Posted on 12/27/2018 7:21:03 AM PST by buckalfa
Many Americans have left the hospital concerned or surprised at how much or little they've spent for a service there.
Well, thanks to a federal law, there will soon be more transparency on how much you'll be spending after your hospital visit.
Starting on January 1, 2019, a federal law will require hospitals to post a master list online for how much the facility charges for a service.
Often times, little to no price transparency can make it difficult for consumers to price compare.
Other times the final bill is almost never the same as the "sticker price" due to other charges such as insurance, and other discounts or premium charges, before a final charge is determined.
“The list prices are so high that the vast majority of hospitals don’t even try to collect list prices from uninsured patients,” said Benedic Ippolito, with the American Enterprise Institute, who has researched hospital list prices.
The federal law is being brought out as a measure to improve competition and help educate consumers, according to the Journal-News.
“We are just beginning on price transparency,” Seema Verma, head of U.S. Centers for Medicare & Medicaid told the Associated Press. “We know that hospitals have this information and we’re asking them to post what they have online.”
But real transparency comes when consumers can easily see what they will pay to a provider based on their insurance benefits, said Thomas Campanella, Baldwin Wallace University health care MBA program director. He said some insurance companies are providing that information through price comparison tools.
“I almost see it being more of a political ‘look at what we did,’” Campanella said of the requirement to post list prices.
They must post in advance the real prices, with appropriate discounts for immediate payments and various group memberships. And then bill according to that schedule.
Yes, the free markets bring costs back in line, insurance companies and government are the reasons for high costs.
You need to start somewhere to know how good your insurance discount really is. Since you only see what they tell you after the procedure, the numbers on your invoices mean nothing, except for the bottom line of how much you are left paying.
Even hotels have to post their maximum rates so we know what they might charge us under adverse situations.
There was a Texas Supreme Court case this year where a hospital was compelled to provide its reimbursement rates from private insurers in discovery in a case where an uninsured patient was disputing the amount of the hospital’s statutory hospital lien over his personal injury case.
As you might imagine, the hospital fought tooth and nail to avoid giving that information up, but the trial court ordered them to disclose it, and the court of appeals the Texas Supreme Court both agreed.
20 for a tylenol
That’s cheap. It’s 80 the last time I paid out of pocket.
When I used to pay out of pocket, they would bill me the usual ridiculous numbers, but I would get on the phone with AR and tell them I’m paying out of pocket, and follow it up with an actual plan to pay.
They scrapped all of the normal numbers and gave it to me straight. And yeah, that 80 tylenol (Figurative, of course) still cost $10 but it was a help for them to bring things back to normal figures.
My son has spent 250 days in the hospital in the last 14 months. They would need to deliver his bill with a forklift.
I can give another example ... Lactated Ringer’s solution for IV’S. The bag of the solution ... theine/tubing from the bag and the 16-18 gauge needle into the vein ... roughly $175 per set. (From an ER bill from 2009). My sister’s cat had kidney failure and needed fluids, lactated ringer’s, about the same time. Paid the vet about $100 .... for 12 bags of solution, 12 lines/tubing sets and 100 18 gauge needles.
Hospitals jack up the basics because they do not think anyone will look at the wholesale price of the supplies.
Just my two cents. (Or $75 using hospital math.)
I just threw that number out because I’ve read horror stories about how expensive hospital care was/is. My uncle had to pay $2500 for an ambulance ride of just 35 miles to the local hospital when he fainted. IOW, don’t get sick, ever. Or hurt.
This will make it a bit easier for average Americans to see what a HUGE sucking, drain illegal immigrants are on our economy.
Not only price compare. I negotiate EVERY bill I get from a provider.
For example, my son was in a fender bender car accident in August. He was hit from behind while he was stopped at a light. He ended up going to the hospital 1 mile away in an ambulance. After Cigna negotiated the bills with the hospital, ER doctor, radiologist and ambulance. I was still left with bills totaling over $3000 that I needed to pay out of my Health Savings Account. Originally they were over $8K.
The hospital bill was $2355 after insurance. I called them and said I could not pay it. Immediately, they dropped the bill 35%. I offered them $1000. The person stated she would have to speak with her superior. She called me back the next day and said the best she could do was $1435. I paid that amount.
I did the same with the rest of the bills. They all dropped the price to some extent.
“I did not feel it was right that I be charged more than an insurance company”
How did you know that you were being charged more than an insurance company?
I got that beat.
My son’s ONE mile ride of $2378 plus $45 for the first mile.
PLUS, he shared the ride with the other individual that was at fault in the car accident. I am sure that guy got the same bill. Two for one.
A relative sells joint replacement hardware. It’s sold to the hospital which re-sells it to the patent at double the price they paid for it.
They should do this with Dentists.
Good to know. I have no health insurance and had a “mental episode” (I am 65) a few weeks ago and was admitted to the emergency in our small town hospital. Thy did either a cat scan or an MRI (the one that doesn’t pound loudly) and I spent a half hour in a bed. They gave me a blood pressure pill and said my brain looks great and then I was out.
I’m “looking forward to” finding out how much it’s gonna cost. It will still be cheaper than the five years of health insurance premiums I’ve saved.
I had a reverse of that. My health care provider is an independent nurse practitioner. I’ve been with him for many years. I was embarrassed when I saw how little medicare paid him for a procedure. That there is the reason some health care providers cannot take on new patients covered by medicare.
I actually offered to pay him additional but he said it was not legal. He did have a fund that he was paying into to help pay for people who couldn’t pay their bills, so I donated to that.
Regardless what misguided FDR’s state sovereignty-ignoring activist justices wanted everybody to think about the scope of Congress’s Commerce Clause powers (1.8.3) when it wrongly decided Wickard v. Filburn in Congress’s favor imo, while this hospital law protects consumers, it is an unconstitutional expansion of federal government's powers imo.
"Article I, Section 8, Clause 3: To regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes;"
"In every event, I would rather construe so narrowly as to oblige the nation to amend, and thus declare what powers they would agree to yield, than too broadly, and indeed, so broadly as to enable the executive and the Senate to do things which the Constitution forbids.” —Thomas Jefferson: The Anas, 1793.
"State inspection laws, health laws, and laws for regulating the internal commerce of a State, and those which respect turnpike roads, ferries, &c. are not within the power granted to Congress [emphases added]." —Gibbons v. Ogden, 1824.
"... the care of the property, the liberty, and the life of the citizen, under the solemn sanction of an oath imposed by your Federal Constitution, is in the States, and not in the Federal Government [emphasis added]." —Rep. John Bingham, Congressional Globe (See middle of third column.)
”From the accepted doctrine that the United States is a government of delegated powers, it follows that those not expressly granted, or reasonably to be implied from such as are conferred, are reserved to the states, or to the people. To forestall any suggestion to the contrary, the Tenth Amendment was adopted. The same proposition, otherwise stated, is that powers not granted are prohibited [emphasis added].” —United States v. Butler, 1936.
Using terms like “concept” and “implicit,” here is what was left of the 10th Amendment after FDR’s justices swept it under the carpet in Wickard v. Filburn.
"10th Amendment: The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people."
"In discussion and decision, the point of reference, instead of being what was "necessary and proper" to the exercise by Congress of its granted power, was often some concept [???] of sovereignty thought to be implicit [??? emphases added] in the status of statehood." —Wickard v. Filburn, 1942
“I would like to see both the list price and the “usual and customary” price the insurance company pays.”
Damn, that would be great. Make the hospitals list the Average Amount ACTUALLY PAID (be it cash and/or insurance), rather than list prices.
The only caveat is that I have them exclude the non-payers, since that would distort things.
The terminology has been an issue since way back when hospitals actually presented itemized bills. What good it did, they were in a totally different language.
Everything universally number coded and a layman’s translation app maybe?
We have a provider that comes to our office to administer flu shots each fall. They also offer the option to have blood drawn for standardized blood panel.
They bill our health insurance over $6,000.00 for the blood work (drawing and labs). I expect the insurer pays under $200 for it.
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