Posted on 03/07/2017 7:18:50 PM PST by Wisconsinlady
Sometimes called direct pay, and closely related to concierge care, this sort of business model was once seen as the perquisite of rich folks and medical tourists from foreign lands. But nowadays many of the people seeking cash-based care are middle-class Americans with high-deductible insurance plans. For a patient with an $11,000 family deductible, for example, it might make more sense to seek out a cash-based center like the Premier Medical Imaging facility in Minneapolis, which offers a basic MRI for $499, than to cough up the several thousand dollars that the same procedure generally costs at a traditional hospital. Cash payments don't count toward a patient's deductible, but for some it's worth the gamble.
(Excerpt) Read more at time.com ...
Anyone pricing an MRI needs to make sure that the places they are comparing use machines with the same resolution. The resolution depends on the magnetic field strength. The standard now seems to be the 3 Tesla (3T). Some locations that give a better deal might only have a 1.5 Tesla machine that will not give as detailed a picture, but it’s also possible for things to be the other way around.
- Hospital sets a price for a procedure at $10k
- You buy insurance to protect against that expensive price.
- you pay up to your deductible for that procedure (up to 10k)
- if you are past your deductible, insurance covers $500 (the real price of the procedure)
- if you pay cash you can negotiate a similar rate
- hospital has to provide care for people with no insurance
- when those people don’t pay, they write off the full $10k as bad debt minus whatever they can sell the debt for ... usually that same $500
- collection agencies harass you for the rest of the money
But ... you also need to insist all health care providers provide the prices for everything upfront so people are actually agreeing to pay a pre-arranged amount.
Then ... you need to disallow discharging of medical bills in a bankruptcy so health care providers, who are obligated by good samaritan laws to provide emergency care, have a chance to get paid.
Having different prices for each insurance company and then charging the uninsured people huge prices to make up for those who will eventually default is a strange way to run any industry. It is a perversion of capitalism’s “charge what the market will bear” into a Marxist gouging “from those according to ability, to those according to their needs”.
Belong to a Health Share!! Your cash payments count toward your deductible. You really CAN use any doctor or medical practitioner you wish (no cosmetic or mental health though). No prescriptions but you can get them at discounts and from Canadian pharmacies etc.
It is wonderful to be a cash pay patient. There are discounts and yu simply shop around for services. I know some great docs who are thrilled to have cash patients and don’t charge unreasonable amounts.
That would be a good thing.
agreed - I often think Health Insurance should be eliminated
They give me a receipt. ;o)
The desparity in rates makes it obvious something is wrong. I don’t mind paying a doctor a good fee, they earned it. But there is a huge parasitic side to this that must stop.
But you only get the cash discount when no claim is submitted. So you never get anywhere toward the deductible.
Wow.
I would say it costs $11,000 BECAUSE insurance covers it.
I spent several hours in a waiting room at a local teaching hospital. Several groups of medical students came through and I only saw one or two out of 25 that looked American. Many women in headscarfs. It was depressing.
I had a good customer who was a doctor. He was very slow paying his bill and I called him about it.
He said no problem, just come by the office and ask the lady to pay it. I went by just after lunch and she told me I was too late. She showed me an empty cigar box that was cleaned out by the bill collector ahead of me.
The doctor took cash in and into the cigar box and then paid local vendors directly from that cash.
on Drudge right now... Forget your GP, robots will 'soon be able to diagnose more accurately than almost any doctor'
Not even remotely true.
Very true - I had a procedure that the hospital billing system claimed $140K for - insurance allowed $41K.
If one has something done and then actually reads the statements, they will know that hospitals and other medical institutions seem to pull high costs out of their arses to ensure they get whatever max the insurance companies will cough up.
BINGO. You win the prize
Pretty much. And the drug company has a program that refunds us all but $5 for the drug portion.
The rest of it is just the service charge at the infusion center.
It’s settled down, but when this all started, we also found thousands of dollars in billing errors, all of it in favor of AETNA. We sent them a letter threatening to bill them $200 an hour for forensic accounting services.
My wife has an accounting degree and understands that stuff. They weren’t counting on that.
Actually, P.I.L.O.T. is quite common at the municipal and state level as I’ve learned over my career. Sad.
Resolution with an MRI is a function of power and time. A low power MRI can make up the resolution by having the patient lie there longer. A lower power MRI can be safe for people with implants too.
I know them well.
IBD is a real drag but they (infusions) have allowed me to be able to function and get back to work and a productive life again.
Also a fabulous gastro doctor. That’s the key. I’ve gone through about 4 over the years.
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