whole lotta vaccine injuries - Page 50

Jibartik · #**491** 12-10-2021, 02:44 PM

I thought someone pays that 3 mil? Like insurance or someone?

Gatordash · #**492** 12-10-2021, 03:16 PM

Quote:

Originally Posted by Jibartik [You must be logged in to view images. Log in or Register.]

I thought someone pays that 3 mil? Like insurance or someone?

No, you have a "contracted rate" with health insurance companies.

So if I'm charging $100 for a new patient exam (99201) and I have a patient who comes in with United Healthcare, I have signed a contract with United Healthcare that says for CPT code 99201, they only have to pay me $40 or whatever price it is.

They can bargain this because they have a population of customers (patients) that you can be "in network" with if you agree to their rate (this is actually a little different with hospitals but its the same principle). Kind of like if you buy something in bulk you get a different rate from what is advertised.

The problem is that with the regulations of Obamacare, its difficult to have enough money to cover all those regulations so smaller health insurance companies have been getting bought up by bigger companies which greatly decreases competition which greatly increases insurance companies leverage on the bargaining table. So now UNH says well we have way more customers so instead of the $40 our last contract had we will pay you $20. So as a provider/hospital you say oh well our price for 99201 is $200 now due to reasons x,y,z so how about we agree to $30? And then next time UNH buys more companies and says well now we will pay you $10. And then the provider/hospital says oh well now we charge $300, etc. And that is how you get crazy inflated hospital bills that say you are being charged a ton but they are only collecting a small portion of that.

Jibartik · #**493** 12-10-2021, 03:24 PM

So if the universe isn't a simulation my reality is. Got it.

Thanks!

Gatordash · #**494** 12-10-2021, 03:39 PM

I guess I should note that if you don't have health insurance, you will get a bill for $3 million. But even then a hospital is well aware you can't pay that, so you call their billing department and come up with a payment plan like any other collections payments. The hospital will agree to it and take what they can get. There are also actual professionals who will help do this for you. Our insurance rep when my wife was in the hospital was able to negotiate even our co-pays from the hospital from like ~20k to 6-7k which I didn't actually know was possible. The total bill was something like 300k I think.