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US Healthcare/Insurance System,...it's impossible to figure out what anything costs!
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Wife and 3yo daughter out of state in FL for the week, ie out of network. 3yo daughter slips while getting out of a pool and smacks her head. Comes up bleeding out of one nostril which scares everyone. Rushed to ER and passes neuro tests with flying colors, but doctor wants to do a CAT scan just to be safe. We say we think that makes a ton of sense but would like to know cost given our fears that we're out of network and will have to cover it. Ie if it's $8k like I read horror stories about on the internet I want to call another hospital. No one at the hospital has a clue, and furthermore, the CAT scan technically would be billed by 2 separate departments which may bill differently, ie the ER and then Radiology. They suggest calling my insurance. I ask how much it costs if insurance isn't involve. They don't know this either and reiterate I need to call my insurance. I call insurance, they state they have no way of knowing how much this will cost as "it all depends on the agreement they have with the specific provider". Cool, how about XYZ Hospital? This doesn't help, apparently agents don't really KNOW what any of the agreements are either. The agent THINKS the ER visit should be in network given the emergency but isn't sure about the Radiology consult to read the CAT scan. Throw my hands up in the air and just tell the hospital to do the CAT scan, because, you know, my daughter. CAT scan comes back NORMAL! which is huge relief obviously. Still miffed at how little transparency there is in America related to healthcare and insurance though. The bill will be what it is, and we're fortunate to be able to afford it regardless, but where else in America do neither the consumer OR service provider have a damn clue about how much anything else costs? What a stupid system! Don't even mean for this to be a political rant, but there is no way to fix healthcare in America without consumers or users having a better sense for how much stuff costs.

Rant over

Edited to get rid of Hospital name. Don't want to disparage any individual institution, as I don't believe that not knowing what a procedure costs is unique to this hospital.
Last edited by: lschaan: Nov 14, 18 14:18
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Re: US Healthcare/Insurance System,...it's impossible to figure out what anything costs! [lschaan] [ In reply to ]
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Can always ask for the cash, uninsured cost. They should give you that. Then multiply by 10 to see what they will charge the insurer, to then knock it down to the agreed rate which will be less than the cash price (made up, but prolly not far off)
Last edited by: ChrisM: Nov 14, 18 13:44
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Re: US Healthcare/Insurance System,...it's impossible to figure out what anything costs! [lschaan] [ In reply to ]
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Yes it’s bad, stupid, ridiculous and we should not have to care about cost when our child hits their head.
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Re: US Healthcare/Insurance System,...it's impossible to figure out what anything costs! [lschaan] [ In reply to ]
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Maybe there should be a law that requires hospitals to disclose their fees/charges to their customers.
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Re: US Healthcare/Insurance System,...it's impossible to figure out what anything costs! [Harbinger] [ In reply to ]
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Harbinger wrote:
Maybe there should be a law that requires hospitals to disclose their fees/charges to their customers.
love it

________
It doesn't really matter what Phil is saying, the music of his voice is the appropriate soundtrack for a bicycle race. HTupolev
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Re: US Healthcare/Insurance System,...it's impossible to figure out what anything costs! [lschaan] [ In reply to ]
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who is "they" billing department certainly would - they want your money. Others should be caring for your child, not worrying about the cost.

Thought most insurance has out of network coverage for emergencies, just need to contact them - this and getting your daughter well should be priority.
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Re: US Healthcare/Insurance System,...it's impossible to figure out what anything costs! [Harbinger] [ In reply to ]
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Harbinger wrote:
Maybe there should be a law that requires hospitals to disclose their fees/charges to their customers.

It's my understanding there really is no such simple number, though. There's a complex web of contracts, reimbursement rates, etc. Such that two customers who receive the exact same treatment might go through very different billing processes.

This idea came up recently with respect to some new proposed legislation for prescription drugs that has a regulation that requires pharmaceutical companies to state the list price of the drugs in advertisements. As much as I like price transparency, this doesn't do it. Because the underlying markets are so complicated that putting a "list price" that no one ever pays in an ad might do more harm than good. E.g. scare some patients away with a $10K/month cost when their out-of-pocket might be a tiny fraction of that. Lipstick on a pig, etc.

I don't know how to fix it.
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