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Health Insurance "Discounts/Adjustments" are Nuts!

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Health Insurance "Discounts/Adjustments" are Nuts!

Old 06-29-2018, 11:54 AM
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Default Health Insurance "Discounts/Adjustments" are Nuts!

Seriously, how are we even at this point? $12k bill, $10k write-off. Why not just lower the prices to $2k and have less accounting to do? What am I not getting?


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Old 06-29-2018, 11:58 AM
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Originally Posted by crazybeard View Post
Seriously, how are we even at this point? $12k bill, $10k write-off. Why not just lower the prices to $2k and have less accounting to do? What am I not getting?


contractual collusion so you never consider self insuring?
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Old 06-29-2018, 12:26 PM
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Health insurance....where they screw the other guy and pass the savings on to you...
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Old 06-29-2018, 12:54 PM
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Medicare probably has the most leverage in knocking down medical bills. I've often wondered if Medicare patients get shortchanged on care because the providers know the bill will be negotiated down substantially. Besides that, we're old, so WTH.
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Old 06-29-2018, 01:01 PM
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Originally Posted by yarcraft91 View Post
Medicare probably has the most leverage in knocking down medical bills. I've often wondered if Medicare patients get shortchanged on care because the providers know the bill will be negotiated down substantially. Besides that, we're old, so WTH.
Most Dr have a rule that Medicare patients can only make up a certain percent of their business.
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Old 06-29-2018, 01:53 PM
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BCBS here....


bill total 29K.......they are billing me for 16K of the 29K
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Old 06-29-2018, 01:55 PM
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Of all the things any healcare legislation that comes up in the future should contain Is a requirement for published pricing.
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Old 06-29-2018, 02:12 PM
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It is crazy. BC//BS/NC sits down and negotiates the pricing with hospitals and doctors well in advance. But the hospital or doctor, knowing what they negotiated, will still bill the full costs and then wait for BC/BS/NC to beat them down to their negotiated prices. Why not just bill what you agreed to? The really stupid part is that if you just offer a cash/check/HSA payment you will be billed the higher costs without negotiation. Our health care system ain't totally broken but it could use a LOT of improvements.
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Old 06-29-2018, 02:17 PM
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why am I being billed 16K when my OOP on major medical is 4500
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Old 06-29-2018, 02:23 PM
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Originally Posted by bluffman2 View Post
why am I being billed 16K when my OOP on major medical is 4500
Out of network versus In network doctors?

​​​​​it's all BS scam, such a mess is healthcare system...
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Old 06-29-2018, 02:24 PM
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Originally Posted by obx4me View Post
Out of network versus In network doctors?

​​​​​it's all BS scam, such a mess is healthcare system...
its in network for sure....
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Old 06-29-2018, 02:24 PM
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Originally Posted by bluffman2 View Post
why am I being billed 16K when my OOP on major medical is 4500
I still can't figure that out. We hit our $4K OOP early this year and have had some issues since then but we still get billed. Wife is in an MRI as I type and I'm sure we will get the full sized bill noting "insurance pending" and then we will get an EOB from BC/BS stating we owe nothing, and then another bill from the MRI showing we owe nothing. It's a stupid circle.
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Old 06-29-2018, 03:11 PM
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We were promised "much better healthcare, much better coverage for everyone" under a plan that was down to the "short strokes" in January of 2017. Whatever happened to that? unforeseen complications?
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Old 06-29-2018, 03:16 PM
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It’s crazy
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Old 06-29-2018, 05:06 PM
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The providers routinely balance bill even though it should not be done. They hope some will pay it and not ask for it back after the EOB comes in. Lots of “revenue enhancement “ schermes, in a free market system.
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Old 06-29-2018, 05:20 PM
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Originally Posted by yarcraft91 View Post
Medicare probably has the most leverage in knocking down medical bills. I've often wondered if Medicare patients get shortchanged on care because the providers know the bill will be negotiated down substantially. Besides that, we're old, so WTH.
Most leverage certainly. Shortchanged, Not so. At least in the Philly area. Medicare is the best of all payers, and private insurance (largely BC/BS) is merely a percentage of MC rates. Philly is one of the biggest/best healthcare markets in the country. Medicare arguably receives some of the best care in all of medicine.
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Old 06-29-2018, 07:37 PM
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I refuse to buy into Obamacare. As we spend most of our time on Cozumel we have insurance there. We pay an additional premium to cover us in the US - Aetna. Many know I had Achilles surgery there last spring - all really good. My oop was $350 US. If anyone wants to talk to my insurance agent let me know. She is amazing. Premiums last year, with the US rider, less than $4000.
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Old 06-30-2018, 01:17 AM
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Sure, I'd love to get a quote skibum. However we are not going to get care locally if at all feasible to get back to the US.
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Old 06-30-2018, 03:25 AM
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Depends on what your deductible is! lol... High ded like mine at 5k, well, gee golly, the bill got reduced to 6k...you owe 5k.
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