Thanks to the $14,500 I pay each year for insurance, a recent $4,500 procedure is only going to cost me $2,500. A true bargain.

Three bills from the Doctor, Anesthesiologist, and the hospital which owns the outpatient facility wanting the largest share of that money.

It's not the end of the world, but like everybody else I'd like to pay less. And we all know if you don't ask you won't get. So I start making phone calls.

I ask each of the billing persons representing the doctors what my options are. I know many like to make payments. What if I pay right now? BAM! Both offer a discount right off the bat. 10%. I'll take it.

Next up the hospital. Let's see what we can do. OH! You just missed the cut off for a 25% discount by 7 days! How can that be I asked? The bill isn't even due yet. No mention of discounts or cut off dates. The expiration of that offer was only 2 weeks after the procedure. Today is 3 weeks. Bill isn't even due for another week. I'd like the 25% deal and will pay you right now. Who can I speak with?

Sorry sir, there are no discounts available now. None? Zero.

So wait. Just a week ago people were getting 25% off, and today nothing? Yes sir. Not even the 10% that the others are offering? Sorry, no discounts.

My response? I won't pay it at all. You know who will take 75%? The first collector you sell it to for 5%, AND, it won't even be on my credit report. I guess I'll call them back in 6 months and see if they still want to stick to their guns.

This message has been edited. Last edited by: a1abdj,

Hmmm. How does this not
show up on your credik?

quote:

Hmmm. How does this not
show up on your credik?

Laws were changed to require 180 days before they can even report it. Should be reported it can also be removed by mutual agreement of both parties....which if you're negotiating with a creditor to pay them should be part of the deal.

Won't work with many other types of bills, but tends to with medical bills.

I just got stuck paying 1700 dollars to an anesthesiologist because they decided to charge more than the usual and customary charges and didn’t bother with a pre approval. Pretty fucking disgusting. They did the same thing to my step dad, anesthesiologists are scum.

quote:

because they decided to charge

That's my main problem with healthcare. Nobody can tell you what it costs prior to you agreeing to the service. You have to get the work done, then you'll see what's in the bill.

That's why I have no problem telling them I'm not going to pay what they billed me and attempting to negotiate. My insurance company did the same thing. I don't feel guilty at all.

It would be a totally different situation if it was a service that I agreed to pay for at a set amount ahead of agreeing.

I have had a couple of operations this year and last, and have started asking for discounts prior to payment. Hospital gives 10%, and one anesthetist group knocked about $200 off a $500+ bill for paying in full, after the insurance had paid a discounted amount.

quote:

anesthesiologists are scum.

Absolutely. I'm going to use an acupuncturist for my abdominal aneurysm repair.

quote:

anesthesiologists are scum

Until you are open on the table and begin to code.

Then they are your savior.

quote:

Originally posted by newmexican:
...anesthesiologists are scum.

Apparently you survived your surgery.

What's your life worth?

I'm right there with you. I had my annual physical in Feb with my PCP. He did a blood workup, normal stuff. I get the bill from the lab (Quest Diagnostics). Retail price is listed as $846.74. Insurance discount of $769.56. Insurance pays $65.00. I owe $12.18. I am happy to pay the $12.18, but c'mon! Insurance discount of $769. Why can't they just charge the $77 for their services (65 + 12)? It's a sham. I feel sorry for the people who pay full price. Also, everything is supposed to be covered for annual physicals. While each test is listed line by line, they can't tell me why I owe anything. Just the entire amount is "discounted".

In a related matter, I am having some type of stomach issue. They want to stick a camera down my throat to see my stomach. Cool. I ask how much. $1,700, including anesthesia I will be mildly sedated, fentanyl and something else I think she said. I scheduled everything yesterday. I get a call today, the scope doc wants to go full anesthesia in a hospital rather than in the office. OK, how much will that add to my $1,700? No one knows. I need to speak with the billing department. Let's schedule you now. No, I need to know how much this will cost before I schedule. Sorry, we don't do it that way. Let's schedule you, then you can talk to billing and cancel if need be. I told them to cancel everything and we can start over after I talk with the doc again.

Frustrating to say the least. The reason I am so cost conscious is because we went to "high deductible" plans this year. I think my deductible is $6k.

Agree that it would be nice if we could have some idea of what it was gonna cost to have a routine test or proceedure done, prior to getting the bill.


Thread drift:

Having had a 3cm bleeding duodenal ulcer cauterized a couple years ago under mild sedation (because no anesthesiologist was available on short notice in what passes for a hospital in the nearest “big city), I wholeheartedly recommend being put under. Having all those damn tubes and instruments jammed down my gullet while I was “mildly sedated”/conscious was incredibly stressful.

quote:

Originally posted by newmexican:
I just got stuck paying 1700 dollars to an anesthesiologist because they decided to charge more than the usual and customary charges and didn’t bother with a pre approval. Pretty fucking disgusting. They did the same thing to my step dad, anesthesiologists are scum.

Did you fight it?

The reason I ask is that I had to have surgery during my 5 years in Alaska. Long story short, it's possible to fight your insurance company on "reasonable and customary" in Alaska.

First, my insurance company had zero doctors in network for that specialty so they granted a temporary "in network" for that doctor for me which saves me 20% (and costs them 20%). I naively thing I'm good to go. Prior to surgery, the front office for the surgeon has me sign a form authorizing them to fight the first proposed insurance payment and tells me they have to do it every time for every patient. Insurance paid at 80% of "reasonable and customary" but since they don't have any in network doctors for that specialty in Alaska they used Washington state prices for "reasonable and customary." Front office of surgeon starts hounding me for payment, but I'm waiting for the revised amount from them fighting the first proposed payment from insurance. MF'ers never did fight the first charges as promised, and the c*nt who manages the front office acts like I'm supposed to know that they weren't going to fight for me. Front office ends up writing off some charges, we settle on a payment amount, I pay it, and leave with a receipt marked "paid in full."

Sigforum provided me a few links for determining "reasonable and customary" so I file a very detailed protest with insurance with the directions that they pay me as I've settled with the surgeon's office. Insurance agreed to most of it, but the MF'ers send the check to the surgeon's office. The c*nt in the front office whom I had settled with takes 80% of it (~$1600) and sends me a check for 20% (~$400).

By this time, I'm in the process of moving to Canada so I didn't have time to fight the surgeon's office in small claims court.

I had an emergency appendectomy Friday.
I am dreading my upcoming bills.
Guess I will try your tactics and ask for a discount before paying. We are well over our FSA for the year so it will be paid for in cash unfortunately maybe that will work to my advantage.
It may take us north of our deductible we’ll just have to wait and see.

I am on my wife’s insurance and she is employed by the hospital where I had the procedure but I am not optimistic the bills will be inexpensive.

quote:

Originally posted by newmexican:
anesthesiologists are scum.

Apparently you have no idea what they do.....

quote:

Originally posted by newmexican:
.........anesthesiologists are scum.

Kind of like airline pilots. Stand/sit around doing nothing in between banging nurses/stewardesses and then collect the big bucks. Ummmmm........right. I’ll take a good one, thanks.

BTW: Do you seriously think the anesthesiologist had anything directly to do with the actual submission of the charges?

My friend, a retired doctor, will readily and strongly tell people "Today there is NO correlation between what service the doctor provides you and the price you pay, all $$$ and costs are controlled by the insurance companies."

With few exceptions the medical industry (yes it is a business) is NOT a free market system, you will rarely be able to get a price. Even if you get A price, the add-ons and other providers will bill, whom you had no idea about.

Medical procedures can vary once started, due to complications, but there should be some sort of menu price for procedures.

Is not there a thread about the Insurance, Hospital & Pharmaceutical complex around here somewhere. I recall a member giving us some great insight.

I even spoke with my primary care physician about it and he concurred. He told me that he was making less money than 10 year before. The money all goes to the aforementioned entities.

Always remember, all you are doing is buying time with medical procedures. No one gets out, alive.

Harsh but true. I suspect I too will have to make that fateful choice one day - buy time and transfer my little wealth to the complex or just call it quits and pass my little wealth to family members to improve their lot in life. Tough choice, but then so is life - and then you die anyway.

Also, always remember that the purpose of insurance by the insurer is to make a profit first and payout claim second. Just think - try to get private flood insurance.... Insurers are just like casinos.

There’s no one system, in my observations. That’s from conversations with sis (retired RN), and tracking billing during wife’s breast cancer last year. High deductible plan, her individual deductible met quickly ($3k), somewhere around half a mil handled between insurance and hospital. Neulasta is some expensive shit, the little module attached to the arm is billed at $25k a dose. Aetna paid half that. I’m out $6k overall, but we’re showing clear 6 months later, I consider myself lucky.

In many cases, the negotiated rates are a percentage of list rates, which is why they are so high to start with. But I don’t think it’s the same everywhere.... contracts with insurance companies seem to vary among the combinations of provider and insurer.

I’m interested in seeing what the Berkshire-Amazon-JPMorgan healthcare shakes loose. The industry is due for a shakeup, and it’ll take a pile of cash to do it.

Others will be able to speak with more authority. But I understand anesthesiologists now “float” though multiple operations at the same time, supervising Physicians Assistants (specializing in anesthesia) and charging their full rate plus what the assistant gets. I’m not bagging on them. My friends dad is an Anesthesiologist. Still practicing in his late 80’s and making a ton.

It’s funny how wide the spectrum of what people get charged can be. Usually based on geography, as opposed to the quality of care.

You are paying for the parasite class to get the best care for free.