But I have insurance, why is the charge different than if I were a cash paying patient? So this is the story of my Colonoscopy bill. I’m naming names and the stupidity of what is going on with fake billings. NWO Gastroenterology Associates sent me a bill for their services. The Charge is $1,271.00, Insurance receipts .oo, Adjustment $966.15, balance due $304.85. Because I have insurance they accept whatever the insurance says is an allowable fee. That would be the amount I paid. No insurance, no deduction, pay the full charge of $1,271.00. My question is the same, doctor, hospital, labs, etc. Why is it you will accept whatever the Insurance Industry says is allowed for you to charge. But that charge is not the same if one has no insurance. Same thing goes for the Dentist and their ripoff charges. No, we don’t have dential insurance, I need to get that told upfront for this next bit of information. A patient goes to the dentist for oral surgery, cost $3,500.00, but if the patient had insurance, even if the insurance paid nothing, the dentist would have accepted the allowable amount set by the insurance company which was $900.00. The insurance company pays providers according to “reasonable and customary” charges, which may be less than the provider’s usual fee. The provider may also have a separate contract with the insurer to accept what amounts to a discounted rate or capitation to the provider’s standard charges.
I’m just saying that reform was long overdue, but what does it do for you. Read all about it over here, then we can talk! Now lets talk about Socialized medicine! I can talk about that, I lived in Canada for 10 years and know first hand of the care I received. I had all the services I needed!
Just yesterday I received a phone call from a firm wanting me to answer a survey about my call to Medical Mutual Insurance Company-My Insurance provider. Sure, no problem, but after the survey she made the mistake of asking me if I had any question! That’s when I went into my story at the beginning of this entry. She had no answers, I said maybe someone could call me and tell me why. She said all calls are recorded, so maybe someone would get back to me on it. I said I would be willing to bet I would not get a call back, how much I said are you willing to bet, she wouldn’t take any bet because she agreed with me that a call was not likely.
Anyone out there who think the rip-offs won’t affect you-guess again!!
Medical providers gouge non-insured people. Capitalistic swine that they are.
Why should anyone who has no insurance be required to pay the full $1271.00 that you mention if that same medical provider will take your $304.85 as payment in full and write of the other $966.85 that the insurance company will not pay because you have not met the deductible required under the insurance plan. What are people without insurance or without the financial means supposed to do?
THAT’S JUST NOT RIGHT!!!!
I got caught in that dental mess you mentioned. I still get dental care, but not as much as I would like, nor as much as my dental health provider would like; but, I will be damned if I get caught paying the outrageous fees for anything but the absolute minimum necessities now. That means no implant (or crown) for the one molar that had to be extracted; it is a good thing for me that the empty spot in my mouth is not readily visible to others, although it does make chewing food a bit cumbersome.
How dare, I SAY HOW DARE, the anti-universal heath care supporters advocate the denial of adequate health care for all Americans regardless of their economic abilities!!! I wonder if any of those tea=party type people have been in the position of needing necessary health care but were unable to get it because they either had no insurance or could not afford to pay for it themselves.
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Amigos Judy and Roland,
fer to the self
The way that I see it, the Insurance companies, by their size, have the clout needed to be able to negotiate lower costs.
Unfortunately, that clout does not transfer to those who self pay, so they are charged more so that the medical provider can recoup some of the service costs that they are forced to provide to those who cannot pay.
Now, I’m not saying that this right, but it does keep the doors open.
A thought:
Have you ever tried to negotiate the cost of a service before receiving the service?
Two more EOBs related to Judy’s colonoscopy procedure have arrived since Judy first wrote her “Medical Cost Ripoff” entry.
NWO Endoscopy Center, 4411 Monroe St. #111, Toledo, Ohio 43623 charge for services is $1100.00, but they only get paid a total of $602.00. Insurance paid $481.60 and we paid $120.40. There was an adjustment of $498.00 because apparently that is how much the medical provider charged over what a person might considerable a reasonable charge, or as others may call it – the usual and customary rate.
Consulting Pathologists Corp, 5620 Southwyck Blvd., Toledo, Ohio 43614 charge for services is $210.00, but they only get paid a total of $55.65. Insurance paid nothing while we paid the $55.65. The balance of $154.35 was “written off” as an adjustment.
HT, I think Roland answered you with what I would have said. That being the case, I’ll now put in my two cents worth. While I respect your view point, I 100% disagree with your way of thinking it is good business on the part of those with Clout. Once a price as been established by the Doctor they should never charge a private pay person more than that period, end of the story!!! You have worked in the belly of the beast, but I lived with socialized medicine before, no one can ever put it down to me.
“Tom Taylor learned a lesson about healthcare finances when he had both his knees replaced a couple of months apart at separate hospitals in Northern California.
The tab at the first hospital was $95,000, but the second cost $55,000. The same doctor performed identical surgeries on both knees, and Taylor says he can’t detect any differences between the two.”
This was written by Duke Helfand of the LA Times, interesting?
More EOBs. More expense. More rip-offs by medical providers.
Details:
Mercy Integrated Laboratories (aka Northwest Ohio Integrated Lab)
2222 Cherry Street
Toledo , Ohio 43608
Amount billed: $256. 83
Amount allowed: $40.60
Insurance paid: $0.00
We paid: $40.60
Written off: $216.23
Steel City Anesthesia, LLC
Mailing Address:
PO Box 2164
Youngstown, Ohio 44504
Amount billed: $680.00
Amount allowed: $360.00
Insurance paid: $248.30
We paid: $111.70
Written off: $320.00