling when they have to pay the doc $200 for those stitches but insurance decides the doc costs too much and only cuts a $100 check. [cue the outrage due to the patient getting shorted]

 

[Route 45]

It is really simple, pay for your own healthcare. Then no one can tell you what to do. Until then, others are going to tell you what you get…

 

[hoosierdoc]

Used to be easier. What if we just cut insurance companies and the government out of some of these decisions? What if we severed the link between insurance companies and providers? The patient isn’t the real customer now. It’s essentially the insurance company.

Patient comes in with a cut. You work out with the patient what it’ll cost. You fix the cut as agreed. You send the patient the bill. Patient files a claim. Insurance company sends patient a claim check. Patient pays you.

Insurance company only works out coverages with the patient. The patient is the insurance company’s only client in that transaction. You work out what you’re going to charge with the patient. The patient is your only client in that transaction. And of course, the government stays the **** out of it other than standards of care, fraud prevention, etcetera.

Federal law states we will see and stabilize any emergent condition. Is a cut an emergency? Maybe. The law is extremely vague. Getting rid of EMTALA would help a lot.

Most of what a nurse does in a patient chart in the ER is useless. "Are you safe at home? Have you been vaccinated? Do you smoke"

But you assume the patient actually has the cash to float what the doc is charging while they wait for insurance reimbursement... assuming insurance even reimburses the patient fully. I can see the patients rebelling when they have to pay the doc $200 for those stitches but insurance decides the doc costs too much and only cuts a $100 check. [cue the outrage due to the patient getting shorted]

Bad cosmetic outcome is one of the top lawsuits in emergency medicine. How much is it worth to buy lottery ticket that can pay out $250,000?

 

[Shadow01]

But you assume the patient actually has the cash to float what the doc is charging while they wait for insurance reimbursement... assuming insurance even reimburses the patient fully. I can see the patients rebelling when they have to pay the doc $200 for those stitches but insurance decides the doc costs too much and only cuts a $100 check. [cue the outrage due to the patient getting shorted]

The solution here is your level of coverage. 80/20, 90/10, 70/30. Insurance pays the percentage of the total bill. You know your share. Also the feds needs to mandate timely payment with financial penalties to the insured patient for missing payment deadlines by the insurance company. I figure 140% of the initial bill as a starting point for penalties.

 

[jamil]

But you assume the patient actually has the cash to float what the doc is charging while they wait for insurance reimbursement... assuming insurance even reimburses the patient fully. I can see the patients rebelling when they have to pay the doc $200 for those stitches but insurance decides the doc costs too much and only cuts a $100 check. [cue the outrage due to the patient getting shorted]

I don’t know how old you are. This is how it used to work. Seemed to work pretty well. The problem was, insurance companies and providers weren’t making as much money as they could have. They took the decisions away from the patients. Now it’s a cash cow.

 

[jamil]

The solution here is your level of coverage. 80/20, 90/10, 70/30. Insurance pays the percentage of the total bill. You know your share. Also the feds needs to mandate timely payment with financial penalties to the insured patient for missing payment deadlines by the insurance company. I figure 140% of the initial bill as a starting point for penalties.

Okay, but you still need to sever the relationship between healthcare providers and insurance companies. That’s the problem. There is no market involving the patient. There is no downward pressure on price.

The patients should be the only customers of either. Doctors bill you. You file your own claims. You get the claim check. You’re on the hook for your own bill. It would work much more like a traditional 80/20 plan.

Until the market drives prices lower, something would need to be done to help low-income patients. Also, we’d need to require insurance companies change their model. They’ll need to make policies clear and easy to know what the coverages are. They’ll need to be more responsive to claims. Claims and coverages need to be black and white. It should be easy to file a claim.

 

[PapaScout]

Okay, but you still need to sever the relationship between healthcare providers and insurance companies. That’s the problem. There is no market involving the patient. There is no downward pressure on price.

The patients should be the only customers of either. Doctors bill you. You file your own claims. You get the claim check. You’re on the hook for your own bill. It would work much more like a traditional 80/20 plan.

Until the market drives prices lower, something would need to be done to help low-income patients. Also, we’d need to require insurance companies change their model. They’ll need to make policies clear and easy to know what the coverages are. They’ll need to be more responsive to claims. Claims and coverages need to be black and white. It should be easy to file a claim.

Do we have any other business model here in the US where companies make more money by doing less? Insurance premiums are fairly static over the course of a contract year so the only way to increase profits is to pay out less/deny claims. Truly criminal. Like putting foxes in charge of the henhouse and you have to beg the fox for dinner.

 

[HoughMade]

It is really simple, pay for your own healthcare. Then no one can tell you what to do. Until then, others are going to tell you what you get…

Yes.

The price disclosure laws are just more feel-good, do-nothing laws until people have to pay the prices directly and price shop.

 

[jamil]

Why? They are paying for them.

No they’re not. The insured are paying for it in the form of premiums that they have no market power to control. That’s another reform I’d like to see. Get health insurance out of employers hands. And into individuals’ hands.

 

[HoughMade]

No they’re not. The insured are paying for it in the form of premiums that they have no market power to control. That’s another reform I’d like to see. Get health insurance out of employers hands. And into individuals’ hands.

I've been buying my own health insurance privately for about 20 years.

 

[BehindBlueI's]

The patients should be the only customers of either. Doctors bill you. You file your own claims. You get the claim check. You’re on the hook for your own bill. It would work much more like a traditional 80/20 plan.

My father in law had stints put in his heart in Jordan. He paid up front, as required. While inside him they discovered extra work that needed to be done, left him open on the table and went and told the family. He was left open on the table while they scrambled around withdrawing money by multiple family members, rushing back to the hospital, and paying the new bill so they'd put the extra stints in and close him up. Be careful what you wish for.