this was something I saw more of in NYCHC hospitals, especially for people with no coverage and undocumented immigrants.
Correction: heard of I suppose. I’m not billing anyone.
You and ikes are both kind of correct.
You are not allowed to bill any other payers (including cash paying patients) less than what you bill Medcare.
However, you are allowed to bill a patient more than what you bill Medicare and then offer a discount that takes the bill down to an amount that is less than what you would have billed to (or even collected from) Medicare. The mechanics of exactly how that discount can be offered is a bit of a gray area, but you can make it very easy. I’m sure any entity that does this (there are many) will run their scheme by some lawbro to make sure they’re not breaking any rules. This is done quite frequently. However, whenever it is done, there exists some initial charge which was >= what Medicare would have been billed.
Also, I haven’t looked into this in a while, but I’m not sure what the penalties for violating this are. But I think that even if you bill someone else less than Medicare, but it is still more than what Medicare pays, then you would probably be fine. But there is no reason to do this and I don’t think that anyone actually does.
The couple in the article would have been way better off not buying “insurance” at all. That’s a colossal regulatory failure.
Even 60% may not have got you to below what Medicare would have reimbursed for the services in question. You could probably look that up easily if you are so inclined.
But, yeah, that’s one way to get around the problem.
If I ever get one of these mega bills even if I can pay it I’d like to just be like lol fuck you. How hard can they go coming after assets, probably depends on the state?
They can go pretty hard. That’s why so many people have to file bankruptcy because of medical bills.
Assuming I can’t declare bankruptcy if i have the means to pay the bill I rather pay a lawyer to fight it than the hospital. Or maybe I could pay some shady finance guy to hide my assets.
There is not a lot that can be done to “fight it”.
That’s easier said than done and you need to have a fuckton of assets before the cost of hiding them becomes trivial.
I’m talking about the kinds of things shady finance guys do. If you’re just gonna hide it in your mattress, that’s a lot cheaper.
Say i have 5 or 10 million in assets, I can’t hide it in some kind of anonymous trust that makes suing me a big pain in the ass for collection agencies?
If you have 10 million in assets, then paying off a 200K hospital bill is probably the most +EV move. The only reason not to pay it would be spite, which I definitely understand.
Rich people have real insurance and never have to deal with this shit, which is why nothing changes.
Yeah, we’re way off in hypothetical land.
Can’t you read dummy? It’s from Freedom Life Insurance. How can you be against freedom, commie?
Yeah hospital billing is horrible. There is no rhyme or reason for costs for so much.
They seem to decide how much profit they want their non profit to make then work backwards to determine costs.
The most under-covered part of this is how rich private equity assholes are getting ravaging our already broken system. It’s truly fucking insane they are allowed to own hospitals, doctor groups, medical device companies, etc. etc. etc.
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I have talked about it before but that is why my uncle killed himself. He had over a million dollars in medical bills in the early 80s from my aunt,
Something has to change. Dropping 6 digit bills on people who make 3 digits a week has to generate health issues all on its own.
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Went to go get my Covid booster last night, and my HMO only covers Flu Shots if done through my Primary Care Provider, and if I wanted to get it at Walgreens it would be $50 out of pocket.
Makes total sense.
What’s the good lord here?
OP is a moron in that thread. A busy as fuck ER isn’t going to “upsell” things like that. Yes you still get charged for being evaluated by a doctor and then deciding you don’t want to wait.
edit: LOL, OP fell down a bunch of stairs which is a high risk mechanism. OP is a moron. Tests were almost certainly needed.
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I don’t know about that one. I think you have to take it with a fuckton of salt. I only read OP. If more info comes later, let me know.
-He’s claiming that the nurse is “upselling” like she is on a commission or something. It’s not like they get paid more if he gets whatever tests they are recommending.
-We would need a lot more detail about what happened to determine if such tests are warranted. Imagine the alternative scenario where he really needs some tests to figure out if there is something else wrong and they don’t do them (or offer them). Then everyone goes on about how incompetent they are. Maybe they even face a lawsuit if the omission is serious enough.
-If the dude was able to walk out of there just fine, I’m sure whatever “bleeding for an hour” he was doing was not significant. Presumably he had been triaged and someone competent determined that whatever he needed could wait. Yeah that sucks, but it’s not like COVID-related staffing shortages are not a thing.