Yeah, that sent me into tilt earlier.
It is super duper fun when you get some completely fraudulent medical collection that you donāt even know about for like $9.88 that hits your credit score for like a 50 point drop right before you try to get a mortgage. Ask me how I know.
That is preposterous. Iād love to know how many cases exist where the patients had any direct influence over which lab tests were sent to if they havenāt been scamed by this before. Iād bet there are more toothpicks in a box than instances of this ever happening.
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I would like to subscribe to your newsletter. Seriously, I donāt disagree just have some ingrained thoughts that keep me playing the game.
unsub, sorry, nvm
ha I feel this. Iād be down to read about someone ludicrously uncompromising to the point where it damages their future (or doesnāt!). Sounds like the backbone of a novelā¦ probably is.
Riverman lives in a house?
This strategy has a reasonable EV if executed correctly. But itās always plan B. Plan A should be to just win the damn game. Obviously because of the various lotteries in life, thatās not possible or practical for everyone (or even most people).
But if you can win the game, youāre better off just trying to do that. In a forum of ex-poker players, Iām sure weāve all come across people who could have won and just didnāt try. Thatās a suboptimal strategy.
But if you try and fail, going into victormode isnāt the worst idea in the world.
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On topic of in/out of network, my mom has to schedule an appointment with a Nurse Practitioner. She asked her insurance if this provider was in network but they canāt tell her because they canāt find her name in their search program, likely because she bills under one of the doctors at the practice. Apparently some of the doctors are in network and some are not. It took my parents (who are extremely competent with insurance issues) multiple phone calls to the umbrella medical org that the practice falls under, the practice itself, and the insurance company. Best they got was a verbal āthat NP does work with cigna, you should be fine but check with your insurance to be sureā. I can only imagine how impossible this is for people who donāt know how to navigate the system and what questions to ask.
Fine system weāve got here.
I thought this was known, but guess seeing those screenshots really highlights the ridiculousness of it and makes for a good news story. I canāt believe the hospital set up their software like that.
I didnāt do a deep dive but it seems like some of those prices might be massively inflated even before the markup. For example, the $73.50 for the cleaning solution seems sus. Iām not saying that itās not possible for that to be reasonable, but Iām doubtful. That already seems like a substantial markup before adding the 575%.
I donāt want to sound like Iām stanning for the hospital, but they are more or less telling the truth when they claim that it is the insurance system that leads to this strategy. On the other hand, the side effect is that uninsured patients get put in a terrible position. Itās true that they can apply a discount for such people (which they often need to know to ask for). Nevertheless, the side effect of this whole farce is a lot of uninsured people get wrecked. And the hospitals really donāt give a fuck about that. Or at least not enough fucks.
One might wonder, āWhy donāt they just charge the uninsured something reasonable up frontā. Unfortunately there are contractual obligations to insurers (including Medicare) that highly disincentivize that. So we end up with the shitshow described in the article.
Media bros on the case:
A bipartisan effort in Congress created a law to curb the practices; it goes into effect next month.
In a statement, Envision said: "Envision has always advocated for bipartisan solutions to resolve the issue of surprise medical billing while improving patientsā access to affordable care.
If you do a replace-all on ābipartisanā with another word like āfakeā or ātoothlessā here it makes way more sense.
So full disclosure here, AAEM is suing because of self-interest, and them winning would definitely help me. Corporate and private equity EM groups like Envision, EMcare, TeamHealth and so on (I think envision merged with EMcare) have put a stranglehold on EM doctors wages and benefits in some areas.
That being said, they are utter shitstains for lots of reasons. Iām just not sure that doctor run practices are exactly covering themselves with glory in a way that matters to you guys.
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Truly mind boggling we accept this shit.
Just ridiculous:
Where is the legislation to stop this shit? LOL DEMOCRATS
Itās so indefensible.
I want a US version of the British system. Everybody gets a paycheck from the US govt. The buildings belong to the US govt. Open some new US govt medical schools to go with the US govt hospitals.
I worry āmedicare for allā will leave too many middlemen gaming the system. So many of the existing players need to be nuked from orbit.
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nothing makes me wish for an afterlife to be a reality than this shit
I love how the hospital just fires off a $175,000 bill. Like, what a complete waste of time. Sure letās ruin this poor familyās life after they tried to do the right thing and buy insurance, knowing full well weāre just going to end up writing it off. Fuck you.
nah hospitals can do special pricing below medicare pricing