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donnay
05-27-2012, 11:04 PM
Many hospitals, doctors offer cash discount for medical bills

The lowest price is usually available only if patients don't use their health insurance. In one case, blood tests that cost an insured patient $415 would have been $95 in cash.

By Chad Terhune (http://www.latimes.com/business/la-fi-medical-prices-20120527,0,4627745.story)

May 27, 2012, 5:00 a.m.
A Long Beach hospital charged Jo Ann Snyder $6,707 for a CT scan of her abdomen and pelvis after colon surgery. But because she had health insurance with Blue Shield of California, her share was much less: $2,336.

Then Snyder tripped across one of the little-known secrets of healthcare: If she hadn't used her insurance, her bill would have been even lower, just $1,054.

"I couldn't believe it," said Snyder, a 57-year-old hair salon manager. "I was really upset that I got charged so much and Blue Shield allowed that. You expect them to work harder for you and negotiate a better deal."

Unknown to most consumers, many hospitals and physicians offer steep discounts for cash-paying patients regardless of income. But there's a catch: Typically you can get the lowest price only if you don't use your health insurance.

That disparity in pricing is coming under fire from people like Snyder, who say it's unfair for patients who pay hefty insurance premiums and deductibles to be penalized with higher rates for treatment.

The difference in price can be stunning. Los Alamitos Medical Center, for instance, lists a CT scan of the abdomen on a state website for $4,423. Blue Shield says its negotiated rate at the hospital is about $2,400.

When The Times called for a cash price, the hospital said it was $250.

"It frustrates people because there's no correlation between what things cost and what is charged," said Paul Keckley, executive director of the Deloitte Center for Health Solutions, a research arm of the accounting firm. "It changes the game when healthcare's secrets aren't so secret."

Snyder's experience is hardly unique. In addition to Los Alamitos, The Times contacted seven other hospitals across Southern California, and nearly all had similar disparities between what a patient would pay through an insurer and the cash price offered for a common CT, or computed tomography, scan, which provides a more detailed image than an X-ray.

Health insurance still offers substantial value for consumers by providing preventive care at no cost and offering protection from major medical bills that could bankrupt most families.

But cash prices — typically available for hundreds of common outpatient services and tests — have a real appeal to millions of consumers who are on the hook for a growing share of their medical costs as employers and insurers cut back on coverage and push more high-deductible plans.

Some doctors are trying to spread the word about cash prices and they're urging patients to pressure hospitals and insurers to offer a better deal.

David Belk, an internist in Alameda, launched a website about medical costs and speaks to community groups about the huge markups compared with the prevailing cash price.

Belk recently told a group gathered at a seniors center about the vast price difference when he requested routine blood work for a patient last year. A local hospital charged her $782. Her insurer said that with its discount, she owed only $415.

"She could have gotten it for $95 in cash. How does that make sense?" Belk said. "The last thing the insurance companies want you to know is how inexpensive this stuff really is."

For those patients who have insurance, getting the lower price would typically mean withholding that information from the hospital or clinic. Experts warn that doing so, however, means any payments don't apply to customers' annual insurance limits for out-of-pocket spending.

The decision on whether to pay cash or apply the fee toward the deductible will depend on a variety of factors, including the amount of the deductible and whether the person expects to incur more medical bills that year.

The cash discounts evolved over time after hospitals were criticized in recent years for charging the uninsured their highest rates and then hounding them at times with overzealous collection efforts.

Copyright © 2012, Los Angeles Times

donnay
05-28-2012, 08:44 AM
O'Romney Care will put a halt to this! If only we had a truly free market, this is how the medical community would work. The competition would lower the rates as well.

phill4paul
05-28-2012, 09:12 AM
It only goes to prove that the corporate controlled government has skewed the true pricing of goods and services. Much like the student loan debacle. Capitalism and 'free-market' be damned...there is money to be made.

mad cow
05-28-2012, 10:26 AM
I have no insurance.I finally had to see a doctor this February about worsening hand problems.He is affiliated with a local hospital and they offered me 40% off for paying in cash.I was nervous,40% off what?It's not like they have a menu or I even knew what I needed.

I have been very pleasantly surprised,so far.Some visits and all splints and such have been free,all part of the procedure I am told when I offer to pay.

I have paid more for electricians and auto mechanics.

slamhead
05-28-2012, 10:38 AM
I pay cash. The price is basically what the insurance companies pay the Doctors and such based on there contract.

LibertyEagle
05-29-2012, 04:00 PM
The most discount in Texas I have ever been offered for cash payment is 10%. But, I will be testing this again very soon.

Brian4Liberty
05-29-2012, 04:35 PM
The most discount in Texas I have ever been offered for cash payment is 10%. But, I will be testing this again very soon.

I have found that they are often hesitant to give out the real cash price.

There is no open or competitive market in medical care. The Medical-Insurance-Pharma-Corporate-Government Complex does not want competition.

thoughtomator
05-29-2012, 04:53 PM
No insurance company pays anywhere near the listed price. And they pay less than the cash price too. They are ruthless and cheap as hell as any doctor can tell you.

tangent4ronpaul
05-29-2012, 11:27 PM
Yeah, a PA I know told me that the insurance companies his practice use force them to bill out (tell the patient) it costs twice what they compensate them for a given procedure, but that they are also contractually bound to charge the full bill out price for a given procedure to anyone who doesn't have their insurance. He also said he could afford to give deep cash discounts to cash customers, if he didn't have to do so much paperwork. But he's not allowed to do that if he wants to do business with the insurance company.

-t

tttppp
05-30-2012, 12:34 AM
Thats not my experience at all with hospitals. I went to the ER twice without insurance and I believe they charged me few thousand dollars each time, for very little work done at all. They completely scam you without insurance, especially if you have a job. The second time I went to the ER, I was stupid and told them I had a job when they asked. Once they knew I had a job, they figured they could scam me into paying figuring I'm a white guy with a job. I notified them in writing and over the phone that I was disputing the charge. This didn't stop them from screwing my credit report and placing the account to collections the second I was late. If any of you know what happens when they send your account to collections, there is no way to negotiate a way to get this off your credit report once this happens. So they basically screwed me, hoping I would pay. This is 100% bad business practices. If they charged me a fair price of $50-$100 I would have paid them, even though the didn't even deserve that.

If you go to a private practitioner, typically they'll do the opposite and give you a discount if you tell them you have no insurance. There were times they only charged me $50 for the same amount of time the ER gave me.

Ron Paul needs to come up with a solution to these scams from the hospitals. They try to scam people without insurance so that they will eventually buy insurance to avoid being scammed in the future.

tttppp
05-30-2012, 12:37 AM
Yeah, a PA I know told me that the insurance companies his practice use force them to bill out (tell the patient) it costs twice what they compensate them for a given procedure, but that they are also contractually bound to charge the full bill out price for a given procedure to anyone who doesn't have their insurance. He also said he could afford to give deep cash discounts to cash customers, if he didn't have to do so much paperwork. But he's not allowed to do that if he wants to do business with the insurance company.

-t

Paperwork is another problem I have with doctors. They spend about a half an hour documented what you said for every 5 minutes you have with a doctor. This is a big reason these doctors make you wait so long for just a five minute checkup.

I had a different experience with acupuncture. My acupuncturist did not accept insurance. He did little to no paperwork. And there was generally very little wait time as a result.

wrestlingwes_8
05-30-2012, 04:04 PM
Paperwork is another problem I have with doctors. They spend about a half an hour documented what you said for every 5 minutes you have with a doctor. This is a big reason these doctors make you wait so long for just a five minute checkup.

I had a different experience with acupuncture. My acupuncturist did not accept insurance. He did little to no paperwork. And there was generally very little wait time as a result.

What were you having treated by your acupuncturist? I've been thinking about trying it for my seasonal hay fever symptoms; I've heard many people have success with that route.

LibertyEagle
05-30-2012, 04:24 PM
Yeah, a PA I know told me that the insurance companies his practice use force them to bill out (tell the patient) it costs twice what they compensate them for a given procedure, but that they are also contractually bound to charge the full bill out price for a given procedure to anyone who doesn't have their insurance. He also said he could afford to give deep cash discounts to cash customers, if he didn't have to do so much paperwork. But he's not allowed to do that if he wants to do business with the insurance company.

-t

Yeah, I've been told that before too.

LibertyEagle
05-30-2012, 04:27 PM
Thats not my experience at all with hospitals. I went to the ER twice without insurance and I believe they charged me few thousand dollars each time, for very little work done at all. They completely scam you without insurance, especially if you have a job. The second time I went to the ER, I was stupid and told them I had a job when they asked. Once they knew I had a job, they figured they could scam me into paying figuring I'm a white guy with a job. I notified them in writing and over the phone that I was disputing the charge. This didn't stop them from screwing my credit report and placing the account to collections the second I was late. If any of you know what happens when they send your account to collections, there is no way to negotiate a way to get this off your credit report once this happens. So they basically screwed me, hoping I would pay. This is 100% bad business practices. If they charged me a fair price of $50-$100 I would have paid them, even though the didn't even deserve that.

If you go to a private practitioner, typically they'll do the opposite and give you a discount if you tell them you have no insurance. There were times they only charged me $50 for the same amount of time the ER gave me.

Ron Paul needs to come up with a solution to these scams from the hospitals. They try to scam people without insurance so that they will eventually buy insurance to avoid being scammed in the future.

Agreed.

Not to mention the fact that when you go to the hospital, you get one charge from the hospital, a different charge from the various doctors' groups, another charge from the imaging company, another from the anesthesiologist, and on and on. It makes it next to impossible to negotiate a cash price on the front-end.

tttppp
05-30-2012, 05:03 PM
Agreed.

Not to mention the fact that when you go to the hospital, you get one charge from the hospital, a different charge from the various doctors' groups, another charge from the imaging company, another from the anesthesiologist, and on and on. It makes it next to impossible to negotiate a cash price on the front-end.

Thats exactly how my experience was. There wasn't one place I could call to try to negotiate with. Just by going to the hospital they obligate you to have to call multiple departments to sort things out. Its a lot like dealing with my college. Anyways, I was so pissed about the quality of service, the fact that they overcharged me, and that they threw it on my credit report and into a collection agency even though in disputed it in writing, that I wrote the CEO of that hospital and told him I hold him personally responsible for these actions. He said he'd take care of it, but nothing happened.

tttppp
05-30-2012, 05:04 PM
What were you having treated by your acupuncturist? I've been thinking about trying it for my seasonal hay fever symptoms; I've heard many people have success with that route.

I had many problems. Acupuncture and herbs can cure most problems. What exactly is hay fever?

wrestlingwes_8
05-30-2012, 05:50 PM
I had many problems. Acupuncture and herbs can cure most problems. What exactly is hay fever?

It's an allergic reaction to the wind-borne pollen of grasses and weeds. I get mine around this time every year for about 3 weeks. Itchy eyes, stuffy nose that kind of thing. Other people can have more or different symptoms though and at different times during the year.

tttppp
05-30-2012, 05:55 PM
It's an allergic reaction to the wind-borne pollen of grasses and weeds. I get mine around this time every year for about 3 weeks. Itchy eyes, stuffy nose that kind of thing. Other people can have more or different symptoms though and at different times during the year.

Yeah, acupuncture can fix allergies. My brother has a similar problem but chooses to go to the doctor year after year to cover up the symptoms instead of doing acupuncture.

tangent4ronpaul
05-30-2012, 11:19 PM
Thats not my experience at all with hospitals. I went to the ER twice ...

If you go to a private practitioner, typically they'll do the opposite and give you a discount if you tell them you have no insurance. There were times they only charged me $50 for the same amount of time the ER gave me.

Ron Paul needs to come up with a solution to these scams from the hospitals. They try to scam people without insurance so that they will eventually buy insurance to avoid being scammed in the future.

You could stop with the bolded part above. ER's are for emergencies, not routine medical care. If you go to one, expect to pay $1,000 just to walk in the door and sit down. If you NEED to be there, it will be the best $1,000 you ever spent. There is nothing you can get for $50 in a ER. ER's are also not first come, first serve. They are triage based. The question as to your priority in one is will you still be alive or suffer permanent bodily injury if you don't get help NOW! Lots of people go to ER's expecting instant gratification and then bitch because they sat around for 12 hours waiting to be seen.

Private practitioners are becoming rare. Most are being driven into group practices and under networks due to gvmt regulations, insurance companies, etc. most that remain are going for gourmet care practices where they stop taking new patients and maintain a waiting list to become one. If you want inexpensive medical care, find a independently owned walk in clinic (not part of a chain) or go to a non-profit, religiously owned hospital. These are the ones most likely to negotiate with you.



Paperwork is another problem I have with doctors. They spend about a half an hour documented what you said for every 5 minutes you have with a doctor. This is a big reason these doctors make you wait so long for just a five minute checkup.

I had a different experience with acupuncture. My acupuncturist did not accept insurance. He did little to no paperwork. And there was generally very little wait time as a result.

believe me the docs hate the paperwork too. If they don't do it they risk being sued and the insurance companies won't pay. docs used to do lab, x-ray, billing - everything with one assistant. Now they need a staff. Government is the reason medical care is expensive and government will never admit that they made a mistake.


Agreed.

Not to mention the fact that when you go to the hospital, you get one charge from the hospital, a different charge from the various doctors' groups, another charge from the imaging company, another from the anesthesiologist, and on and on. It makes it next to impossible to negotiate a cash price on the front-end.

Thank government regulation and insurance companies. In the late 1800's or early 1900's this started with the gvmt deciding that there was a conflict of interest with a doc prescribing meds and selling them to you, hence was born the pharmacy. Over time, special interests have caused the fragmenting of "specialties" that charge out the nose because they are separate.

Medical costs are largely responsible for bankrupting this country. The problem isn't how to pay for expensive care, the problem is why medical care is so expensive. The answer is the government and special interests.

-t

tttppp
05-30-2012, 11:34 PM
You could stop with the bolded part above. ER's are for emergencies, not routine medical care. If you go to one, expect to pay $1,000 just to walk in the door and sit down. If you NEED to be there, it will be the best $1,000 you ever spent. There is nothing you can get for $50 in a ER. ER's are also not first come, first serve. They are triage based. The question as to your priority in one is will you still be alive or suffer permanent bodily injury if you don't get help NOW! Lots of people go to ER's expecting instant gratification and then bitch because they sat around for 12 hours waiting to be seen.

Private practitioners are becoming rare. Most are being driven into group practices and under networks due to gvmt regulations, insurance companies, etc. most that remain are going for gourmet care practices where they stop taking new patients and maintain a waiting list to become one. If you want inexpensive medical care, find a independently owned walk in clinic (not part of a chain) or go to a non-profit, religiously owned hospital. These are the ones most likely to negotiate with you.




believe me the docs hate the paperwork too. If they don't do it they risk being sued and the insurance companies won't pay. docs used to do lab, x-ray, billing - everything with one assistant. Now they need a staff. Government is the reason medical care is expensive and government will never admit that they made a mistake.



Thank government regulation and insurance companies. In the late 1800's or early 1900's this started with the gvmt deciding that there was a conflict of interest with a doc prescribing meds and selling them to you, hence was born the pharmacy. Over time, special interests have caused the fragmenting of "specialties" that charge out the nose because they are separate.

Medical costs are largely responsible for bankrupting this country. The problem isn't how to pay for expensive care, the problem is why medical care is so expensive. The answer is the government and special interests.

-t

The visits I was talking about both were about a year apart. Both times related to an eye condition that could have possibly led to blindness if left untreated. I would have lived but I would rather have both eyes. The first time I could not find any doctor who could set up an appointment that day, so I went to the hospital which was the only same day treatment location I knew of. The second time was on the weekend and the urgent care place I knew of was closed. So what was I supposed to do, wait a week for an appointment for the first visit, or wait until after the weekend for my second visit?

There is nothing about the business of hospitals that require them to be so expensive. They just like to stick it to people without insurance to get them to buy insurance. And if they find out you have a job and you are white, they like to stick it to you even more because they think there's a better chance that you'll actually pay.

Bruno
05-31-2012, 07:07 AM
I had heart surgery last November. The total hospital bill for all charges was originally around $75,000, the negotiated rate insurance paid was $28,000. Since we had already met our out-of-pocket max due to our son's appendectomy, our cost was $0.

tttppp
05-31-2012, 05:24 PM
I had heart surgery last November. The total hospital bill for all charges was originally around $75,000, the negotiated rate insurance paid was $28,000. Since we had already met our out-of-pocket max due to our son's appendectomy, our cost was $0.

Thats way too much. Even the $28,000 is way too much. Where does all that money go?

roho76
05-31-2012, 06:09 PM
We pay cash for routine stuff and buy catastrophic/Hospitalization for emergencies. This is the best option/cost in my opinion. My doctor actually sent me a check for $165 because "I was not supposed to be charged for the last visit". We didn't have any credit and she knew that. It's easier for her to deal with me as a patient when the insurance companies are out of the way. I suggest everybody go to this style of insurance.

donnay
05-31-2012, 08:03 PM
I had no insurance and my daughter broke her arm. I took her to the emergency room, they asked me immediately for my insurance card I told them I do not have insurance, and I would be paying for it myself. They set it and put a cast on it, with two follow-ups. The next month the bill came in and it was $300.00.