Rule of thumb...

"The larger the building the higher the price for a medical procedure."

quote:

Originally posted by ZSMICHAEL:
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.

Absolutely true.

On a side note, Mrs. Flash worked 10 years for a County Hospital doing medical billing and it's a little known fact that if you call and tell them you don't have the money and can't pay they'll usually drop the price substantially.

I had a kidney stone a year ago and my Urologist requested that I stop by a radiology center near his office for an Xray prior to my appointment with him. Cost me $40. A month later he requested another Xray to determine if the stone had moved. I asked if they could set it up for a facility near my home and they did. Big mistake! The same fuckin Xray cost me near $400 out of pocket. Actually, it wasn't the same. The first was digital and second was film. I warn off anyone who will listen to avoid the second facility.

quote:

it's a little known fact that if you call and tell them you don't have the money and can't pay they'll usually drop the price substantially.

I have a personal story along these lines and to the tune of about $100,000.

This is one of the problems with health care. There should be a price, but there is no price. There's 1,000 different prices depending upon 1,000 different variables. Could you imagine this business model in any other form? What if you went to the grocery store and everybody in line paid a different price for milk. There would be no prices on anything, you would get to the register, they could make up whatever total they wished, and you would be compelled to pay that amount. Not to mention that if you went week after week and always purchased the exact same items you would never have the same total.

It's nonsense.

Yes, it is a scam. It is worse than buying a car. You never know what the actual cost is, and how much your insurer is actually paying, even though you get statements purporting to tell you the price and the insurance reimbursement. But, as you have learned, if there is no emergency, shop around and negotiate your rate in advance.

quote:

Originally posted by a1abdj:

This is one of the problems with health care. There should be a price, but there is no price. There's 1,000 different prices depending upon 1,000 different variables. Could you imagine this business model in any other form? What if you went to the grocery store and everybody in line paid a different price for milk. There would be no prices on anything, you would get to the register, they could make up whatever total they wished, and you would be compelled to pay that amount. Not to mention that if you went week after week and always purchased the exact same items you would never have the same total.

It's nonsense.

It is one of the things Trump was going to fix and not sure how far he made it.
Certainly Fake Pres Bite-Me has no concerns about this.
I decided not to get any MRI as my shoulder started to fee better with a little RICE, steroids from the Doc and a little time.
I kept getting calls from the hospital trying to schedule the $850 MRI (my part) and they still allegedly get an insurance kickback but I told them no way in hell am I paying that they said they would quit calling me.
What a racket!

quote:

I kept getting calls from the hospital trying to schedule the $850 MRI (my part) and they still allegedly get an insurance kickback but I told them no way in hell am I paying that they said they would quit calling me.
What a racket!

^^^^^^^^^^^^^^^^
What do you mean by kickback? If that is happening it is ILLEGAL and punishable by civil and criminal penalties.

My insurance plan has different co pay levels depending on where I get the MRI. If I used "in network" preferred facility my copay was 10 percent. Also one needs to beware when shopping around for MRIs as the quality of the equipment and the resolution of the images it can produce vary and it may matter depending on what the doctors want examined. My last MRI session took 90 minutes, ugh.

Glad you were able to get everything resolved without an MRI.

Talking to people at different medical offices and MRI personnel I am hearing that insurance companies are pushing back hard against MRI due to cost and are getting pretty strict about pre approval especially if other options may be available such as CT Scan. In my case the MRIs have been all approved so far as they do a much more detailed imaging that is needed in my case.

Yep, my experience with the medical and pharmacy industries is they are a rip-off. If you want to stay alive and relatively pain free, what else can you do?