HOORAY sit-rep. Great to see you. REAL NEWS from a citizen journalist.
Good news. Medicaid will pay them about $400.
Total scam.
Trump was right, as he often is, that medical billing prices should be published by the provider. Let the customer choose. Right now the whole thing is so opaque, with different insurers getting different discounts and pharmacy suppliers giving rebates etc etc.
And you thought figuring out the dealer price for a new car was difficult!
If you look at the elective surgical industry - nose jobs, tooth implants, breast augmentation and the like - they are very transparent about their pricing because they have to compete in a free market and there is no insurance for those procedures. The price they quote is the price you pay and you can shop around for price and quality and other factors. The entire medical establishment should do the same.
you don’t have health insurance? I thought only homeless people didn’t have health insurance.
If you are eligible why not sign up for it?
btt
This sounds like a job for SuperPrez, Joe Biden!
Don’t know what type of insurance you have, sounds like the hospital is what is known as balance billing. The hospital wants the full amount not what your insurance paid, don’t know about Florida law, but Medicare and medicaid in Cali does not allow for balance billing. Until you get an actual bill from the hospital ignore them.
Not sure why you call this Medicaid fraud. Provider fraud would be more like it, although no worse than all the others.
Yeah, I had an upper endoscopic exam last year. Everybody and their brother sent me a bill - anesthesiologist, endo doc, hospital. Came out to $20k. Even with insurance, couldn’t you quit farming out the load, keep it in-house, and work out a payment plan?
So a couple things. Based on your presentation, I am guessing you are not insured. Most hospitals have an uninsured discount, but also a medicaid pending status.
The hospital is attempting to recuperate costs it spent on you that is otherwise not recoverable. What most people do not understand is under Clinton, hospitals were required to have a single charge master. In other words, the charges for a service can only have one price. That price is meant to cover the entire gambit from people who do not pay all the way to the best insured
Insurance contracts tend to be pegged to Medicare reimbursement. That is to say, 85% - 125% of MC reimbursement which is set by the federal government. The way reimbursement is calculated is the DRG x CF which yields a single dollar amount. All insurance contracts have a contractual write off so that the actual reimbursement has nothing to do with the price of the charge master of the hospital.
In terms of medicaid, the hospital has the right to charge medicaid for one year following the billing if you are Medicaid eligible. The hospital will not make $8,000, but the medicaid rate, which is a very small rate. The other poster who said the hospital may recover $400 is perhaps a little optimistic, perhaps somewhat less than that.
The bottom line is that there is no fraud here. This is what must happen in order for the hospital to cover the costs that are legally required (free care) and keep the lights on and the doors open.
My best advice — get health insurance.
The sad truth is despite stating you dont want a hand out, by not paying the bill or accepting insurance, you have stuck the tax payer with the costs of your care.
Think survival at any cost. You can philosophize later.
Do whatever you have to do to give that wound a chance to heal and close up on it’s own without any infection gaining ground. Good luck to you. I used to be that idealistic until I encountered some very serious medical situations over the years. Not every Government program is a bad idea.
What you describe isn’t medicaid fraud. That would be falsely billing medicaid for treatment you didn’t receive. If you did sign up, medicaid would only pay the hospital what they allow per their billing schedule, a small fraction of the $8,000 they want you to pay.
The “scam” is that hospitals are not transparent about how much they are going to charge you. And that they charge uninsured people far more than what they get paid for insured patients. They also know it’s a bit of a pain to shop hospitals while you are hurt and in need of care. So, they bill you $8,000 because they can. Being uninsured can be expensive, and that’s not going to change any time soon.
If you are between age 18-65, not pregnant, and not legally disabled, it is almost impossible to get Medicaid.
Point Two - medical care in ANY hospital emergency room is the MOST expensive medical care that you can get in the USA.
Point Three - if you have medical insurance, through your job, personal insurance, whatever, they frequently will not cover ER visits if you could have received the same treatment from your own medical provider within a reasonable time.
Bottom Line...
Sorry, if you do not have your own medical insurance, the ER bill is coming to your house, and no where else.
Did you mention to them that you had no insurance??
Did they ask for your insurance information or financial situation???
I’m pretty sure you can make some kind of arrangement with them unless they’re just trying to overcharge you.
I would call around and find out the cost of the services rendered....
Good Luck 👍
Do you have medical insurance? If not you can probably negotiate this down, how much I don’t know. Or get on a payment plan and they will take whatever you say you can pay, even $25 or less a month. I personally would just stick it to them!
Oh yeah if you have any assets whatsoever Medicaid will come after them. There is no free ride and they did not tell you that.
Thank goodness insurance paid whatever amount, and I was stuck for 2,500 of the bill, if I remember correctly my amount. All I can be sure of is it was an amount I could afford.
Think of it like this. You go to dinner but the prices aren't posted on the menu. When you get your bill it's $500 while the guy at the table next to you gets his bill and it's $25 for the same meal, the difference being that his company has a pre-negotiated price list that keeps the restaurant from charging arbitrary prices for food, you don't have that so they can charge whatever they want and there really isn't anything you can do about it, there's no law saying they can't do it.
The "system" is designed so you're screwed if you try to pay for your own health care, you end up being charged many times a fair price. It almost forces you into either having overpriced health insurance or being a freeloader on medicaid. It leaves prople little other choice because unless you're allied with an insurer the hospitals are going to stick it to you just because they can.