I got a bill from the lab for a standard blood and urine test. The list price was $1500. The insurance contract price was $75 and my copay was $5. How can any business have a 20-1 ratio between list and actual price?
I would like to see both the list price and the "usual and customary" price the insurance company pays.
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 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.
“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.
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.
That’s because the list price is a lie. Insurance companies only pay a percentage of the bill presented by the doctor/ hospital/ lab. So they jack up the bill they send to get what they actually want. And eventually the insurance companies figure out they’ve been figured out and they drop their percentage. Then the bill gets bigger. It’s a silly game of hilo. If you want to find out what they actually charge tell them your insurance company is Visa.