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The Company Behind Many Surprise Emergency Room Bills

nytimes.com

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Re: The Company Behind Many Surprise Emergency Room Bills

#141

Post by cookiecaper »

mistermann wrote: post #105
ydt wrote: post #70

Earlier quoted context omitted.

I had this same thing happen. My daughter was admitted via ER and it turned into a 6 day stay. At the end we received a bill for 40k for being out of network. Luckily I have friends in the industry and it turns out if they fail to inform you within 48 hours that you're not in network you don't have to pay the out of network cost. We ended up paying just our deductible after a letter was drafted. Do not take what the…

Can someone knowledgeable on the subject comment on whether the "Obamacare movement" has been up front in acknowledging this aspect of the problem with health care in the US? My perception is that the problem is typically framed as a lack of insurance problem for financially challenged people, but the "abuse" on the billing side to me seems like at least as big of a problem. And if this is being conveniently ignored,…

The insurance model is at the heart of the medical system's issues; it distorts the market by disconnecting prices from providers and consumers and severely disaligns their interests.

The provider must set a high sticker price so that they can give the insurer the expected 60-80% discount to get in-network (and still tolerate underpayment and other shenanigans). The consumer is either intentionally misled or confused (usually both) about basically everything cost-related, and often won't learn the true out-of-pocket cost of a service until ~1 year after receiving it, when the billing process has (mostly) finished.

Example: just yesterday I got a new bill for a routine lab test I received in December. It says that the insurance discount applied, but they never sent a payment, and thus I owe a balance of over $200 to the lab company. Now I have to call the insurer to figure out why they denied payment, which is sometimes due to an administrative error, sometimes a paperwork thing like signing a document that verifies there is no other possible insurance carrier whom may have been responsible for the bill, etc.

Obamacare is thus anything but up front, because honestly working to fix the American medical system would involve excising market-breaking, paper-pushing leeches from the marketplace, but Obamacare props up this destructive apparatus by forcing every American to pay in or get fined.

Re: The Company Behind Many Surprise Emergency Room Bills

#142

Post by getemback »

rwmj wrote: post #4

Over here (in Europe) we get the impression that US has such a crazy healthcare system. Why aren't people marching in the streets? Is it not as crazy as it sounds for most users? If you're taken to ER how are you supposed to know if the doctors are all part of "your network" (whatever that even means)?

Essentially, poor white Americans oppose any kind of social service that might benefit black Americans. Virtually every problem that America faces is complicated by this one simple fact, which is an echo of the fact that half the country literally went to war over their preference to enslave black people. Despite this glaring and obvious reality, most commentators are afraid to mention it.

Re: The Company Behind Many Surprise Emergency Room Bills

#143

Post by chimeracoder »

dv_dt wrote: post #138
chimeracoder wrote: post #125

Earlier quoted context omitted.

> They're pretty good at dealing with pregnancies, cancers, and emergencies I agree with everything you say, except the part about cancer. Even by European standards, the NHS is actually quite terrible at dealing with cancers - even "routine" cancers (like breast cancer and prostate cancer), let alone rare cancers. The five-year survival rate for prostate cancer in the UK is 55%, whereas in the US it's upwards of 90%…

And yet the UK life expectancy is 81.2 vs 79.3 in the US. For men in the two nations, the gap is even bigger - 79.4 vs 76.9. https://en.wikipedia.org/wiki/List_of_countries_by_life_expe...

> And yet the UK life expectancy is 81.2 vs 79.3 in the US.

I don't understand the point you're trying to make. [Treatable] cancer isn't the leading cause of death in any country[0], so no matter how good (or bad) a country is at treating cancer, you wouldn't expect that to be visible in the overall life expectancy rates.

[0] Ordinally, cancer is #2, but that includes untreatable cancers, and the tail is very long, so getting better at improving five-year survival rates for cancers won't budge your life expectancy at all, outside of the margin-of-error.

Re: The Company Behind Many Surprise Emergency Room Bills

#144

Post by seppin »

ydt wrote: post #70
coreyp_1 wrote: post #22

I am having problems with my insurer at this very moment. I went to an in-network hospital for an ER visit, which turned into an 8-day stay (yes, it was serious). Evidently, none of the doctors at the hospital are in-network, however, (claims from various technicians are still "in processing", so I don't know how they will turn out) despite the fact that the hospital itself is definitely in-network. I had no choice a…

I had this same thing happen. My daughter was admitted via ER and it turned into a 6 day stay. At the end we received a bill for 40k for being out of network. Luckily I have friends in the industry and it turns out if they fail to inform you within 48 hours that you're not in network you don't have to pay the out of network cost. We ended up paying just our deductible after a letter was drafted. Do not take what the…

> Do not take what the hospital/insurance Co say at face value. Call an attorney.

What a terrible industry.

Re: The Company Behind Many Surprise Emergency Room Bills

#145

Post by getemback »

wnevets wrote: post #24
rwmj wrote: post #4

Over here (in Europe) we get the impression that US has such a crazy healthcare system. Why aren't people marching in the streets? Is it not as crazy as it sounds for most users? If you're taken to ER how are you supposed to know if the doctors are all part of "your network" (whatever that even means)?

socialism is bad, most americans stop thinking at the point until it affects them directly.

Most Americans repeat "socialism is bad" while driving down their toll-free interstate highways.

Re: The Company Behind Many Surprise Emergency Room Bills

#146

Post by dsfyu404ed »

Every time I read a story about ER-billing I have to fight the urge to spend a few hundred bucks on the materials and equipment required to produce "official enough looking" forms of ID.

Seems like getting a hospital to think they treated someone who doesn't exist is a better bet and no more stressful than getting your insurance to cover things to the extent you are lead to believe they would be covered

Re: The Company Behind Many Surprise Emergency Room Bills

#147

Post by icantdrive55 »

coreyp_1 wrote: post #22

I am having problems with my insurer at this very moment. I went to an in-network hospital for an ER visit, which turned into an 8-day stay (yes, it was serious). Evidently, none of the doctors at the hospital are in-network, however, (claims from various technicians are still "in processing", so I don't know how they will turn out) despite the fact that the hospital itself is definitely in-network. I had no choice a…

If you don't have a house that has more than 120k in equity, or a bucnch of expensive personal items; declare a chapter 7. (I believe 120,000 of the personal home is safe in a bankruptcy in California. Texas has has am unlimited homestead exemption. Meaning you can own a mansion, and keep it in a bankruptcy.)

Don't pay the paracites a penny.

Look into doing a straight chapter 7 yourself. I'm planning on doing mine. You'll save $3000 by doing it yourself.

I'm glad you feeling better. They have become weasels. And to those that think hospitals, and doctors don't come after payment; they do. They can be very aggressive.

Good luck!

Re: The Company Behind Many Surprise Emergency Room Bills

#148

Post by jsisksod »

Devthrowaway80 wrote: post #122
mistermann wrote: post #111

Earlier quoted context omitted.

Changing things so all taxpayers are getting robbed rather than just the individual being treated seems like a sub-optimal solution.

Yeah, it won't work. It works in every other developed nation in the world, and they all pay less money for better healthcare outcomes, but hey, the US is Totally Special.

The US is larger than 50 developed nations combined, so yes, we are Totally Special.

Re: The Company Behind Many Surprise Emergency Room Bills

#149

Post by msoucy »

coreyp_1 wrote: post #22

I am having problems with my insurer at this very moment. I went to an in-network hospital for an ER visit, which turned into an 8-day stay (yes, it was serious). Evidently, none of the doctors at the hospital are in-network, however, (claims from various technicians are still "in processing", so I don't know how they will turn out) despite the fact that the hospital itself is definitely in-network. I had no choice a…

And heaven forbid you have to take an ambulance to the hospital - ambulances might not be in network, in which case you're looking at a $800 charge for a ten minute drive (that you can't make yourself due to a variety of reasons). I wasn't even in bad enough health that they would turn on the lights, so I didn't even get that small silver lining.

Then you get to sit in an "emergency room" for hours, when you're physically unable to move, and with your phone dead so you can't even let anyone know where you are. When you're finally wheeled to where you need to be, you're basically dumped in a hallway facing a wall for half an hour, and you're in a wheelchair and so weak that you can't even turn to face anything interesting. I paid about $1000 for that luxury. At that price I'd expect a decent waiting room...

Yes I just needed to vent about that situation. It sucked, especially for a college student. I was hounded for months afterward to pay those bills, because of course when you're throwing up you can pick which ambulance gives you a ride.

Re: The Company Behind Many Surprise Emergency Room Bills

#150

Post by dsfyu404ed »

moheeb wrote: post #132
eatbitseveryday wrote: post #74

Earlier quoted context omitted.

> Luckily I have friends in the industry and it turns out if they fail to inform you within 48 hours that you're not in network you don't have to pay the out of network cost. Curious, can you perhaps provide evidence of this? Seems like a good thing to know. > Call an attorney. This is itself a cost, and maybe only makes sense if you owe ≥ $10k but for procedures billed as $1k when they should be $400 I don't think w…

I agree with dungle6, whose comment is now dead. I say screw them and don't pay. Ignore collections for a few years and don't be a wuss about your credit score. Problem solved.

That's bad advice for the HN crowd because as much as they all say they love the valley they all have their eyes on home ownership and GTFOing in about that timeline.
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