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Old 02-27-2014, 10:03 AM   #41
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I just got my EOB for my "free" flu shot at the University of Michigan Medical Center satellite office. Free means $67 cost to insurance, vs the $20 that I was paying at Costco the year before.
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Old 02-27-2014, 02:46 PM   #42
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In 'old days' of 'traditional' US medicine, doc charges were single fee which was high enough to cover their overhead + prof service. Then this got split into prof fee + "facility" fee, and facility fee grew to be somewhat higher for entities distinct from doc's office itself (facility vs "non-facility" site for service-see link below). Health systems began buying up doc's private offices (in part) to profit from this, and now most US docs are employees (not in private practice).

For those interested in the technical details regarding Medicare physician fee schedules, inc role of "facility" fees, here's a link to get started:
https://www.cms.gov/Medicare/Medicar...hed/index.html


It's enough to make even a seasoned bureaucrat's head spin. IMHO- This transition from simple single total fee to complex separate professional/facility/etc. fee structure has made it extremely difficult to compare actual overall pricing....and comparison pricing is critical to controlling costs in any business.
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Old 02-27-2014, 02:49 PM   #43
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Quote:
Originally Posted by travelover View Post
I just got my EOB for my "free" flu shot at the University of Michigan Medical Center satellite office. Free means $67 cost to insurance, vs the $20 that I was paying at Costco the year before.
Interesting. My wife had a flu shot at a Walgreens last October when we were still on the short-term plan (which didn't cover regular exams or preventative care such as flu shots). Apparently they didn't charge her at the time of the service, but simply took her insurance card even though we were sure it wasn't going to be covered. We got an EOB in November that said the claim was denied (duh) and we may owe $31.99. Walgreens never billed us, so I assume they probably just wrote it off and moved on.
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Old 04-22-2014, 08:40 PM   #44
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The Connecticut Attorney General's office just released this report on hospital facility fees. Among other things, it addresses the need for better disclosure of the fact that one will be charged when a formerly independent physician practice is acquired by a hospital. Note also that the professional fees also go up when that occurs. I thought some might find it of interest.

http://www.ct.gov/ag/lib/ag/press_re...ee.doc200x.pdf
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