Yes it’s anecdotal but all 100% accurate. Some on here know I’ve dedicated a lot of time to mixed martial arts. During that journey I recently tore ligaments in my foot that required surgery. My first visit to a place that rhymes with Orlando Orthopeadic Center they were super nice and sent me out the door with an air cast boot and a referral to a foot specialist. I work for an airline and our Health Insurance is blue cross. 2 months later I get an itemized invoice from the place that rhymes with Orlando Orthopedic center. They billed the insurance company $350 for the boot. That same boot is on Amazon retailing for $90-$120. Ironically Orlando orthopedic was reimbursed $132 from my insurance for the boot which is non surprisingly similar to the full retail cost of the aircast on Amazon. They still insist I owe them roughly $220 for the boot. Those charges are separate form the time with physician. Completely outrageous to have to pay them the extra $220. Oh and same thing on the crutches they gave me. They were reimbursed for the full retail value that the exact crutches that are available on Amazon. If I refuse to pay them triple for a product they have already been reimbursed the full retail price then I go to collections. Total BS scam.
As I understand BCBS coverage and that of other insurers, if the provider is part of your network, they are contractually required to accept the reimbursement from BCBS ….. along with any deductible you should have paid at POS …. as paid in full for the services/devices. Did you seek treatment in network?
You mean, 51% payer. Those of us who actually pay income taxes are your “single payer,” not the magical government, printing funny money.
actually I looked at the website linked below prior, but once there I didn’t dig any deeper as to the differentiation between accepted and ‘in network’. Accepted Insurances | Orlando Orthopaedic Center
I was mowing the yard, which at that time was about 6 acres. Immediately a bug flew into my ear so clean it felt like it hit my brain. I tried to get it out, felt like maybe I was overreacting, so just mowed. Took about three hours. I forgot about it even happening. A couple of weeks later I was having sinus issues, still not even recalling this bug. Went to the doc, he saw it with a scope. THEN I remembered. An assistant came in and squirted warm water in my ear and it washed out, alarmingly preserved. The assistant told me to get my own squirt bottle and distilled water and do it myself if it happened again. They charged me for “surgery.” Sent me a bill for $400. This went on for months. DIY surgery? The office told me they were forced to code it that way, insurance told me the office chose to code it that way. Neither would give. Eventually I paid because I also faced collections. Obviously it would cost me more to fight it, even if you just count my own time with no lawyer. And I had been to law school and knew better than to “represent yourself.” I saw 500 people lose cases they were totally getting screwed in because a lawyer/judge technicalitied them into submission. Either entity had the resources to run out my clock.
The stories are legion about how screwed up our healthcare system is. It is entrenched and probably not susceptible to reform due to those making obscene fortunes on the present system. It didn't use to be this way. Attempts to pass meaningful reform have always been met with, "I don't want government interfering with my health care. I want to be able to choose my own doctor." I know for a fact that some members of Congress receive bribes from the industry, and there are probably plenty more I don't know about. When one was an attorney and active in the community and the local Bar Association, one hears things, including from our representatives in Tallahassee and Washington. Apparently, they majority of whose who could positively impact the system are frustrated by the the lack of action due to the power of those benefiting from the systems as it is.
So as soon as a relatively minor thing happens to you personally, that’s the signal the whole system needs to be reformed? Oh, you are a conservative, it all checks out.
Yep, and look how a certain party fought him mercilessly. "Campaign contribution" (wink, wink) will tempt even the most principled, but there are enough unprincipled in Congress to cabve in and thwart reform.
Exactly. According to some, Medicare negotiating drug prices for their cohort = communism. But muh provider didn’t price match Amazon = FrAuD. Mmmkay.
Sounds like this issue is with the provider. He has insurance, and the insurance appropriately covered it. But the provider are still trying to charge even more for the price of the boot. Is this illegal? If they didn’t charge a markup on the boot itself, maybe they’d have some other nonsensical fee. The crux of the problem with healthcare is you generally have no idea what it costs until the bill comes in. How much did ACA crack down on providers doing this? Maybe they should have addressed trixie provider billing (rather than focusing so much on the insurance side), but let’s not pretend even a single conservative would be supportive of that.
The doctor’s office is not Amazon. The cost for them to buy it, inventory it and sell it is going to be higher than Amazon. $220 higher, I don’t know. But higher. What I don’t understand is how you got partial reimbursement but have to pay the balance if it is in network, but I don’t know all the aspects of the plan.
I like the idea of costs being up front like a menu. Had they told me when I was sitting there that the boot was $350, and crutches north of $100, I would have googled/amazon price checked both and asked why. Instead I wait 2 months and the billing company an Orlando business uses is in NC and gives them “ well sir we are just an3rd party billing blah blah.
I will admit I checked their website to make sure they took Blue Cross, but didn’t differentiate between accepting blue cross vs in network. Had they charged me 30% markup then whatever. But 210% 2 months later when I can’t decline is the shi—y part. Same for crutches. separate but similar story, a technician told me $197 per pound for Freon on my HVAC. I told him on the spot to GTFOOH and he came back immediately with ok. $105. At least I had the chance to object.
So do you want price regulation? I thought conservatives were against that. Conservatives are usually about consumers being educated and making those choices. So you could have refused the boot and ordered one on Amazon.
