re: Even with good health insurance, a CT scan is costing me $2,000 out of pocket

quote:

---

What be your proposed changes to the medical industry?

---

Eliminate the fee for service payment model and replace it with one that actually reimburses payments for outcomes not just services.

My wife had an ER visit at the end of Dec for some lady parts issues.(I'm looking at the EOB)

CT ABD & PELV w/CONTRAST - Provider Billed - $5,926.00. Member discount - $5,559.41. Net charged - $366.59 Your plan paid - $366.59.

Tell me there isn't some frickery going on with that nonsense.

quote:

---

CT ABD & PELV w/CONTRAST - Provider Billed - $5,926.00. Member discount - $5,559.41. Net charged - $366.59 Your plan paid - $366.59.

Tell me there isn't some frickery going on with that nonsense.

---

Its like sticker price on a car. You see the $5,559 number and think “Oh thank gawd i have insurance!” It’s the best advertising insurance companies could ever get. If you paid cash, your bill would have likely been $366 or less.

Thug POS insurance company's.

quote:

---

Imaging center, but it is being billed as an outpatient hospital service, so deductible/coinsurance, not a copay

---

So basically a hospital associated imaging center. Bet if you got a line item breakdown of the cost, you'd see a large facility fee tacked on. You wouldn't see this at independent imaging centers etc.

One of the many rackets of Healthcare and insurance. Hospitals and associated hospital practices including imaging centers, doctor specialities, etc. Are allowed to charge an additional facility fee in addition to the normal cost of the procedure and/or clinic visit. Theoretically this allows hospital to recoup lost costs elsewhere and that in general its more expensive to run a hospital facility therefore they get reimbursed more.

Doctor owned or independently owned
practices are not allowed to charge facility fees. So you have a situation where it's advantageous to the hospital to run speciality own practices and bring in higher revenue than what an independent doctor office can. Some offices find it hard to compete with the hospital because of this
And all in the end it just costs the rest of us more in insurance premiums.

quote:

---

CT ABD & PELV w/CONTRAST - Provider Billed - $5,926.00. Member discount - $5,559.41. Net charged - $366.59 Your plan paid - $366.59. Tell me there isn't some frickery going on with that nonsense.Its like sticker price on a car. You see the $5,559 number and think “Oh thank gawd i have insurance!” It’s the best advertising insurance companies could ever get. If you paid cash, your bill would have likely been $366 or less.

---

Then the hospital gets to use the discount to maintain their nonprofit status.

quote:

---

64-slice CT machine goes for about $250-350k. Most hospitals have 16 or 32 slice. They're $90-150k.

---

quote:

---

Our machine is $1 million.

---

Pretty big discrepancy here

You are getting screwed. Bad!

Advice: Have a friend call the same facility and ask how much $$ for the exact same procedure you had if he/she paid in cash.

There are medical billing errors all the time. Like often.

That scan should cost about $2500 - $3000 cash. And about $250-$300 for the Radiologist reading fees.

Its a sad day when you take a nice little chunk out every paycheck for health insurance hoping never to use it. Then the day comes when you finally have to use it and boom you get a huge bill even after paying a ton into it. To top it off most hard working folks try holding off ever having to go to the emergency room but when you do BOOM 300 right out of pocket for checking in. Then while waiting you see all the regulars there with a cough or a sneeze waiting to be seen for minor bullshite knowing they wont even see a bill. That's where the middle class is these days scared to death to go to the hospital.