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Transparent medical prices
Old 02-25-2020, 03:41 PM   #1
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Transparent medical prices

After my recent experience with medical billing for a colonoscopy I'm a bit more sensitive to the shenanigans by hospitals and other medical facilities.

Here is a summary of an article on Marketwatch.com where a women was given an estimated charge of $143,396.66 by Stanford Health Care hospital system for a breast biopsy. (This happens to be down the street from where I had my colonoscopy done - must be something in the water.) She ended up paying $7,750 and the insurance company was billed $67,088. According to the article, the $7,750 would have covered the entire cost of the procedure at Surgery Center of Oklahoma. The article goes on to talk about using MDsave, MyMedicalShopper and SurgiPrice to get transparent pricing - something I'll have to look into the next time I need medical services.

Here is the link to the article:
https://www.marketwatch.com/story/a-...?mod=home-page
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Old 02-25-2020, 05:20 PM   #2
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That is one of the attractions for me of some variation of Medicare for All.... this medical provider billing stupidity would go the way of the dodo bird.... there would be a single rate book similar to Medicare, but of course, the rates would need to be higher so the medical providers can still survive.... probably closer to an average of insurer negotiated rates than to Medicare.
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Old 02-26-2020, 10:48 AM   #3
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Great article. I didn't know of the comparison websites, thanks.

Our current systems are broken and totally out of whack. I planned on paying out of pocket for a surgery, nobody could even provide an estimate. I was just looking for 5k, 10k, 100k guesses, nada. After receiving a bill it was 15k. When I asked about a discount for self pay, they're now suggesting they'd write it off!

When I was still working I remember a visit to a large hospital that had improved their billing turn around time. Apparently this is a big metric the administration staff is rated on. This hospital had made a large investment in technology to improve its turn around time. I attended a review of the whole project.

The project was implemented and declared a huge success based on the improved billing turn around time. In this review they brought in the billing staff to help us understand what changed. These ladies were great, they'd been there for many years and knew how the systems were broken over time. They declared: "the new system allows us to see all the procedures the patient had done so we can bill properly". When they were asked how they did the job prior to the new system being implemented: "we guessed, we had a report with a bunch of two digit codes that were supposed to map into the billing codes but for the last 5 years they're many procedure codes that overlap. So we made our best guess to what the patient had done".

I wonder how many errors did that process generate over the years it was not meeting the needs of the people who were doing the billing. That was one hospital, how many more are still using inadequate solutions?
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Old 02-26-2020, 03:40 PM   #4
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^^^^ Scary MRG.

Perhaps you should have taken them up on their offer to write it off and then just make a contribution for what it was worth to you.
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Old 02-26-2020, 04:39 PM   #5
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Quote:
Originally Posted by pb4uski View Post
^^^^ Scary MRG.

Perhaps you should have taken them up on their offer to write it off and then just make a contribution for what it was worth to you.
That's where I am at. I've turned in their paperwork to write it off, been waiting for a few months. After Medicare age I'll donate a sum to make it whole.
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