Current Events > Visiting a doctor's office: $1,325.43. Thanks Obama.

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Labwork Details:


Labwork:
How does $752.42 charged go down to $65.43 because of insurance (91% off!), then insurance only pays $7.50, so that I have to pay the remainder?

Doctor:


Similar story with the doctor; how is it that they charged $600.01, but that goes down to $380.66, which is fully covered?

Insurance is such a bullshit game.

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countries without universal healthcare are a fucking joke

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Damn I'm an Internist and I wouldn't order that many labs in a clinical visit.

A1C, TSH, CBC, CHEM14, urine studies (do you have renal disease?), etc.

Also that combination of labs suggests to me that you have diabetes.

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an apple a day

Go to in network doctors for no copay

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DarthAragorn posted...

countries without universal healthcare are a fucking joke

UK here. Its good for emergencies. Not so much for less serious issues. Grandad had a heart attack and needed a triple bypass and all sorted out really quickly.

On the flip side I tore my hamstring. On the NHS they pretty much told me Id wait so long to be seen by a physio to go private or I risk it not healing properly. Paid 50 and got seen within the week privately.

DarthAragorn posted...

countries without universal healthcare are a fucking joke

IdiotMachine posted...

How does $752.42 charged go down to $65.43 because of insurance (91% off!), then insurance only pays $7.50, so that I have to pay the remainder?

Because that's the amount your doctor has agreed to accept from the insurance company.

What's your maximum out of pocket?
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my uncle has to go into hospital to get surgery to remove a tumor from his foot. it's been hurting him very badly over a month.

if it gets removed there won't be anymore pain. it's not cancerous.
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skermac posted...

Go to in network doctors for no copay

These are in-network brah.

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DarkRoast posted...

Damn I'm an Internist and I wouldn't order that many labs in a clinical visit.

A1C, TSH, CBC, CHEM14, urine studies (do you have renal disease?), etc.

Also that combination of labs suggests to me that you have diabetes.

Yup. Got diagnosed with diabetes last year.

harley2280 posted...

Because that's the amount your doctor has agreed to accept from the insurance company.

What's your maximum out of pocket?

Thats what I mean, that if they make money from $65, why charge $750 to begin with?

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DarthAragorn posted...

countries without universal healthcare are a fucking joke

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IdiotMachine posted...

Thats what I mean, that if they make money from $65, why charge $750 to begin with?

As a stab-in-the-dark guess, I'd guess maybe they can write off the difference (or at least part of it) when tax time comes, or something like that?

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Solution: Be poor and enjoy that sweet expanded Medicaid.

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IdiotMachine posted...

Thats what I mean, that if they make money from $65, why charge $750 to begin with?

Capitalism


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The reason doctor bills are so outrageous is because the insurance companies don't actually pay them that amount. If a doctor thinks that a procedure should cost $100, they have to "charge" you $230 in order to see $100 from the insurance.

The total amount our insurance was billed for my wifes 6 day hospital stay when our daughter died in the womb last month was about $65,000

the allowable amount so far has been only $6000 with us owing $2800

theres still two claims totaling $30k to be processed. Out of pocket max is $5000 so guessing itll hit that

but yeah its weird how it can cost so much and insurance can be like lol no were only gonna allow it to be this much smaller amount and the hospital is like sounds good bro

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how do doctors in good conscious go through with this?

Feline posted...

UK here. Its good for emergencies. Not so much for less serious issues. Grandad had a heart attack and needed a triple bypass and all sorted out really quickly.

On the flip side I tore my hamstring. On the NHS they pretty much told me Id wait so long to be seen by a physio to go private or I risk it not healing properly. Paid 50 and got seen within the week privately.

Might be a uk thing

Denmark responding

Sister has broken her arms twice (both times due to a horse letting her off in not so gentle ways. First time i remember her and mom being away for a good few hours. Mighta been the better part of the weekend in the hospital but not weeks (got a cast)

I myself had polyps removed dont remember any waiting either.

And then theres the time i got a ball of aliminium foil stuck in my nose during school. Got that out same evening (after i got home)

And a few years ago i sprained my ancle. After a few days with little recovery, went to doctor then redirected to the emergency room for an x ray. Once again just a few hours (2-3 8 think it was)

TLDR. I have a few family incidents that required hospital visits but i dont remember anything regarding insane wait times, and certainly nothing beyond a few hours.

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Biden America
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fohstick posted...

how do doctors in good conscious go through with this?

We have literally no role in billing whatsoever. Aside from assigning diagnosis codes, of course.

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DarkRoast posted...

Damn I'm an Internist and I wouldn't order that many labs in a clinical visit.

A1C, TSH, CBC, CHEM14, urine studies (do you have renal disease?), etc.

Also that combination of labs suggests to me that you have diabetes.

I know medical advice isn't free but if there was a chance of that wouldn't TC be made aware?

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medical insurance has been smoke and mirrors voodoo for a long fucking time.

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DarkRoast posted...

We have literally no role in billing whatsoever. Aside from assigning diagnosis codes, of course.

that's the thing. i have never heard any doctor on the news actually criticizing about this billing practice aside from "it's not my responsibility". Silence is not a good answer to this

It's always so weird to me that you can't shop around at hospitals. Like you would think that I can shop around for the cheapest price to fix my broken leg as I would for my broken engine.

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Medussa posted...

medical insurance has been smoke and mirrors voodoo for a long fucking time.

Yep, since it was tied to employment back in the 30s in the U.S. That fucked everything up...

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littlebro07 posted...

but yeah its weird how it can cost so much and insurance can be like lol no were only gonna allow it to be this much smaller amount and the hospital is like sounds good bro

So from a post just above yours, it sounds like the reasoning is because insurance do that - so they set the upfront price higher, such that what insurance actually pay, is about on par with what the hospital actually want to charge. I've also heard anecdotally that usually if you're paying cash and ask, they'll cut the bill to a similar point to what insurers end up paying.

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Trumble posted...

So from a post just above yours, it sounds like the reasoning is because insurance do that - so they set the upfront price higher, such that what insurance actually pay, is about on par with what the hospital actually want to charge. I've also heard anecdotally that usually if you're paying cash and ask, they'll cut the bill to a similar point to what insurers end up paying.

Metabolic panel member cost was like $8 from OP, but if you were to order it yourself (cash price), its $155:
https://questdirect.questdiagnostics.com/products/basic-health-profile/8491ffeb-03f4-4809-bc8d-844c1e43a98b

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