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Watch this California man learn in real-time how our entire medical billing system is a scam
Not The Bee ^ | April 28, 2025 | Staff

Posted on 04/29/2025 4:51:25 AM PDT by Red Badger

The absolute state of things.

https://x.com/i/status/1916677603299414361

Insurance is a scam. Cancel it. pic.twitter.com/wccD3V51YS— James Li (@5149jamesli) April 28, 2025

Customer: 'I think there's a mistake on the bill ... we got a bill and then we realized that you guys didn't have our insurance, so we sent you our insurance and it looks like the bill went UP.'

Agent: 'It went up?'

Customer: 'Yeah, the first bill we got without the insurance was 600 bucks, and then the second one was almost 1300 bucks.'

Agent: 'Yeah so the first invoice you received, that's a discount you received if you're uninsured, so you're not eligible for the discount because you are insured. So the bill was $2,342.14. We billed your insurance; your insurance only paid $1,078.85.

Customer: 'Can I go back to the discount without the insurance?'

Agent: 'No sir, you're insured, so you're not eligible for the discount.'


TOPICS: Business/Economy; Health/Medicine; Society; Weird Stuff
KEYWORDS: medicalbilling
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To: z3n
So the question I have is who is making that decision?

In the video, the agent on the phone says that California passed a law saying that hospitals give discounts to the uninsured. But there's also the broader problem beyond law.

If someone else pays the cost of your decision, you're okay with it being an expensive decision. It doesn't matter if the "someone else" is insurance or govt. So if you, the patient, decide to undergo a scan or procedure, you're okay with there being a higher cost unless you're the one footing the bill. States allow hospitals charge insurance more so they can get money that they know they'll get (insurance co's have bigger pockets) as long as they charge the cash payers less (patients = voters).

21 posted on 04/29/2025 6:08:15 AM PDT by Tell It Right (1 Thessalonians 5:21 -- Put everything to the test, hold fast to that which is true.)
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To: Brian Griffin
This is enforced by federal law that requires the ambulance to take you to the nearest hospital, not one a half mile further away that would be 30% cheaper.

I respectfully disagree. I know plenty of people who get to choose the hospital even in the ambulance. But I live in the free state of Alabama.

22 posted on 04/29/2025 6:09:42 AM PDT by Tell It Right (1 Thessalonians 5:21 -- Put everything to the test, hold fast to that which is true.)
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To: Red Badger

YES health insurance is a BIG SCAM.

No Insurance, blood clot in knee, emergency room,tests,shots,... Total Cost about $2500

with Insurance $13,000, $7000 deductible, 30% copay on balance of $6,000, your cost WITH INSURANCE $8800!!!

My hospital list the 2 prices on every bill and I had NO INSURANCE so I paid about $2500.


23 posted on 04/29/2025 6:09:46 AM PDT by eyeamok
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To: Red Badger

In years I won’t meet my deductible I pay cash for all medical care. It’s usually cheaper than my deductible. When I asked I say I do t have insurance because I don’t on the first $8,000. One place doesn’t care but tells me take my pick because once they bill you in cash they will not bill insurance and will not cooperate if it is submitted.


24 posted on 04/29/2025 6:09:52 AM PDT by FreedomNotSafety
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To: PGR88

AMEN to the idea of insurance free zones!!!!


25 posted on 04/29/2025 6:11:41 AM PDT by Ikeon ( Why don't they, do what they say? Say what they mean? One thing leads to another. )
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To: Red Badger

Got a better one.

My son had surgery to remove some intestine. Later I went to get a coffee and met the surgeon in the elevator. She introduced me to a colleague.

A few weeks later we saw a line item in a bill. The dirtbag colleague billed me $800 for a consult.

We refused to pay.

I sent the insurer a letter showing the thousands of dollars in “mistakes” all in their favor. I told them that we haven’t begun charging $200 a hour forensic accounting services yet but that would begin on the next “mistake.”

Magically the “mistakes” stopped completely.


26 posted on 04/29/2025 6:14:12 AM PDT by cyclotic (Don’t be part of the problem. Be the entire problem)
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To: Red Badger; All

Many people use the ER for their family doctor, even though government assistance is available to them. They do not apply for what’s available to them and just walk out after treatment.

The hospital sends the accounts to collection. The collection people make application for the people who got treatment and the hospital gets pennies on the dollar… the collection guys get the rest.

Then the hospital can recover the rest of the money lost to the cheaters by padding the bill for everyone they treat … who HAS coverage.

1. The taxpayer is stiffed to fund government programs for the ‘underserved’
2. The taxpayer pays premiums on a health plan for himself and family
3. The taxpayer pays a deductible-out of pocket
4. The taxpayer pays for office visits-out of pocket
5. The taxpayer is overcharged by the hospital… to help the hospital recover money lost to collection guys
THE TAXPAYER JUST PAID FIVE (5) TIMES… and the doctor hasn’t touched him yet.


27 posted on 04/29/2025 6:16:11 AM PDT by SMARTY (In politics, stupidity is not a handicap. Napoleon Bonaparte I)
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To: Bloody Sam Roberts

**How did a CT scan resolve your lower back issue?**

I have no idea if the ct scan with dye did anything, because the following week there was no change.

Summer of 65, at age 10, I fell out of the favorite climbing tree, broke my left femur, was in traction for 6 weeks, not aware that my L4-L5 disc was damaged on the left side also. Occasional back pain through the years finally came and stayed in 2000.

MRI showed the old damage, with a fragment finally pushed out and not going back. Microdiscectomy took it out and I was good for the next 17 years. Lifting heavy furniture for the move to TN caused a similar pain that would not go away, until a week after that ct scan. Don’t know if the needle used in the scan had an impact. If it did, it didn’t start to have an affect for 7 days.

I know the wife and I had been praying a lot about it.


28 posted on 04/29/2025 6:39:41 AM PDT by Zuriel (Acts 2:38,39....Do you believe it?)
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To: Brian Griffin
Hospitals set their list prices at absurd levels so the healthy folks have to buy medical insurance which subsidizes the sick folks that get lots of care.

The third party payment system is the root of this, along with government mandates that providers must treat the uninsured. The entire system is set up for the purpose of cost shifting, which is NOT the same thing as insurance, which is based on aggregating people with similar risk profiles and spreading the cost within that group, all of whom would be insured.

Government is the root of the problem. We should move decisively to a market based system with maximized price transparency, competition, and consumer choice. This would lead to the stranding of high risk groups.

Covering the uninsured high risk groups is a welfare question, and a great deal depends on why a given person is in a high risk category or perhaps uninsurable at any price. A great deal also depends on why a person is uninsured. If someone has an adequate income and simply wants to freeload, I do not feel very charitable; they can take a chair and wait their turn in the deadender welfare clinic. But a 12 year old diabetic, or a kid who is diagnosed with Fanconi's anemia at age 10 and needs a full bone marrow transplant, or people with CF or many other serious, genetically based problems should (IMHO) be generously supported. In between is a huge gray area.

In general, we should be personally responsible for the things that are under our control, which would include problems linked to drinking, drugging, twinkie and cheetos diets, collecting STDs for a hobby, and myriad other reckless, self-destructive lifestyle choices. This would require politicians to be upfront about who they were choosing to subsidize and why, which would involve all the difficult problems associated with distinguishing between the deserving and undeserving cases -- i.e., the same distinction between the deserving and undeserving poor that the politicians have been trying to avoid for just as long.

29 posted on 04/29/2025 6:44:49 AM PDT by sphinx
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To: Flavious_Maximus

It is indeed a total scam.

\/

its also

Cloward-Fauci-Piven


30 posted on 04/29/2025 6:47:49 AM PDT by cuz1961
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To: Red Badger

The insurance company owes the man $478.85.


31 posted on 04/29/2025 6:52:14 AM PDT by Responsibility2nd (Nobody elected Elon Musk? Well nobody elected the Deep State either.)
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To: z3n
Why wouldn’t insurance companies leverage their market share fight the bills for their customers?

You must be new here.

We have been told repeatedly that their customers and the people that they must serve are their shareholders. They are at the top. Which means it is all about profit margins. And you make better profit margins by raising rates and not paying. Especially when you are a product that people must, by law, buy.

You can't lose.

32 posted on 04/29/2025 7:10:17 AM PDT by Harmless Teddy Bear ( Not my circus. Not my monkeys. But I can pick out the clowns at 100 yards.)
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To: z3n

I do believe it is made based on negotiations and what the law allows. You can (I think) opt to not file insurance and tell a facility you want to do self-pay. They may not give you the same discount as someone who is uninsured but you can certainly negotiate when you get the bill. A good starting point is finding out what Medicare allows for the same procedure (It should be available.) and starting with that figure. Medicare would have you pay 20% of the allowable. NOT 20% of the bill. Then go off that asking for a further discount if you pay cash within a certain time frame.

If a bill is high enough you might just want to let it go to a collection agency. Usually they will accept a steep discount if you pay cash within a certain number of days.

Just remember your living expenses (the necessary ones) do not need and should not get shunted aside to line the pockets of HCA executives. So keep that in mind when presented with medical expenses that are way disproportionate to your income.


33 posted on 04/29/2025 7:18:11 AM PDT by lastchance (Cognovit Dominus qui sunt eius.)
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To: Brian Griffin

BINGO!


34 posted on 04/29/2025 7:33:03 AM PDT by Glennb51
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To: sphinx

John McCain suggested that people who can’t get or pay for private sector market-based health insurance could be placed on Medicaid.


35 posted on 04/29/2025 7:35:51 AM PDT by Brian Griffin
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To: Red Badger

Shows how much “free” health care is being doled out, especially if you’re an illegal.

Read about a case where a man was fighting his insurance company tooth and nail b/c he was charged for a surgery that was never performed b/c his wife died before the surgery was done. Didn’t matter, he still got a bill and the insurance company wouldn’t dismiss it.


36 posted on 04/29/2025 7:45:22 AM PDT by Bon of Babble (You Say You Want a Revolution?)
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To: Bon of Babble

Then that means the hospital and surgeons & anesthetist must have billed the insurance company for the surgery that didn’t happen. His beef was with them, not the insurance company..............


37 posted on 04/29/2025 7:49:17 AM PDT by Red Badger (Homeless veterans camp in the streets while illegals are put up in 5 Star hotels....................)
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To: pierrem15

“In any other business, doing this and concealing the real price from the consumer would be considered a clear case of fraud.”

I believe that because of Trump you can find hospital prices if you are willing and able to invest lots of time.

I have in the past suggested that hospital-based services be priced under state law on Medicare pricing multiples, with necessary and proper exceptions allowed.

If Medicare would by $15,000 for a specified DRG (Diagnostic Related Group) item and the hospital set its multiplier to 1.3, a private pay patient would get billed and expected to pay $19,500 by the hospital.

If the ER doctor posted a multiple of 3 and Medicare would pay him $250 for a service, a private pay patient would get billed and expected to pay $750.


38 posted on 04/29/2025 7:53:34 AM PDT by Brian Griffin
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To: Zuriel

Miracles DO happen. You are proof. I have seen one or two in my many years. Praise Jesus.


39 posted on 04/29/2025 8:02:34 AM PDT by Bloody Sam Roberts (Perfection is impossible. But if you pursue perfection...you may achieve excellence.)
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To: Zuriel

About 12-13 years ago we were without insurance for awhile. Mr. GG2 had to go to the ER. When they called him about the bill it was over $1200 by when he said we would pay cash it dropped to about $650.


40 posted on 04/29/2025 8:05:54 AM PDT by Georgia Girl 2 (The only purpose of a pistol is to fight your way back to the rifle you should never have dropped)
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