How About a Price List at the Hospital or Doctor’s Office?

By Paul Michael on 21 May 2010 (Updated 16 May 2011) 36 comments
Photo: tahitianlime

In the past, I’ve been lucky enough to have very good health insurance. And before health insurance, I had the National Health Service in Britain. So it’s fair to say I haven’t really been fully invested in the healthcare debates that have steadily increased in the U.S. over the last few years. However, after recent events in both my life and the lives of friends and family around me, I am becoming more and more frustrated (and outraged) at the current state of healthcare in this country.

In my days in England, a trip to the Emergency Room was just something that happened. Costs were not considered as it was all paid for through taxes. If you got sick, you went to the E.R. The same applied to any other kind of care, including routine operations, dental work, mental health and more.

But fast forward a decade and I find myself looking at medical bills that just leave me scratching my head. And I know I’m not the only one.

Recently, my wife was having very intense pains her arm, enough for her to call me crying in agony. I obviously told her to go straight to the doctor, but he couldn’t see her. There were no appointments for days. That left the E.R. So, she managed to get herself there, with two kids in tow, and received treatment. She was in the E.R. for an hour or so, had some X-Rays, a shot of muscle relaxer, and was given a prescription for the pain.

The co-pay for that little excursion was $150, which we happily paid. $150 for treatment and peace of mind that my wife was OK seemed a small price to pay.

That was just the start of the bills. A few months later, we received a bill from the doctor on call that day, for around $600. And then, a week later, another bill from the hospital, and this one was close to $3,000! I couldn’t believe it. Less than 90 minutes in the E.R. a couple of X-Rays and a shot of muscle relaxant came to the same price as a very nice 1 carat engagement ring!

I looked through the bills and got nothing from them. They were muddled, confusing (purposely I believe) and used terminology that was impossible to decipher.

Our insurance company negotiated a big chunk of it for us, but we’re still out of pocket for much more than we can afford this month, and next month, and the month after. We will have to pay it, of course.

Then I started asking around and heard very similar stories. E.R. visits are costing people a fortune. A real fortune. And people have neither the knowledge nor the abilities to fight the bills and decipher the confusing medical terminology. Overbilling is rife in the medical system, and if you are not an insurance company with a staff of experts on call, you’re out of luck, and out of pocket.

A friend of mine recently went to the E.R. suffering from chest pains. They ran a few tests, kept him in overnight, and discovered he had a pulled muscle in his chest. The prescription for ibuprofen helped. The bill a few months later for over $12,000 almost put his heart under serious pressure.

If he had known of the costs before he agreed to the treatment, he could have made the decision to check himself out of the E.R. and spend the night at home. That alone would have cut the bill in half. He could the have came back the next day if the pains continued.

If my wife had been given a quote before her treatment, before she was admitted, of the $3800 bill that was about to be given to us, she may have asked for just the muscle relaxant and pain meds. No X-Rays, no 90-minute stay.

In fact, in most other professions, including the practice of law, you are given price quotes before you agree to anything. “My retainer is $1,200” a lawyer will say “and $300 an hour after that.” If you go to a mechanic, you are told the financial damage before anyone puts a wrench in the engine. At a restaurant, the prices are on display. Come to think of it, I can think of very few professions, if any, that have the billing free reign of the hospitals and doctors. It almost seems arbitrary what they can charge.

On a recent bill a doctor friend of mine received, he noticed a tetanus shot was priced at over $300. The actual price of the shot is under $30, and he should know…that’s what he pays. How can something be priced up by a factor of 10?!

Some will say that we shouldn’t know the costs, as it will stop the doctors from doing their jobs. Maybe. Maybe not. But I do know that as the price of healthcare continues to skyrocket with no oversight, and more and more families going bankrupt or falling deeply into debt because of medical bills, something must be done. And a price list at the entrance to the hospital or doctor’s surgery is start. A quote for the services about to be performed, even better. At least you don’t get a nasty surprise months after the event.

Do you agree? Do you have a better solution? Have you experienced nightmare medical bills. Let us know, and tell us how you handled them. In the meantime, I would strongly suggest everyone budget for unexpected medical costs, even if it's just $50 - $100 a month. Hopefully, you won't need to dip into it, but with healthcare costs becoming more and more outrageous, something tells me that won't be anywhere near enough.

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Guest's picture
blue

one of my favorite things about the walk in clinics they now have in walgreens here is that they do have a price list up front... on the kiosk as you check in. you agree to the price upfront.... and even the times that its been more complicated than i thought (for example, sinus infection that had also turned into an ear infection and ruptured eardrum), they still have only charged the base rate ($65 in that case).

Bonus points for their openly telling me the prescriptions they wrote was on the walmart $4 list... rather than just automatically pushing me towards the walgreens counter 10 feet away.

Guest's picture
Guest

You should never visit the emergency room for a non-life threatening condition.

If your doctor's office can't make room in his or her schedule to see you on the same day for the condition you described, then it's time to find another doctor.

If you can't see your regular physician, then you should consider going to an "urgent care" facility. This is a bit more expensive than seeing your physician, but it is vastly less expensive than an emergency room hospital visit. Not only is it less expensive, but it is also more likely that you'll be seen sooner by a doctor there than by a doctor in an emergency room.

Obviously, the above does not apply for life-threatening conditions. Your friend with the chest pains did the right thing by going to an emergency room. For non-life threatening conditions, however, see your physician or visit an urgent care clinic.

Julie Rains's picture

It is difficult to get pricing information! I've tried and found that very often I need to be unusually persistent. There are some providers who offer this information upfront but there are many others that seem to have no idea why anyone would even ask.

Case in point: long story, but a doc tried to order an MRI for my son to diagnose back pain (from over training) despite telling us that the test probably wouldn't give us more info about the cause or influence the treatment plan. I pressed for a price and we were told to bring $200 the day of the session, and were assured that insurance would cover the rest. At the time, we had a high-deductible policy and I knew that it wouldn't be covered; we opted not to have the test and obviously won't be seeing that doctor again. The fee btw would have been $1800. We weren't in an emergency situation so obviously it was easier to make a decision. (I wrote about this in How Much for Healthcare?
http://www.openforum.com/idea-hub/topics/money/article/how-much-for-heal...)

I think it's crazy that providers would think that people have thousands of dollars to spend on care, given the economic situation and problems with insurance. I do understand that they don't want to treat people based on wealth but they often seem oblivious to cost.

I am puzzled though that the regular doctor or someone in his office didn't have appointments available for emergencies; that is supposed to be one way that we can all avoid ER visits.

Guest's picture
Guest

I know people in our small town that have shopped around for MRI services and found amazing variations in pricing. Since it isn't ER, you should be able to find the best price by making phone calls.

Guest's picture
MNK

I'm a young adult and have recent experience with the health care circus. Since I'm not too long out of college and working a "starter job" I don't yet have much of a cushion for financial upsets, but I plan as best I can with a medical savings account. I've always been very healthy, but in the last year I was having frequent sinus infections and all the family doc did was issue several rounds of antibiotics to no avail, so I finally ponied up and saw a specialist (only by my own initiative) who determined I had to have my tonsils/adenoids and part of my sinuses removed, only to continue to struggle with ear and sinus problems. A friend recommended chiropractic so I tried it out of desperation (regretfully). I finally decided to try allergy testing only to find that it's likely that all my issues were allergy related (something I had asked repeatedly in the previous months, only to get the response "No, I don't think so, let's try this first" from the ENT). It took over 10 mos. and over $3000 out of pocket (I'm grateful that my job offers decent health insurance as it could have been much worse) and hours of frustration and appointments to find this out. I've been making payments as best I can, but it will likely take me at least a year or two longer to pay this off. I just hope there's nothing more that comes up that puts me back in the doctors' office several times a month.

As I am getting more savvy (and sick of the bills!) I try to call ahead to find out costs of procedures and visits, but it can take hours to speak with the doctor's office and then health insurance companies to see what is covered. Even then you only have a best guess of the bill. As health care consumers we need to demand more transparency and better cooperation between insurance and health care facilities; they are in business because of us anyway. More and more people are being forced to weigh the benefit of being healthy versus being in considerable debt before getting medical treatment. It's simply wrong.

Guest's picture
Amanda

As GUEST says, the ER should only be used if you think you are dying. Seriously.

BCBS offers an ask a nurse line, which gives some excellent feedback and can tell you if you should go to the emergency room. We've used it a number of times when we had situations we weren't quite sure were serious enough to demand an emergency room trip.

Also, choose a doctor that has a larger practice if possible, so there are many alternatives within the place, including RNs, etc. That will increase the chance that you can get an appointment in a hurry.

Finally, you can leave your doctor a message. I've always had good luck with them calling back within a few hours. They may able to tell you something over the phone to do before an appointment is available, give you a prescription or referral, tell you to go directly to the emergency room or maybe even find a way to work you in for an appointment.

Guest's picture
Amanda

As GUEST says, the ER should only be used if you think you are dying. Seriously.

BCBS offers an ask a nurse line, which gives some excellent feedback and can tell you if you should go to the emergency room. We've used it a number of times when we had situations we weren't quite sure were serious enough to demand an emergency room trip.

Also, choose a doctor that has a larger practice if possible, so there are many alternatives within the place, including RNs, etc. That will increase the chance that you can get an appointment in a hurry.

Finally, you can leave your doctor a message. I've always had good luck with them calling back within a few hours. They may able to tell you something over the phone to do before an appointment is available, give you a prescription or referral, tell you to go directly to the emergency room or maybe even find a way to work you in for an appointment.

Guest's picture
Former Small-Town Girl

Amanda and Guest obviously don't live in small town New Mexico. Please don't assume that everyone has access to Urgent Care facilities. (Shoot, the closest one to our former town was over 80 miles away.) Or that their insurance allows access to a wide variety of doctors. There are still plenty of places in the US where your only choices are your doctor or the emergency room.

Philip Brewer's picture

Being able to get price information would sometimes help, but it's no kind of solution.

Suppose the guy with chest pains who balks at the cost of overnight in the emergency room goes home, then turns out to be having a heart attack and needs an ambulance trip back to the hospital? He hasn't come out ahead (and that's before considering that the further delay might cause more serious injury costing an order of magnitude more in treatment costs, rehab costs, lost earnings, etc.).

The real problem is not that people can't shop around (although it's true that they can't), the real problem is that it's impractical to do the shopping around when you're sick or injured. Very few people who show up at the emergency room with a dislocated shoulder are going to seriously consider asking for a price list and then going to a different emergency room with better prices; they're going to be much more concerned with whether the doctor who will be reducing their injury has the skill to know whether their injury is one of the rare ones that needs other-than-routine treatment. (There are fractures that look like dislocated shoulders where you can do permanent disabling injury if you treat them like a dislocated shoulder.)

Yes, you might decline some particular expensive treatment option if you could line up a much cheaper one that's almost as good, but when you're scared and in pain is not the best time to be making that sort of decision.

The upshot is that the "shopping around" should be done up front—which is what insurance companies do via negotiated rates. Shopping around at the point when you need care is never going to work.

Guest's picture
Des

I agree about making the costs known, but I think your examples are flawed. The problem is, when pain turn out to be something simple we say "those doctors are just greedy." But what if it had turned out to be something serious and the doctor released your friend to go home? Then he would come back with a lawsuit saying "the doctor should have known better than to let me go home!" What would you do as a doctor? Risk someone's life and a potential lawsuit, or err to the side of caution and keep your friend with the chest pains overnight? That procedure saves lives, and saving lives is expensive.

Guest's picture
Rich

Unfortunately ER visist costs need to be extremely high in order to cover their costs. You may just see a few xrays and meds being given but you do not see they very expensive overhead of an ER. All kinds of specialists need to be staffed whether they are used or not. (Cardiologist, ortho, surgeons, etc) This is what makes the cost very high, and there is simply no way around that.

Also the problem of patients suing hospitals drives up the cost, and not just in the form of malpractice insurance. Doctors HAVE TO order all kinds of unnecessary tests to rule out the most obscure possible causes to your problem. An example of this is if you come into an ER with Apendicitis, and you need surgery, most surgeons will not perform the surgery until after you have a catscan, even though the DR's and Nurses know you have apendicitis. The reason they do this is because of the very small amount of people who will not have apendicitis. The problem being here is that while you are waiting for that catscan, your apendix might burst and you might die. But there is less liability for that, than opening up someone who does not have apendicitis.

Guest's picture
jim

"Also the problem of patients suing hospitals drives up the cost"

I think the cost of lawsuits is very exaggerated. That sems to be the doctors and hospitals pointing blame elsewhere. Its a red herring.

Malpractice accounts for 1-2% of the total cost of healthcare in the USA. Doctor errors are estimated to add about 2% of the cost of healthcare.

Guest's picture
sylrayj

http://pediatrics.aappublications.org/cgi/content-nw/full/103/1/SE1/329/T1

My daughter was born at 25 weeks gestation and weighed 660 grams. She spent three and a half months in a Level 3 NICU, before being transferred to our home city's Level 2. $1483 a day for a hundred days. When I was in labour, the doctor asked me what sort of medical interventions I wanted, and if I lived in the United States instead of Canada, I wouldn't have been able to walk her to kindergarten this morning, and we wouldn't be singing Happy Birthday to her tomorrow.

Guest's picture
Guest

The cost of this type of pre-natal care is one of the biggest expenses hospitals encounter. It is also a growing problem (more and more pre-natal care, sometimes costing upwards of $500,000 per baby). I would imagine if just 20% of the babies born required even just some specialized care like this it would be unsustainable. In this example I don't think it's really an issue that one country is doing a better job than another. Canada has plenty of complaints against it's healthcare. The problem seems to be that we have too many people requiring high cost medical services in every country - and that's not sustainable. If each and every person with cancer, heart disease, diabetes, premature birth, auto accidents, skiing accidents, blindness, etc. is supposed to be "entitled to" the best care - where will the $250,000 - $1,000,000 per person come from? The average heart attack costs about $150,000 or more. Most people pay about $12,000 or less for their health insurance each year. If they do this for 10 years it's only $120,000. If they do it for 20 years, it's only $240,000 invested. How is this going to be sustainable when they are using up those funds each year?

Guest's picture
Jan Sackley

Our system has to change but I do not know a good solution. On the one hand, some doctors do not receive enough in payment from Medicare for some procedures, much less Medicaid. On the other hand, there are undisclosed conflicts of interest which the patient may wish to know before proceeding with certain diagnosis tools or treatments. I wrote about one of my own experiences, though I have had several more since the date of this article: http://bit.ly/3CI5aj

Guest's picture
jim

$3000 for emergency room visit and X-ray is pretty steep. I had a similar emergency room visit not too long ago with xrays. The hospital charged about $1300 and the insurance rate negotiated it down to $600.

I agree that health care billing is a nightmare. Hospitals charge almost random amounts of money that are probably 10xx the true costs, they give an invoice with indecipherable gibberish and then the insurance company pays a fraction of the bill. You get the same treatment from 2 hospitals and the price can vary drastically. The same treatment paid for by 2 different insurance plans and the price can vary drastically. The whole system is a complete mess.

I don't think haggling with the doctor in the emergency room is the best solution for our current system. Our system is setup so that the insurance company will handle the haggling. That way you and the doctor can focus on the illness or injury and not waste time and effort with the paperwork and negotiating the cost of your bed pans.

Guest's picture
Guest

So, focusing on the problem at hand is important, I agree. Having Health Insurance is great. What if the patient does NOT have insurance? Who is going to haggle? Think the E.R. Doc knows costs? Is there another business where the owner doesn't know the costs as well as the customer(s).

Guest's picture
Jen

Last year I was in a car accident and spent four hours in the ER as a result. The cost for sitting on their cot for four hours? $6k. I was billed separately for all the actual services performed (X-rays, CT scan, setting of a broken bone, morphine given, etc.). That 6k was just for the pleasure of lying on their cot.

Guest's picture
Craig

I live in Australia, and have been lucky enough not to need to use the public medical system anyway, but I've been hearing for years how people in the US keep getting socked with huge medical bills that really put a strain on their finances, but this is the first time I've seen actual figures.

$12000 for an overnight stay in a hospital with some tests? Sounds to me like at least some parts of the system are insanely overpriced. If avoiding the overnight stay would have save roughly have the price, what in the world justifies charging around $6000 for an overnight stay in a hospital?

Those prices sound absolutely absurd. I'd love to see someone justify those figures. I doubt they could.

Guest's picture
Guest

There's got to be a lawyer lurking on these posts. I've always wondered about suing to enjoin collection on some of these egregious prices. Oftentimes the minor procedures (checking blood pressure, temperature, etc.) aren't related to the issue at hand, but are billed in a manner to collect $. Why not attempt to enjoin collection under a theory that there was no agreement there. In cases where the thing being charged for is what you came in for (stitches, let's say), and they bill you 3k for 3 stitches without discussing the cost, couldn't you enjoin the hospital from collecting on a theory that that price is not the fair market value of the procedure, and you never agreed to it. Someone help me out here.

Guest's picture
Shana

ER visits are the type of claim that are most frequently processed incorrectly. There are typically 2 bills - the facility bill and the doctor bill. Based on the order they are received by the insurance company, they may be paid in 2 very different ways. If the doctor bill is received before the facility bill, it normally shows that you owe a bunch of money. If they are received in the opposite order, you generally only owe your ER room copay or some percentage of the charge.

If you have any doubt about how the bills were processed related to an ER claim and think the charges may be incorrect, ALWAYS call your insurance company.

Guest's picture
Lori

There is the other side of the coin from the hospital's perspective, though, too. Yes, we see the cost but have you seen the books of the hospital and the default rate? One the one hand, your doctor orders lots of test to CYA. If he didn't and it turned out there was something seriously wrong, then within seconds he'd have a negligence lawsuit thrown at him and his malpractice insurance would skyrocket, if not be dropped, whether or not he did anything wrong.
Further, sooo many people come to the emergency room for the slightest thing because they know that in the U.S. they cannot be denied treatment and they first must see you to determine if that is the case (which by the way then leads to point 1, ordering of unnecessary testing). But then guess what happens, they never pay the bill. Well, if 50% of people don't pay their bill, guess what happens, the other 50% have to pay twice as much to make up for the losses to the hospital. Throw into that same equation that insurance companies negotiate what can be charged for services received by their clients (and thus don't pay 2x the price to make up for the non-payors), then can you guess what happens. The people without insurance, that do pay their bills, are the ones left to make up for those who don't pay and who use ER's as their private physician.
So, in many instances, the real problem is ourselves. We rule against doctors out of sympathy, rather than basing it on the facts, and give these unfortunate individuals large settlements because well, the doctors and hospitals have it to spare. Then to make matters worse, we waste valuable time going to the ER for a cold and walk out on the bill, because well, the hospitals must have lots of money. But as with anything else, money does not grow on trees and someone must pay for these actions. Guess what? That someone is us!

Guest's picture
Jerry

I figure they ten-tuple the bill because they figure they'll just sell it to a collection agency for ten cents on the dollar. So they do something worth $100, charge you $1000, sell it to a collection agency for the $100 they wanted in the first place.

Guest's picture
Jane

Health care in his country is scary. I am one of those "waiting" for medicare..(no insurance)..not that I want that mind you, but at this point it is my only option...My health care of choice is alternative medicine and there is NO provisions for that anywhere!
Guess what people...
Who do you think pays for the illegal aliens who need to go to a hospital or receive medical care?? They get better care than I do!
Anyone with children HAS to have some sort of insurance...it is as bad a scam (ON US) as big banks and wall street...

Guest's picture
Guest

There actually a few doctors that are bucking the system.. accepting no insurance and keeping their costs down. I would love to see this trend continue. http://thephysicianspractice.com The one locally even does house calls. You can see his price list on the website. This is one of a few doctors passing savings onto the customer.

I agree with others.. E.R. is not the place for non-threatening medical services but it is where the illegals go for care... and we all foot the bill as the they not only don't have insurance, most don't pay at all. Those costs are spread to the rest of us. I don't believe government care is the answer anymore than forcing people to purchase services they don't need or want.

Guest's picture
Robert

I'm self employed and I live in the U.S and live in the state of Massachusetts where they made it law you had to pay for health insurance.

So we were paying for our health insurance, then yearly they kept raising the cost for the Insurance. This year they raised my health insurance to $15,600.00 a year($1300.00 a month)
So i called and ask why so high, there reply was "you used it". Yes I had my yearly physical. The physical only cost $600. either way they refused to budge so i canceled it. I went to the state where they pool it together and suppose to give a discount to people who are self employed or have a small business. they said they want $22,800.00 (1900.00 a month) I don't think so..

So i pay the fine instead $258 a month to the state.. I told my wife if we ever get real ill just go to the ER and I'll send them $10 a month. I am not going to be plunged to death financialy by these mobsters. wait till 2014 and the law goes into effect for the whole country, instead of just our state. there will be an over flow of americans moving to canada..

http://rjcleaningservice.com/

Guest's picture
Ken

I find it absurd that hospitals would be so sneaky about fees. As an Australian, general healthcare is covered by medicare, however dental is not. I recently had some urgent wisdom tooth work done all out of pocket (I'm uninsured). All fees were known up-front: the initial consultation, the x-rays, and the extraction by an orthodontist. As I'm a student, they even gave me a choice of two different painkillers which varied in price. No way would I EVER get medical work done in Australia without knowing the price first. I really don't understand why people would support USA's broken health care system. I know our's isn't perfect, but I won't be risking bankruptcy if I end up in hospital.

Guest's picture
tabatha

Being aware of costs and forcing medical providers to compete on price are all part of the intent of Health Savings Accounts and their linked High Deductible insurance plans. The idea is that the insurance is there to save you from financial ruin from extraordinary medical expenses, but the average visit or medication is paid for by the patient.
Getting a check-up shouldn’t be a big deal, should be the equivalent of getting an oil change. In the end this will happen by engaging the consumer and getting rid of the distance currently seen in these scenarios.

Guest's picture

I had sex change surgery in Bangkok, Thailand and the doctor I went to see had a price list on his website. I want to get natural breast augmentation, it's only offered here in the United States and there's no pricelist on any doctor's website. They say it is dependent on how many points they have to perform liposuction. Well, then, tell me how much it would cost per point and then the base cost. Hell, if my surgeon in Thailand did that surgery, he would likely have that info on his website.

*sigh* Why are doctors so afraid of quoting us prices so we know how much we have to pay?

Guest's picture

I my self was also got into confusion how things on ER goes along with it's valuable billing. It seemed that insurance are not capable of covering expenses that is incurred in the ER. It was so devastating that facilities we wish to help us get through our pains and relieved us causes a lot more sorrows for us. I wish there should be a way out of these, or we'll all gonna be in shock after a medication for a very inconsiderate financial reasons.

Guest's picture
Guest

I experienced this exact scenario when I was involved in a car accident a year ago, and have been preaching about the need for upfront pricing ever since. When I called the hospital to attempt to work out a payment plan, and was told "this is a hospital, not a bank", I realized that I was not a patient, I was a consumer. As such, it is my right to know the exact price of every test, treatment, and bandaid before being touched. You're right, we have that option in every other facet of our lives, from the auto mechanic to the lawyer, and it should apply to healthcare as well.

Guest's picture
Guest

I am shoked when I receive my statements from my insurance company regarding services I have recieved. I have been seeing a podiatrist for Plantar Faciitis for well over two years. he conduct a treatment that first had to be authorized by my insurance company and once it was they paid such a small percentage of the billed cost, I was shocked.

The treatment was billed at 680.00 per session. The insurance company paid 130.00. I did not have to pay anything, thankfully. but when I saw that, I started paying attention. I always recieve these statments from the insurance company for treatment at any facility or by any doctor. My wife, covered under our plan, fell in a bathtub in a hotel. She nearly broke her nose, but was thankfully, just in a lot of pain. The visit to the ER lasted over five hours!

The billed expenses were over $7,000.00!!!! The insurance company paid only 1200! And we had to pay nothing, the hosiptal accepted the 1200 dolalr paymnet as payment in full!

This is what I do not understand -- if the insureance company is able to pay so little and have it accepted - why do people without insurance have to pay so much more!

My dental coverage is not as good. I have to pay 40% of the billed amount. This shuld mean that the insurance company is going to pay more than me, correct? A root canal cost me $200.00. I know it is a bargin based on a typical $800 - to $1000 dollar bill. But my insurance company only paid $80!!!! How is this 60% of the bill if I had to pay 200?

Do we need reform? Maybe, but it MUST start with fair billing!!! Right now - if you and I went to the same ER, at the same time, with the same complaint -- we would certainly recieve unlike bills because the hospital will mark mine up because they will only recieve such a small percentage from my insurance company whereas you will pay the full amount.

this is why health care costs are so arbitrary -- the insurance company only pays what the treatment is worth, not what the doctor charges!

Andrea Karim's picture

Late to the party here, but I just wanted to say that I'm self-paying for surgery in April, because my insurance doesn't pay for what needs to be done. As a result, I am paying drastically reduced prices because hospitals charge insurance companies more than they do patients. For instance, I have to do a series of lab tests. If my insurance company is billed for them, they will likely reject them, and after insurance rejects them, my cost would be close to $600. But if I simply pay upfront, it's $190.

It seems like leaving out the middle man saves a lot of money, but to be honest, I'm not sure why. I wonder if the process of billing insurance agencies is just so high that hospitals HAVE to charge an arm and a leg? Or if they just charge that much because they CAN?

Guest's picture
Guest

Don't forget the sticker shock for prescriptions, and the often completely muddled insurance (if you are lucky) coverage for same, including $200 deductibles, copays, generic price differentials, all of which the physician who writes the scripts cares little if nothing about....

Guest's picture
José

The only way anything gets "fixed" is by making it into law. And the way you do that is by writing to your congress representatives and/or voting to those who hear you - regardless if its blue, red, green or fuscia. This will never stop because we all want to feel better without worrying how much it's going to cost. If my mechanic tells me my car will be fixed with $8000, I will take a ride with a friend, the train, the bicycle... but if the ER tells you we need to make sure your head is not going to explode in 5 minutes, you'll go for that MRI no question about it - then endup paying the $8000. It has to stop, and the only way is for ALL of us to do it the way is done in America: through politics. Where it hurts them the most.