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Old 05-10-2016, 07:17 AM   #21
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From a couple years ago:

Ideal Medical Practices: How do doctors get paid?

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Imagine going to your favorite restaurant. You are greeted at the door by the hostess, who seats you and takes your drink order. You order through your favorite waiter, Andrew, who recommends the special of the day: prime rib with a dinner salad and a chocolate torte for dessert. Soon after, the food is brought out and it is delicious! You have time to enjoy your food. You then receive the bill and pay for your meal, returning to your home satisfied, all your dining needs met. Let’s say, for simplicity's sake, you paid $75 for this meal: $50 for the steak, $10 for the salad and $15 for the dessert.

A change then occurs in the restaurant industry. A new form of eating out has been adopted. Your favorite restaurant has now contracted with over 30 different ”restaurant insurance companies.”
and a video that explains it visually:

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Old 05-10-2016, 07:24 AM   #22
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Maybe there is something to hospitals and facilities getting huge tax write-offs for overpricing then negotiating down.
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Old 05-10-2016, 07:28 AM   #23
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I remember getting the itemized bill for a surgery 20 years ago when they still printed them out on line fed printers. I don't remember the amount owed, but the printout was over 6 feet tall.


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Old 05-10-2016, 07:36 AM   #24
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I'd like to find out, too. I'm guessing it's to cover all the uninsured or underinsured or those that can't make their 20-30% copays. Eventually they'll find a rich person with deep pockets that's forced to pay the rack rates because for some reason their insurance didn't cover it all (out of network or covered as in network as an emergency but balanced billed for the amounts not covered by the insurance).
But is hoping to soak the rich a legitimate, moral or even legal business model? Can you imagine this being a widespread model for transacting our daily lives?

Here is your hamburger, fries and a coke. That will be $2,563.
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Old 05-10-2016, 07:36 AM   #25
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Maybe there is something to hospitals and facilities getting huge tax write-offs for overpricing then negotiating down.
No. They cannot recognize revenue that has not been collected, and only the actual cost of services in kind can be deducted, not the price or value.

This looks more like a clear sign that there is a split in the hospital between the cost management and the revenue generation. In other works, the pricing is now independent of and no longer related to the cost of the service provided. This is a bad sign (for health care). On the pricing side, it means every item will be priced as high as possible, and on the cost side, thee will be continuous effort to suppress and minimize where possible. This separation means the management views the primary goal as financial and health outcome is now a measurement.
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Old 05-10-2016, 07:37 AM   #26
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NBC News had a story on this very topic. In this situation, the patient tried her best to dot the I's and T's ahead of time but still got socked with a hefty bill:

How to Protect Yourself From Surprise Medical Bills - NBC News
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Old 05-10-2016, 08:06 AM   #27
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No. They cannot recognize revenue that has not been collected, and only the actual cost of services in kind can be deducted, not the price or value.
Well I wondered, as it seems like every business would use this technique to become "non-profit".
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Old 05-10-2016, 08:11 AM   #28
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I had a pharmacist the other day launch into a rant with me, unbidden. He said that they order hydrocortisone suppositories (and no, that is DEFINITELY NOT what I was picking up, lol) and the cost had jumped in the last month or so to over $200 a blister pack. For the same hydrocortisone that you could buy off the shelf. I had to ask if he was advising customers to "roll their own" to save money.

The whole system is simply broken.
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Old 05-10-2016, 08:26 AM   #29
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For the folks on Medicare, doesn't getting a supplemental plan F (plan type) pretty much cover everything hospital and doctor related that Medicare doesn't? I'm still years away from Medicare but made several mental notes about the supplemental plan.
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Yes.
My mother must have had a plan F supplement. I knew she had one, just wasn't sure what. When she died 3 years ago, she was in intensive care for 10 days before passing. I never received one statement from the hospital or any kind of medicare/insurance EOB statement. I thought that was odd.
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Old 05-10-2016, 08:31 AM   #30
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So, given all this, might "large number of nearby doctors and specialists willing to accept Medicare" a necessary criterion for "Where shall I retire?"

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Old 05-10-2016, 08:33 AM   #31
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I had a pretty terrible experience.

When I was in my early 20s... I started to get what felt like heart attacks... multiple times a week.

I'd go to the emergency room... nothing was wrong but they told me (obviously) to come back.
My empathy!

In 92 I had the same kind of issue but only a one time hit. Checked into ER for chest pain and a numb left arm and was treated as if I was having a heart attack. Then told it's nothing but a panic attack, which is not nothing. Since my insurance had no mental benefits I was stuck. Luckily it was not what you got tagged for, but it hurt. I acted as though it was a car payment every month.

People tell me they have no need for mental coverage, they are clueless.
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Old 05-10-2016, 08:35 AM   #32
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So, given all this, might "large number of nearby doctors and specialists willing to accept Medicare" a necessary criterion for "Where shall I retire?"

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That doesn't mean it won't change as soon as you move.
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Old 05-10-2016, 08:47 AM   #33
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For the folks on Medicare, doesn't getting a supplemental plan F (plan type) pretty much cover everything hospital and doctor related that Medicare doesn't? I'm still years away from Medicare but made several mental notes about the supplemental plan.
Be aware that the 2015 "Doc Fix" legislation states no new Plan F policies will be sold after Jan 1, 2020 - although existing policy holders will be grandfathered. Also, there is a high deductible Plan F that may continue to be available (no ruling on that yet).

Consider Plan G as a close alternative.
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Old 05-10-2016, 08:49 AM   #34
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So, given all this, might "large number of nearby doctors and specialists willing to accept Medicare" a necessary criterion for "Where shall I retire?"

Amethyst
Look for areas that have a large percentage of population over 65 Physicians in those areas have little choice but to take medicare because that is a large part of their business.
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Old 05-10-2016, 09:10 AM   #35
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Practical advice from my (even older) neighbor re health costs and medicare:

"Things aren't going to change. Best advice is to not pay any of the bills you receive for at least three months, while the doctor, Medicare, and your supplement straighten out the details."

The "You may be billed..." part of the invoice is meaningless, and any payment made based on that statement, has a fair chance of being lost along the way.

But then, you already knew that, didn't you.
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Old 05-10-2016, 09:37 AM   #36
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I had looked into this a few years ago and learned about something called "chargemaster"
https://en.wikipedia.org/wiki/Chargemaster, it's where the inflated charges start

The Times reporter Steven Brill did an article that hit on it, http://www.uta.edu/faculty/story/231...ndAndGreed.pdf
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Old 05-10-2016, 11:53 AM   #37
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RonBoyd,

That restaurant video was excellent. Thanks for posting it.
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Old 05-10-2016, 11:58 AM   #38
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Be aware that the 2015 "Doc Fix" legislation states no new Plan F policies will be sold after Jan 1, 2020 - although existing policy holders will be grandfathered. Also, there is a high deductible Plan F that may continue to be available (no ruling on that yet).

Consider Plan G as a close alternative.
I'm still awhile away before medicare. But mental note made.
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Old 05-10-2016, 12:00 PM   #39
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My mother must have had a plan F supplement. I knew she had one, just wasn't sure what. When she died 3 years ago, she was in intensive care for 10 days before passing. I never received one statement from the hospital or any kind of medicare/insurance EOB statement. I thought that was odd.
I had a friend who a few years before passing away, seemed like she went to the ER several times a year for various tests and treatments. I had the same "I thought that was odd" thought too. Even more odd I thought was when she switched from one F supplement plan from one insurance company to another, save coverage (as dictated by law) but different premium costs.
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Old 05-10-2016, 12:11 PM   #40
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I had a pharmacist the other day launch into a rant with me, unbidden. He said that they order hydrocortisone suppositories (and no, that is DEFINITELY NOT what I was picking up, lol) and the cost had jumped in the last month or so to over $200 a blister pack. For the same hydrocortisone that you could buy off the shelf. I had to ask if he was advising customers to "roll their own" to save money.
Sounds like a pain in the butt.
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