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- Oct 13, 2010
- Messages
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We all know that those of us with health insurance never pay the 'rack rate', which is typically 4 times the price that the insurance company has negotiated.
So when deciding on a health insurance carrier, you want one that did a good job of negotiating, right? How are you supposed to figure that out?
My current provider "A" has an estimator, so I can pick something meaningful to me: the colonoscopy procedure. If it's not done in the hospital, the going rack rate is around 5,500. Let's say insurance company "A" has negotiated a rate of $1,244. Unfortunately, "A" is not playing ball with the AHA.
So I call "B" and ask them how much they estimate the same procedure would cost. They say that they "don't disclose that information". It's in a contract between them and the provider. I call "C", same story. There are only two companies on the exchange.
So let's say I save a few bucks choosing "C" in the much heralded "marketplace" (where I'm supposed to have all the information I need to compare one plan with the other). Then when the time comes, I submit the claim with "C" and only then discover that their negotiated a rate for the procedure is $2,000! And my neighbor then tells me that "B" did a good job negotiating and so he only got reamed for only $1,000.
If their ain't a place where plain folks can post actual procedure code charges by doctor or facility, there should be. That's the only way we can get any cost pressure. Right now we're completely in the dark.
So when deciding on a health insurance carrier, you want one that did a good job of negotiating, right? How are you supposed to figure that out?
My current provider "A" has an estimator, so I can pick something meaningful to me: the colonoscopy procedure. If it's not done in the hospital, the going rack rate is around 5,500. Let's say insurance company "A" has negotiated a rate of $1,244. Unfortunately, "A" is not playing ball with the AHA.
So I call "B" and ask them how much they estimate the same procedure would cost. They say that they "don't disclose that information". It's in a contract between them and the provider. I call "C", same story. There are only two companies on the exchange.
So let's say I save a few bucks choosing "C" in the much heralded "marketplace" (where I'm supposed to have all the information I need to compare one plan with the other). Then when the time comes, I submit the claim with "C" and only then discover that their negotiated a rate for the procedure is $2,000! And my neighbor then tells me that "B" did a good job negotiating and so he only got reamed for only $1,000.
If their ain't a place where plain folks can post actual procedure code charges by doctor or facility, there should be. That's the only way we can get any cost pressure. Right now we're completely in the dark.
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