When Hospitals want to take it all

[island911]

Sadly,I currently have a family member paying his own hospital bills for some major medical.

It's great that we have some fine medical available here, BUT. . .

What I am appalled by though, is outragous prices charged to the self-payer. (if insurance, or the government is paying the bill, everything is charged at only ~40% )

The hospitals claim that "everyone is charged the same. . . it's just that some are 'discounted' " (WTF?)

How is it, that when the extra red-tape is involved, the charge is only 40% (of the charge) of guy paying cash directly!?

But the bigger question I have, is how is this combated? . . .what is the best way of dealing with these people who simpley say "all of your money, or your life" ?

[Rot 911]

Has he finished with the medicals? If so talk to the people in the hospital financial office. ***** enough and they will discount the total bill. So many people without insurance never pay so they are always happy to get something.

[turbo6bar]

Call the hospital and see what you can negotiate. The worst that can happen is no discount.

I do agree the "discount" is BS. We aren't talking about buying a case of Cheerios at Costco.

Jürgen

[dd74]

Yeow. I hate to say it, but most countries have it all over us in this department.

Something to be said about Socialized health care.

With that said, I believe cash is cash and "faulting" on medical payments are as commonplace as faulting on student loans. Cash merely insures (no pun intended) the hospitals will get paid something. Thus the discount to further encourage cash payment...

[island911]

Thanks, very much, Kurt.

No, unfortunately he's not finished with the hospitals.

It seems to me that, perhaps, there is grounds for a billing discrimination case. . .perhaps a class-action suit. (?)

Hospitals charging a disproprortionate amount to the self-insured (medical IRA's and such). Effectively, the hospitals are trying to push people into the insurance industrys product. (and people thought microsoft was unethically pushing internet-explorer.)

Jürgen & dd (thanks!)
On "cash discounts". . .yeah, one would think 'cash is king'. . .well this particular hospital give a 20% discount for cash (payed w/in 30 days) . . .so that means the cash payer is only paying TWICE as much as the govt. or insurance co. bill. (again WTF)

. . not to mention, they bill 30 days later and say "you missed out on that 20% discount."

So really, I'm getting pissed. (this has been festering for a few months, but have been too busy with prior commitments)
Anyway, I'm now ready to play at their level. Any suggestions will be appreciated.

[dd74]

I feel for you Dr. I. It's a bad sitch to say the least.

Friends of ours who comprise a husband-wife photography team, got into a nasty little hospital deal when the husband was hit by a car during a shoot. His leg was nearly torn out of his torso. Hospital bills far exceeded $10K and they had no means of paying it. As was, I don't think their insurance covered that kind of accident.

What'd they do - or rather what did she do? She went in to the hospital, got hold of a wheelchair, and merely wheeled her husband out. It was gutsy, but they had no choice.

It's amazing they got out. This happened in Cedars Sinai in L.A., which is a fortress for all the right (read: terrorist and Jewish hospital) reasons.

[turbo6bar]

island911, I had a bicycling accident with a car 2 months ago. I tried to be the nice guy. Insurance companies and the hospitals are NOT looking out for your best interests. Be cordial, but don't give them anything, because they aren't giving you an inch. Before they even swing the first punch, you sucker punch 'em in the gut and don't stop punching, even if they say,"Uncle!"

I am still fighting the insurance company, and I still have unpaid medical bills from 2 months ago. Lady at the insurance company said "Sure, we'll take care of it. Can I keep the copies of your bills?" So much for that.

This is one instance in which you must be aggressive. I learned the hard way. I will let you know if I pick up any tricks.

Jürgen

[id10t]

The way it works is that hospitals charge whatever they like. Insurance is billed at "reasonable and customary rates" - state/region average, etc. - , and patient is billed for deductible/copay. Because the ins. co has to pay sooo much money out, they've agreed and contracted with the hospitals to pay X% on billed amounts, *if* they pay within 30 days of claim submission. If they don't pay by then, then they are back to paying the full amount billed to them.

Unfortunately, your friend has not signed a contract, etc. to get that discount. Good news is that he's not in trouble yet (is he?) and he can work with a lawyer/accountant type person to protect major assetts like home, etc. Bad news is he's gonna be getting som e major bills. Other good news is most hospitals are required to take any payment offered and not hound you for the rest, as long as payments are made regularly.

A friend collects large debts for hospitals from insurance comps and he explained it all to me. He also had a bad health period wtih no or minimal insurance, and he is happily paying off $75 per month to his bill. It doesn't show on credit report, etc. as far as I know, or rather, he's had no problem buying a car or refinancing his home.

[Moses]

Originally posted by island911

The hospitals claim that "everyone is charged the same. . . it's just that some are 'discounted' " (WTF?)

How is it, that when the extra red-tape is involved, the charge is only 40% (of the charge) of guy paying cash directly!?

Here's how it (doesn't) work:

Federal law forbids more that one price list. They are, however, allowed to do group discounts, etc. (WTF? is exactly right.) The reason for the law is so that hospitals don't charge Medicare (the Government) rates higher than they would charge your average uninsured patient.

Unbelievably, Medicare pays big bonus $ to hospitals for cases that are more "complicated" than most. How do they determine which cases are more complex and worthy of bonus money? The size of the bill! So hospitals have these ridiculous fee schedules that are intended to defraud Medicare, not the few uninsured patients who can't pay anyway. As a result, ordinary folks who are uninsured or underinsured are caught in the death-grip of greed that dominates hospital administrations. Sad, but true.

[island911]

Originally posted by LynnsABCs
. . .I find it curious that Island911 who takes such a strong Republican/right wing stand on every issue should bring this up. The Repubs are not going to disturb the Physician/Hospital/Insurance and Drug Lobby--too powerful and too much money at stake.

I do NOT take a Republican/right wing stand on every issue. I even voted against Bush in this last election.

It is just that the left is SOOOO lame in its 'business as usual' arguments, that I can't help but to call the BS.

Hillary and health care

You should feel lucky you're old. . ..you have guys like me still paying in to your SS system. ..even though I know this SS system will be shriveled and gone, well before it's any use to me. (just like you, and your "helpful" post here.)

[dd74]

Originally posted by LynnsABCs
8 years ago, Hillary Clinton tried to address that this country had (and still has) a health care problem and half the country when ape **** because the wife of a President is supposed to look nice and bake cookies--not try to usurp the job of her husband.

Regardless of where you thought she wanted to take the health system (and she was accused of lots of bad stuff) the debate STILL needs to take place before corporate america can no longer afford to even partially fund those of us who are employed--our health insurance.

It was a problem then, and it's still a problem. I find it curious that Island911 who takes such a strong Republican/right wing stand on every issue should bring this up. The Repubs are not going to disturb the Physician/Hospital/Insurance and Drug Lobby--too powerful and too much money at stake.

Hillary? I think it was more hatred of the messenger and not the message.

Resolution? Corporate America can't continue to afford health insurance, period. This is why we're having a grocer's strike in SoCal.

Dr. Island? I think he's an Independent; my kind of guy.

[BlueSkyJaunte]

Originally posted by dd74
Corporate America can't continue to afford health insurance, period. This is why we're having a grocer's strike in SoCal.

And this isn't Moses's fault, so don't anyone go blaming the doctors.

My sister has been through 5 physicians in the past year because they keep leaving Ohio--because the malpractice insurance is ridiculous!

The people to blame:
1) Ambulance-chasing lawyers (and the rest of our brain-dead legal system, aka bought politicians--on both sides!--and corrupt judiciary)
2) Insurance industry (aka legalized extortion)
3) Hospitals run like corporations that make Enron look like the paragon of integrity.

[dd74]

Moses is by no means at fault. If at all, he's probably in a pickle because of insurance and hospitals run like Enron.

I wonder if a doctor having a private practice alleviates at least the Enron-run hospital part. I dunno.

It's a shame. It seems like veterinarians have a better future than most doctors.

[nostatic]

yeah, but getting into vet school is a lot tougher than med school. My wife got into Penn vet school back when she got into grad school...she chose to stay in grad school.

All I can say is I'm glad I didn't go to med school. As for lawyers, my wife would likely agree (we had this conversation last night), but it is paying our mortgage, at least for the time being.

[BlueSkyJaunte]

I think there are only 15 (25?) vet schools in the country. They are notoriously difficult to get into and notoriously difficult to STAY in.

The difference, I think, is that is a large proportion of people who go to vet school because they love animals. I'm not sure there is a similar proportion of people who go to med school because they love humanity...

Certainly not, if my (former) doctors are any indication.

[turbo6bar]

10 years ago my physician used to have 1 receptionist/recordkeeper in his office. With the insurance companies being so difficult with regards to claims and paperwork, he now has 1 full-time recordkeeper just to handle the insurance BS.

The entire system is defunct, and there exist no politicians smart enough or brave enough to fix the problems.

Now if the medical field is so far bass ackwards, picture Medicare and Social Security.

Can't believe Thom hasn't chimed in about sending patients to India for medical care...
Jürgen

[dd74]

Personally, I'd go to Canada for treatment.

My godfather's a vet. Where's he live? Behind wrought iron gates in Beverly Hills.

He sez: "People spend more on their pets than themselves."

He's living proof. And he's gotten cheap too, the bastard!

[BlueSkyJaunte]

Originally posted by turbo6bar
Can't believe Thom hasn't chimed in about sending patients to India for medical care...
Jürgen

But I bet most insurance claims etc. are processed there. There was a recent case where a Far East worker was threatening to release SS#s, CC#s, etc. for a pay raise. She worked for a 3rd party who was doing a lot of the paper processing.

Feel safer now?

Sometimes outsourcing is NOT the answer.

[Moses]

Originally posted by BlueSkyJaunte

The people to blame:
1) Ambulance-chasing lawyers (and the rest of our brain-dead legal system, aka bought politicians--on both sides!--and corrupt judiciary)
2) Insurance industry (aka legalized extortion)
3) Hospitals run like corporations that make Enron look like the paragon of integrity.

Couldn't have put it better.

Let me give you a bit of insight from the MD point of view.

Most docs started their careers with the best of intentions. We saw 20 patients per day, and made a decent living. We knew your name and the names of your kids. We felt like you were part of our lives and we were part of yours. HMO's changed all that. Red tape and overhead skyrocketed. In an effort to preserve our income, we doubled, then tripled the number of patients we see per day. Many docs are bitter, tired and angry. We don't know who you are any more. On your third visit, your doc looks at you like you are a stranger. That's because he is seeing 50-60 patients per day!

Our local hospital pays PM nurses $50/hour and has trouble filling the shifts. The M.D.'s work at the same place for $42.50/hour and are always begging for more hours.

I did the HMO shuffle for 10 years before I burned out. I dropped every HMO contract 3 years ago. I spend twice as much time with my patients as I did before. I know their names and the names of their kids. I took a 40% salary cut but I love my job again. This morning I opened my daily mail. There are a lot fewer checks in the mail these days, but it's loaded with Christmas cards from my patients. Fair trade.

[speeder]

Island, I am sorry to hear that someone in your family is in this predicament. I did not have insurance for years and luckily was in good health, but a couple of times I wound up at Cedars and the bills were mind-blowing. I didn't have the loot to pay them, I paid what I could and they never really came after me for the rest. At least not yet.

I don't think that this is the right thread to invoke Hillary Clinton, (especially after what happened last time), , but some food for thought: Under our current system, insurance companies take something like 75% of every health care dollar. 75%. There were buracracies in the old Soviet Union that did better for consumers than that, fer chrissakes. How could socialised health care be worse for anyone, (besides insurance companies, and they can all ski into a tree and make me happy), than that?!

I hope that it works out. Have you thought of just giving them a fair amount, (say like figure $20.00 for each Tylenol instead of $60.00), , and tell them to kiss your ass for the rest? What would happen?