Medical practice growing after refusing health insurance

MRIs cost about $4,000, but his patients pay $400 CT scans are $2,000 with insurance, he said, but are $300 through his practice X-rays are usually $500, but priced at $60 at Pinckney's clinic, the results of which he can check on his smartphone

If you don’t have insurance, you can look up the fee schedule for what Medicare pays and you should be able to get just about any doctor to accept that amount if you pay cash.

They will gladly do it since they get paid immediately, their services are not challenged by Medicare’s UR department and they don’t have to fill out a bunch of useless forms.

The imaging center knows how much insurance will pay, why inflate the price? Why the game?

Under the negotiated rate, the insurance company has to pay the bill within 30 days. If they don't pay the negotiated rate within 30 days, they are liable to pay the usual and customary charge. So doctors send in their bills hoping they get overlooked.

“”These good deals apply only to expenses for things that can be done in the doctor’s office, don’t they? What about a heart operation, for instance?””

Keeping in line with a vow I made at the beginning of the year to read ALL the replies to posts before jumping in -I was going to ask the same question.

Or any kind of emergency - automobile accident or pneumonia? Circumstances that would require hospitalization. What happens then if a person doesn’t carry insurance? Most of us are used to paying our own way and would not expect the hospital to carry the cost of our being uninsured as “some others” in this country do.......

I could see a person carrying insurance just for emergencies and that would take us back to the days of Major Medical coverage which worked pretty good until it got messed with. I’m not entirely sure when that came about but it was at least 35 years or so ago. Nothing was covered except - exactly as the name implies - MAJOR MEDICAL.

“”The imaging center “charged” insurance something like $2000. The insurance “negotiated rate” was $350, of which I paid $70. I do not understand this practice. The imaging center knows how much insurance will pay, why inflate the price? Why the game?””

I don’t understand it either. I have long contended that the amount remaining and NOT PAID by anyone - insured or insurance company - is then written off as an expense like any other “bad debt” but have had doctors jump all over that contention on discussion threads like this one. They try to convince me that that is not true and they do not use it as an expense to their business or on their taxes.

Then WHAT IS THE REASON for billing MORE than they know is allowable by the insurance company?

My husband uses oxygen and our provider doesn’t even bill us until they know what they are going to be paid by the insurance company. I’ve told them and will continue to tell them that this is backassward!! If we haven’t received a billing, I call to find out why and am told they haven’t been paid by the insurance company so they don’t know how much they have to bill!!!!! They talk in terms of “allowable”, “costs”, “plan approved”, etc., none of which answer the question. Cost to me means 100% of the amount charged for product or service but not to a provider or an insurance company.

Try buying a car and having a salesman talk to you about “allowable” or “costs” - you’d walk out of the business and go on to find one that speaks your language.

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