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Re: [OM] IMGS: Christmas 2016

Subject: Re: [OM] IMGS: Christmas 2016
From: Moose <olymoose@xxxxxxxxx>
Date: Thu, 29 Dec 2016 21:19:00 -0800
On 12/29/2016 7:28 AM, Rick Beckrich wrote:
Sorry to hear Tom is doing poorly. I had hoped Santa would have perked him
up.
Yeah!

Hospital bills are indeed shocking.

The whole business seems to me to be as crooked as a game of Three Card Monte, 
but a lot more complicated.

Medicare and insurers never pay the list price. When I was handling the bills for my mother, I was flabbergasted. A bill would come in for, say, $1000. You ignore it entirely. Then, generally weeks later, something comes from Medicare, or some contractor, saying they will pay maybe $550. Then, a few weeks later, comes a bill from the provider showing the original amount, less something generally called 'adjustment'. In Mom's case, with good supplemental coverage, the net after Medicare would usually be $zero, sometimes a few bucks.

We are now in the middle. Carol's Medicare doesn't start for a few months, and we were going 'naked' until then, when a wet restaurant floor broke her ankle. The administrative service for the restaurant is playing coy, collecting bills and medical records while not yet being willing to commit to whether they will (hurray) or won't (PI attorney) pay.

It's certainly been educational. The UMass hospitals that gave emergency care in MA give a 20% discount for payment within 30 days of billing. I wouldn't be surprised if negotiation could make it less.

UCSF gives higher discounts for payment up front. Various services had varying discounts, but the amazing one was the outpatient surgery (four+ hours) to repair the ankle, apparently including followup visits. 'List' price was $61,300 - net, $12,400.

We are incredibly lucky to be able to pay all these bills and wait for reimbursement, rather than running up late fees and/or credit card interest. Was it divine providence that kept me from having repairs the house needs, and I've been saving for, done sooner? Creative Laziness? Cheapskateness?

I haven't tried to really do the math, but I think so far we are out of pocket less than the last few year's premium payments would have been.

Heaven only knows what an insurer would have paid.

Single payer aside, a study showed that just standardizing paperwork between 
all the various players would save billions.

. . .

Anyway, I hope Tom is correct and a simple prescription change will smooth 
things out.
Best wishes for the coming year. Tell Tom we're all rooting for him.

+1 and +1

Discounted Moose

--
What if the Hokey Pokey *IS* what it's all about?
--
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