Having an issue with my shoulder, went to the Doc.
Quick look, Steroid prescription and order for a MRI.
Get a call from their MRI place wanting to schedule.
Whoa, what is the price?
$850 MY PART and insurance pays the rest of $1700.
WTF?
Called a couple other places they want $450 cash and get NO insurance $$.
There is another place that will do if for $300.
Is this some kind of scam ~ I know the machines cost a bunch of money but this seems a bit shady to me!!!

Getting a medical procedure is probably one of the few things you do wherein you go into it not knowing what it is going to cost.

Add to the fact the price range for the same procedure can vary so widely like you just found out.

Stimulus checks are being sent out to most everyone.

Even the Medical folks want a piece of this free money.

Even the cost of Insurance and the co pays and deductibles are all over the place.

quote:

Originally posted by h2oys:
Getting a medical procedure is probably one of the few things you do wherein you go into it not knowing what it is going to cost.

Add to the fact the price range for the same procedure can vary so widely like you just found out.

And airline tickets.

Helium. But they were always expensive

Same with prescriptions. I check goodrx every refill.

Shopping around makes sense.

Doctors, who aren't paying the bills, are as human as the next individual, and aren't going to be spending all their time checking up on costs. Most probably have been sending people to the same old place for years.

Check with your doc and make sure they're OK with the alternative MRI location (sometimes details matter - type of scan, type of dye, type of machine, etc.) and then, go forth and save $$$.

The whole health insurance system is totally effed up if you ask me.

I'm getting a CPAP machine through insurance and I'll have to pay like 48 bucks a month on it for a year but the medical supply company is billing Aetna like 200 bucks a month for it.

So after a year, I've paid almost $600 and Aetna will have paid around $2400 all on a machine that is like $1000 tops.

quote:

Originally posted by PASig:
So after a year, I've paid almost $600 and Aetna will have paid around $2400 all on a machine that is like $1000 tops.

Just like financing a car, isn't it?

Might be worth checking MDsave. Sort of like goodrx does for prescriptions.

https://www.mdsave.com/

Could be the cost of the increasing numbers of uninsured.
They have to take money from those that got it

Re the CPAP pricing. Are those the prices they are billing, or is that what the reimbursement is?
The medical field doesn’t want the ins cos, or Medicare to tell them what to charge. You can see how that could turn out.
And the ins cos and Medicare don’t want to pay too much. Bare minimum is the goal.
So there is a difference in what is allowable, and what isn’t. They can charge $200, chances are they’ll get reimbursed a lot less. Say $50-75. And with the commonly acceptable 20% your OOP would be $10-$15. But if their actually getting reimbursement of $250 a month, then it’s about right. How long do they pay on the CPAP equipment?
I would you might own it soon.

quote:

Originally posted by smschulz:
Having an issue with my shoulder, went to the Doc.
Quick look, Steroid prescription and order for a MRI.
Get a call from their MRI place wanting to schedule.
Whoa, what is the price?
$850 MY PART and insurance pays the rest of $1700.
WTF?
Called a couple other places they want $450 cash and get NO insurance $$.
There is another place that will do if for $300.
Is this some kind of scam ~ I know the machines cost a bunch of money but this seems a bit shady to me!!!

Faced the same thing 6-7 years,
Wife needed couple X-rays, hospital wanted $700-800 for couple X-rays.
Had a private imagine place do them $45 each
It was like $140 out the door with a CD of images.

It's a money making scheme they bill what they think they can get away with and hope you don't question the bill or shop around.

The machines are long paid for and cost X to maintain but load a person in and ring the cash machine.

Where I live under my current plan that is the best you can buy my out of pocket cost for a MRI is a copay of $75.00 dollars. The lower plans are $100.00, $325.00, or the cheapest worst plan is 40 percent after deductible is met.

To put it into perspective if you walk in with no insurance they will bill you $5,000.00 dollars for the same MRI Test.

My friend many years ago hurt his back had the worst/cheapest insurance and they tried to bill him 5K I told him to fight it that is the no insurance rate. After calling them out they magically dropped it to $500.00 dollars or down 90 percent.

He asked for a in full payment discount which they declined and he went on a 50 buck a month payment plan to make them wait for their money even though he could afford it to teach them a lesson.

I'm surprised that they even told you the price before the procedure most of the time they just do it and send you the bill and expect you to not question it and pay it without problem. Had a procedure which I didn't even really need done and didn't want to do and asked with my insurance what my co-pay would be the idiots couldn't answer me, told me that they ask when I check in. 3 weeks later check in they wanted 300 dollars which I didn't want to fork over was going to cancel it, but I did my research it fell under preventative care which is free so once I showed a print out from there very own coverage page magically it was free all along the crooks.

I don't know any industry that can't give you a verbal or written invoice/quote before signing a contract but the medically industry. No wonder our medical costs are so high we are being ripped off right and left.

13 or 14 months ago, I needed a MRI on my knee. I shopped around for 2 reasons:

cost

the assholes at my previous knee MRI made me go in head first (they said no to feet first) and my head had to be in that damn tube with all of the awful noises. Doc wanted to send me back to the same place.

I found the least expensive place that did feet first (not as easy as it sounds as people answering phone have no clue). I made an appointment for the following week.

I punched the address into GPS and arrive at MRI facility. I check in and get the MRI without my head ever entering the tube so I left pretty pleased.

Then, I get the damn bill and it’s not what they quoted. Turns out they had 2 entrances and 2 waiting rooms and I went to “the wrong one” even though both used the same machines, same techs, and same radiologist. I raised a stink as they never told me it was “the wrong one” and checked me in anyway. I got the bill reduced to the quote, but apparently most people either blindly pay the extra or don’t know what it was supposed to cost.

---

Ego is the anesthesia that deadens the pain of stupidity

DISCLAIMER: These are the author's own personal views and do not represent the views of the author's employer.

quote:

I don't know any industry that can't give you a verbal or written invoice/quote before signing a contract but the medically industry.

^^^^^^^^^^^^^^^^^^^^^^^
You bought a car recently?

quote:

Originally posted by ZSMICHAEL:

quote:

I don't know any industry that can't give you a verbal or written invoice/quote before signing a contract but the medically industry.

^^^^^^^^^^^^^^^^^^^^^^^
You bought a car recently?

Yup. The price was on the contract prior to signing. It was slightly lower than what was expected, the sales dude had over-estimated one item when we spoke with him, the paper-work guy did it correctly. Final price was there, we could sign or walk away.

This is WAY different from many medical procedures, especially when hospital-involved, where the cost is not known until after the fact.

In the case of Medicare, the government sets the price and you pay the copay if any. The hospital cannot balance bill if they accept Medicare. The cost to the patient is pretty much fixed.

quote:

Originally posted by PASig:
The whole health insurance system is totally effed up if you ask me.

I'm getting a CPAP machine through insurance and I'll have to pay like 48 bucks a month on it for a year but the medical supply company is billing Aetna like 200 bucks a month for it.

So after a year, I've paid almost $600 and Aetna will have paid around $2400 all on a machine that is like $1000 tops.

Actually, it's doubtful that the insurance company shells out the actual amount billed.

Before and still some today, you'll see several amounts: 1) what the health provider billed, 2) what the insurance actually paid, 3) the "negotiated" adjustment, and 4) what your portion is.

Now, most eobs combine what the insurance paid and adjustment as one number so you don't see what the insurance company actually paid out.

The price invoiced by the health provider is a work of fiction set up between the healthcare providers, pharmaceuticals, and the insurance companies to keep competition out and to increase their profits.