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Old 10-14-2013, 08:18   #151
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Originally Posted by Diesel McBadass View Post
Ive got tricare reserve select which is 48 a month so had no idea what others pay. Tricare sucks
And is a pain to deal with but guess im getting a bargain 600 would be a third of my monthly income after tax and 100 bucks more than my rent
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Yeah, as much as the available services/doctors might suck, hold on to the Tricare with both hands as long as you can. Even if you get another coverage plan, Tricare will be a true second insurance, not a secondary-insurance, so it can help keep your out of pocket down.
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Old 10-14-2013, 08:23   #152
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Im losin it in a couple months when out ill misd the price but not going to miss deLing with them

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Old 10-14-2013, 09:58   #153
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The average cost PER DAY for inpatient hospital stays is around $1700. That's just the hospital costs. Not the doctors, specialists, anesthesiologists, etc. That's just the facility's charge for using their real estate.
And this is the real problem in healthcare that ACA doesn't really do anything to address. When I had my vehicle accident, I had an ambulance trip to the hospital, an x-ray of my leg (nothing broken) and then sent home without even so much as a Tylenol. I was billed individually by the county (for ambulance services), the hospital (for the ER room), the x-ray lab and the ER doc (for looking at the x-ray). Totaled, it was just over $4000 for all that. They did almost nothing at all for me and expected $4000 for their trouble. Where the heck is all that money going such that hospitals can barely keep their doors open? It seems apparent that massive fraud, waste and abuse must be going on behind the scenes.
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Old 10-14-2013, 10:15   #154
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And this is the real problem in healthcare that ACA doesn't really do anything to address. When I had my vehicle accident, I had an ambulance trip to the hospital, an x-ray of my leg (nothing broken) and then sent home without even so much as a Tylenol. I was billed individually by the county (for ambulance services), the hospital (for the ER room), the x-ray lab and the ER doc (for looking at the x-ray). Totaled, it was just over $4000 for all that. They did almost nothing at all for me and expected $4000 for their trouble. Where the heck is all that money going such that hospitals can barely keep their doors open? It seems apparent that massive fraud, waste and abuse must be going on behind the scenes.
The answer(s) to that is fairly simple.

1. They billed $4,000. Even people/insurance who pay the bill will not pay $4,000.

2. All the people who dont pay.

If you do the math, it adds up fairly well. It is very understandable.

If they get 2000 from insurance and 3 others who went in that day dont pay, that means you paid 500 bucks to have a system and technology that would return your life to normal if need be....that 100 years ago might have been the end of your life.

That aint bad.
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Old 10-14-2013, 10:23   #155
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If they get 2000 from insurance and 3 others who went in that day dont pay, that means you paid 500 bucks to have a system and technology that would return your life to normal if need be....that 100 years ago might have been the end of your life.
Usually your posting is fairly spot on. Now, though, you're contradicting yourself...

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If 5 people have a 100 dollar bill at the end of dinner, everyone had the same meal and one person pays 60 bucks and the other 4 pay 10 bucks....if you payed 10 bucks you didnt support anything, you just reduced the size of the handout you got.
So, in your view, when we are assessing such things are we supposed to "average out" these costs, or is it still each man for himself. You've argued both sides of that now.
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Old 10-14-2013, 10:25   #156
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Originally Posted by Geko45 View Post
And this is the real problem in healthcare that ACA doesn't really do anything to address. When I had my vehicle accident, I had an ambulance trip to the hospital, an x-ray of my leg (nothing broken) and then sent home without even so much as a Tylenol. I was billed individually by the county (for ambulance services), the hospital (for the ER room), the x-ray lab and the ER doc (for looking at the x-ray). Totaled, it was just over $4000 for all that. They did almost nothing at all for me and expected $4000 for their trouble. Where the heck is all that money going such that hospitals can barely keep their doors open? It seems apparent that massive fraud, waste and abuse must be going on behind the scenes.
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The answer(s) to that is fairly simple.

1. They billed $4,000. Even people/insurance who pay the bill will not pay $4,000.

2. All the people who dont pay.

If you do the math, it adds up fairly well. It is very understandable.

If they get 2000 from insurance and 3 others who went in that day dont pay, that means you paid 500 bucks to have a system and technology that would return your life to normal if need be....that 100 years ago might have been the end of your life.

That aint bad.
Yep, my young daughter just had a knee injury (ligment pulled a piece of bone off her tibia; in adults it would have been a severed ACL) and required surgery. I plan to post the full details once I have all the detailed bills, but it will be well into 5 figures.

Just the nerve block (an ultrasound guided injection that only takes a few minutes) was billed by the anesthesiologist at $1200. $500 for the ultrasound, and $700 for the injection.

Insurance disallowed about $1050 and the anesthesiologist was paid about $150 ($120 by insurance and $30 by me).

The surgical anesthesiology was another $1000 claim.

Anesthesiology is cheap compared to what the facility and surgeon fees will be.

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Old 10-14-2013, 10:29   #157
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Usually your posting is fairly spot on. Now, though, you're contradicting yourself...



So, in your view, when we are assessing such things are we supposed to "average out" these costs, or is it still each man for himself. You've argued both sides of that now.
Not at all. You dont understand what I am saying at all.

I have done the math of the reality both times. Reality one. If you dont pay a certain amount of taxes, you are not a net tax payer. Reality two, if you go to the hospital and your bill is payed, that payment helps subsidize those who dont pay.

There is no contradiction of the math.

The only opinion I tossed out is I think it is a fairly good deal that for (as in my example) 500 bucks, there is a system in place to transport, diagnose and fix, if need be, problems that would have killed someone not all that long ago.
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Old 10-14-2013, 11:49   #158
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2. All the people who dont pay.
I would categorize that as fraud, waste and abuse.

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If they get 2000 from insurance and 3 others who went in that day dont pay, that means you paid 500 bucks to have a system and technology that would return your life to normal if need be....that 100 years ago might have been the end of your life.
Well, I paid $2000 out of pocket that day and my insurance paid another $2000. So, it's even more skewed than that.

Quote:
That aint bad.
It's not bad for anyone except the people that actually do pay their bills (like me). I hear what you're saying, but my point is that it is the deadbeats and the negative influence of medicare (not me) payouts that are really distorting the market. The ACA is merely a (poor) attempt at addressing the symptoms of a broken system. It does nothing to address the root causes (in fact, it augments them).

Paging Dr. John Galt... paging Dr. John Galt...
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Old 10-14-2013, 12:10   #159
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Our system is beyond stupid -

Go get some blood work - the lab bills for each test -

$279 for one - BCBS (my insurance company) allows $19

$79 for another BCBS says it should be $5

The Lab (Quest Diagnostics) accepts these reduced amounts.

I hate government rules and regulations - let medical companies charge whatever they want - but make them charge the same amount for anyone.

I would just pay cash at time of service but no one can ever tell me how much the charge is - no reason to make it so complicated.
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Old 10-14-2013, 12:40   #160
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Our system is beyond stupid -

Go get some blood work - the lab bills for each test -

$279 for one - BCBS (my insurance company) allows $19

$79 for another BCBS says it should be $5

The Lab (Quest Diagnostics) accepts these reduced amounts.

I hate government rules and regulations - let medical companies charge whatever they want - but make them charge the same amount for anyone.

I would just pay cash at time of service but no one can ever tell me how much the charge is - no reason to make it so complicated.
You have NO idea how insurance works, do you? Those price reductions have NOTHING to do with government regulation. That's a negotiated contract between the insurer and the medical provider. Here's the deal:

Insurance company goes to provider and says "Hey, I have 3 million customers. If you agree to our contracted rates, we'll list you as a a preferred provider in your area so they will come to you, and then you write off the difference. If you don't sign a contract, our people can use your service, but we'll still only pay the reduced amounts. We'll pay them to our customer, and then you have to work out payment with them."

The providers OPT to take the certain payment plus the "preferred provider" recommendation as opposed to being non-contracting and spending their time going after non-paying patients.

Some people are just so damn certain that the government is evil that they refuse to even learn about where there money goes in regards to how their insurance works.
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Old 10-14-2013, 12:45   #161
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You have NO idea how insurance works, do you? Those price reductions have NOTHING to do with government regulation. That's a negotiated contract between the insurer and the medical provider. Here's the deal:

Insurance company goes to provider and says "Hey, I have 3 million customers. If you agree to our contracted rates, we'll list you as a a preferred provider in your area so they will come to you, and then you write off the difference. If you don't sign a contract, our people can use your service, but we'll still only pay the reduced amounts. We'll pay them to our customer, and then you have to work out payment with them."

The providers OPT to take the certain payment plus the "preferred provider" recommendation as opposed to being non-contracting and spending their time going after non-paying patients.

Some people are just so damn certain that the government is evil that they refuse to even learn about where there money goes in regards to how their insurance works.
Do tell, what is the benchmark for those negotiated insurance reimbursements?
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Old 10-14-2013, 13:50   #162
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Do tell, what is the benchmark for those negotiated insurance reimbursements?
That would be the job of the actuarial department.
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Old 10-14-2013, 13:52   #163
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You have NO idea how insurance works, do you? Those price reductions have NOTHING to do with government regulation. That's a negotiated contract between the insurer and the medical provider. Here's the deal:

Insurance company goes to provider and says "Hey, I have 3 million customers. If you agree to our contracted rates, we'll list you as a a preferred provider in your area so they will come to you, and then you write off the difference. If you don't sign a contract, our people can use your service, but we'll still only pay the reduced amounts. We'll pay them to our customer, and then you have to work out payment with them."

The providers OPT to take the certain payment plus the "preferred provider" recommendation as opposed to being non-contracting and spending their time going after non-paying patients.

Some people are just so damn certain that the government is evil that they refuse to even learn about where there money goes in regards to how their insurance works.
I know exactly how it works - no other pricing system in a free market would come up with anything close to this monster.

I never said the government dictated the rate - in a rare situation for me I said they should allow the provider to charge whatever they want - but have a rate that is the same.

The current system that has a standard charge of $250 and allows the insurance company to negotiate a rate of $25 is beyond stupid. The true cost of this procedure is most likely $20 - the $250 charge has no relationship to what the cost is -

If you really want to look at the cause of the mess between what a medical procedure is billed at ($250 in my example) - and what the insurance company determines as a reasonable charge and actually pays ($25) you do need to look at government involvement. But it is more subtle.

Medicare law started to dictate discounts be given for specific procedures - as the discounts grew the providers raised the "standard" rate so they could still make some profit while treating Medicare patients.

Over the years the Medicare discounts have become stupid - 75-90% for some things - and as a result the providers just keep raising the "standard" charge.

The way the law is set - this standard charge less the discount determines what the government pays for a procedure under Medicare law. The provider must charge Joe Blow this amount for it to be valid as a basis for determining the standard GROSS charge.

The end result is - the poor bastard that does not have insurance gets completely hosed and instead of paying a reasonable amount that covers the cost of the provider plus some profit - he must be billed a totally manipulated amount - because if they charged him the lesser amount they would lose out on the Medicare reimbursement.

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Old 10-14-2013, 13:52   #164
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That would be the job of the actuarial department.


Not going to answer the question then, are ya?
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Old 10-14-2013, 13:55   #165
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That would be the job of the actuarial department.
You are just not thinking logically -

Sure in most business situations if you get a big account you can afford to give them a price break.

But the quantity discount would NEVER come up with a different this large.

How much do you guess it costs a lab to perform a test that they will agree to accept $25 as full payment from the insurance company?

Then try and explain how charging an individual $250 for the same service could possibly be reasonable.

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Old 10-14-2013, 14:08   #166
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Not going to answer the question then, are ya?
I wasn't an actuarial, so I can't answer it. Are you? Or are you going to answer without any knowledge and just more nonsense because you think you know?
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Old 10-14-2013, 14:10   #167
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You are just not thinking logically -

Sure in most business situations if you get a big account you can afford to give them a price break.

But the quantity discount would NEVER come up with a different this large.

How much do you guess it costs a lab to perform a test that they will agree to accept $25 as full payment from the insurance company?

Then try and explain how charging an individual $250 for the same service could possibly be reasonable.

Why don't you call your doctor and ask why they accept the lower rate. They don't have guns held to their heads, they willingly sign onto the contract, accepting the lower rates. And when they don't like it, they can not renew their contract.

Perhaps the part you're ignoring is that the DOCTORS are the ones who decide to charge someone $250 for something that only costs them about $20, which is why they take the $25.
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Old 10-14-2013, 14:11   #168
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Old 10-14-2013, 14:29   #169
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Why don't you call your doctor and ask why they accept the lower rate. They don't have guns held to their heads, they willingly sign onto the contract, accepting the lower rates. And when they don't like it, they can not renew their contract.

Perhaps the part you're ignoring is that the DOCTORS are the ones who decide to charge someone $250 for something that only costs them about $20, which is why they take the $25.
Give Quest Diagnostics a call and try and negotiate a special rate - they will say no.

Now if you "can't" pay because you have no cash - they may offer to accept a smaller fee - but that would be after your credit score is dinged - and you have gotten several past due notices.

That is not how I roll -

BTW - If they accept Medicare reimbursement for the procedure and get caught routinely charging less as their standard charge (customer has ability to pay) - they will get a beat down by Medicare.

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Old 10-14-2013, 14:43   #170
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I am actually ecstatic from the lib-tards that voted for this garbage. Happy that they will suffer by their own stupidity. However, for the sensible, smarter people that did not vote for this shyster, I feel terrible. It's like being punished due to the ignorance of the ones that needed their MTv/Nike President. They needed to have their golden one.

Anyway, let's just all sit back and look at Obama's smiling photo-ops and listen to him spin lies about how the ACA is great and what we need.
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Old 10-14-2013, 15:18   #171
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I wasn't an actuarial, so I can't answer it. Are you? Or are you going to answer without any knowledge and just more nonsense because you think you know?
Reimbursement rates are widely benchmarked to Medicare. I thought this was fairly well known.
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Old 10-14-2013, 15:35   #172
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Reimbursement rates are widely benchmarked to Medicare. I thought this was fairly well known.
I honestly don't know, and I'm not going to pretend I do. I had people ask me that a LOT in the job ("How do you guys set the rate?") as well as asking to about the doctors' acceptance ("Why would any doctor sign a contract for that?"). My answers, respectively, were that I wasn't an actuarial and so had no honest idea how those amounts were determined, and to perhaps ask the doctors why they would accept those rates.

Same as I've answered here. And I never got fired for giving those answer.
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Old 10-14-2013, 16:20   #173
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I honestly don't know, and I'm not going to pretend I do. I had people ask me that a LOT in the job ("How do you guys set the rate?") as well as asking to about the doctors' acceptance ("Why would any doctor sign a contract for that?"). My answers, respectively, were that I wasn't an actuarial and so had no honest idea how those amounts were determined, and to perhaps ask the doctors why they would accept those rates.

Same as I've answered here. And I never got fired for giving those answer.
Actuary. The word is Actuary.

Medicare is the answer...that if you didnt know, you really dont know much about this issue.

No, I am not an Actuary but I have the education of one.
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Old 10-14-2013, 16:44   #174
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Actuary. The word is Actuary.

Medicare is the answer...that if you didnt know, you really dont know much about this issue.

No, I am not an Actuary but I have the education of one.
I have 6 years of experience in health insurance, and another 5 before that in property/casualty. You have "the education" of one, which means what, you read Google?

I stated I didn't know the answer. I don't need to try to stroke my own ego by claiming I know things - or have "education" about things - that I don't.

You seem to be an expert in every subject that comes up, though. You must be pretty much the smartest man on the planet with all the various educations you've had.


I'll leave this thread in your capable hands, since you have all the answers for any questions somewhat might ask. Enjoy.
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Old 10-14-2013, 16:54   #175
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I have 6 years of experience in health insurance, and another 5 before that in property/casualty. You have "the education" of one, which means what, you read Google?

I stated I didn't know the answer. I don't need to try to stroke my own ego by claiming I know things - or have "education" about things - that I don't.

You seem to be an expert in every subject that comes up, though. You must be pretty much the smartest man on the planet with all the various educations you've had.


I'll leave this thread in your capable hands, since you have all the answers for any questions somewhat might ask. Enjoy.
I have a masters degree in Math along with my CFP and a few others. I was an owner/broker (partner) in an insurance agency that dealt with high end clients and had flow through of...well, a lot of money. I personally set up the benefits packages of 3 fortune 500 companies.

Not quite google. Also, keep in mind, you are calling me out and you didnt even know a basic industry question.
__________________
In the world to come, each of us will be called to account for all the good things G-d put on earth which we refused to enjoy. ~ The Babylonian Talmud

Whenever you get mad as hell about it all, grab your rifle and head outside. If you are the only one there...it's not time yet

I cross my heart and hope not to die. Swallow evil, ride the sky. Lose myself in a crowded room. You fool, you fool, it will be here soon

Last edited by Rabbi; 10-14-2013 at 16:55..
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