Medical equipment pricing is completely broken when a sling costs $200 • Hacker News Board

Re: Medical equipment pricing is completely broken when a sling costs $200

#71

Post by azernik » Fri, Sep 13, 2019, 11:11 PM UTC

mehrdadn wrote: post #42

throwaway1777 wrote: post #7

Earlier quoted context omitted.

Pretty sure if you go through the effort to challenge such charges you can get them changed. https://www.vox.com/2019/3/22/18261698/how-to-fight-expensiv...

The thing I don't understand about tips like these is, what obligation does the other party have to cooperate at all? Like you "ask for a supervisor" (and then a director!) what incentive do they have to not just say no? Or if you ask for an itemized bill, what if they just refuse? How are you supposed to get past a blunt refusal, which to me seems like the easiest response for them?

Generally, these excessive bills are, to put it mildly, of questionable legality. If you complain, they assume you're the type with enough savvy to maybe sue them, so they'll give in to placate you. And yet they do this anyway, knowing that some people will not properly contest the bill.

See also the US unemployment benefits situation, where many employers will contest an unemployment insurance claim by default even when the worker is actually eligible, in the hopes that some workers will not navigate the bureaucracy well enough to fight back. Because of the weakness of their case, however, they will then back down as soon as their denial is challenged.

Re: Medical equipment pricing is completely broken when a sling costs $200

#72

Post by tomjakubowski » Fri, Sep 13, 2019, 11:13 PM UTC

mehrdadn wrote: post #42

throwaway1777 wrote: post #7

Earlier quoted context omitted.

Pretty sure if you go through the effort to challenge such charges you can get them changed. https://www.vox.com/2019/3/22/18261698/how-to-fight-expensiv...

The thing I don't understand about tips like these is, what obligation does the other party have to cooperate at all? Like you "ask for a supervisor" (and then a director!) what incentive do they have to not just say no? Or if you ask for an itemized bill, what if they just refuse? How are you supposed to get past a blunt refusal, which to me seems like the easiest response for them?

It might be that a blunt refusal would look bad in court if the billed party took them there.

Re: Medical equipment pricing is completely broken when a sling costs $200

#73

Post by mehrdadn » Fri, Sep 13, 2019, 11:16 PM UTC

tomjakubowski wrote: post #72

mehrdadn wrote: post #42

Earlier quoted context omitted.

The thing I don't understand about tips like these is, what obligation does the other party have to cooperate at all? Like you "ask for a supervisor" (and then a director!) what incentive do they have to not just say no? Or if you ask for an itemized bill, what if they just refuse? How are you supposed to get past a blunt refusal, which to me seems like the easiest response for them?

It might be that a blunt refusal would look bad in court if the billed party took them there.

I've thought about this aspect, but the thing is, how would you ever even show you were refused without a recording? (Say if you're in a 2-party-consent state? Which they would obviously not consent to?)

Re: Medical equipment pricing is completely broken when a sling costs $200

#74

Post by mehrdadn » Fri, Sep 13, 2019, 11:18 PM UTC

opportune wrote: post #65

rwcemergency wrote: post #53

Earlier quoted context omitted.

I just got an emergency room bill. I had a severe sore throat and fever for 2 weeks, step tests came back negative. Then at night my back side started hurting so I went to the ER. I paid $850 at the ER and today I received another bill for $850. The only thing on the Bill just says > "Charges": $11,680 > "Adjustmnets: $9,980 I just got off the phone with them and they say that it will take 10 business days to receive…

I am not a lawyer or financial advisor. But I’ve heard that you can’t be sent to collections if you make a good faith attempt to pay your (medical) bill. Which in practice might mean you just pay $5 while you wait for the itemization

That would "acknowledge the debt" or something like that from what I understand?

Re: Medical equipment pricing is completely broken when a sling costs $200

#75

Post by mwambua » Fri, Sep 13, 2019, 11:20 PM UTC

tryitnow wrote: post #47

I went to the ER last year. They ended up making me stay overnight. I was hit with a bill for over $10K, with much of that falling on me. I also used to work in corporate finance and I have a good intuition for how billing works. Before I even got the bill I mentally prepared myself for it by telling myself that it's going to be a long drawn out process. I waited and waited and received an initial bill a few months a…

What do you mean when you say the itemization was incorrect? Do you mean that the prices that they list were incorrect, or that the items didn't make sense given the treatment you received?

In either case, what reference do you use to ascertain correctness? I feel like information asymmetry is a problem for a lot of patients. It's hard to tell if you actually need a treatment, or if you're being charged fairly for it.

Re: Medical equipment pricing is completely broken when a sling costs $200

#76

Post by uptownfunk » Fri, Sep 13, 2019, 11:20 PM UTC

rwcemergency wrote: post #53

brink wrote: post #4

I just got an itemized bill today for a minor fall I took a couple months back.. On top of the nearly $6k in other charges from the hospital, they charged $531 for one dab of superglue or "liquid stitches" on my forehead for something that would have healed by itself. One of my friends died two years ago from pneumonia. He didn't go to the hospital when symptoms first started because he was afraid of the bills that w…

I just got an emergency room bill. I had a severe sore throat and fever for 2 weeks, step tests came back negative. Then at night my back side started hurting so I went to the ER. I paid $850 at the ER and today I received another bill for $850. The only thing on the Bill just says > "Charges": $11,680 > "Adjustmnets: $9,980 I just got off the phone with them and they say that it will take 10 business days to receive…

Any reasonable company should be taking out insurance for work mandated outings

Re: Medical equipment pricing is completely broken when a sling costs $200

#77

Post by kube-system » Fri, Sep 13, 2019, 11:22 PM UTC

mdorazio wrote: post #27

georgeburdell wrote: post #24

So I work in manufacturing. On one of our systems, we recently upgraded the fleet to a $10k computer with a 22nm processor running RHEL 7 supplied by the system vendor. We had all of the install files and could have bought a $2k computer and gone through an extended install and qualification process, and closing the door to some support from our vendor, but we didn’t. We paid the extra $8k for a guarantee that it wou…

Here's where that analogy falls apart: If your 10K computer fails, your vendor will fix it under the support contract for free. If the hospital-provided sling falls apart and you go back to the hospital, they'll charge you again . In most cases, the product is the same one you can get yourself elsewhere, and it still doesn't come with a guarantee.

While that is absolutely true, there is a level of confidence in knowing that the one from a hospital was sourced from a legitimate supplier and that it likely meets some level of quality control standards, legal standards, and supply chain controls.

But this is more of a criticism of Amazon than anything, as those things would be true for a drugstore as much as it would be for a hospital.

Re: Medical equipment pricing is completely broken when a sling costs $200

#78

Post by opportune » Fri, Sep 13, 2019, 11:23 PM UTC

mehrdadn wrote: post #74

opportune wrote: post #65

Earlier quoted context omitted.

I am not a lawyer or financial advisor. But I’ve heard that you can’t be sent to collections if you make a good faith attempt to pay your (medical) bill. Which in practice might mean you just pay $5 while you wait for the itemization

That would "acknowledge the debt" or something like that from what I understand?

From what I understand it, it doesn’t mean you acknowledge that the entire bill is for the correct amount. Also if you know you’re going to have to pay at least $5 out of pocket anyway you’re not really losing money. But again IANAL I’m just parroting advice I read on Reddit one time

Re: Medical equipment pricing is completely broken when a sling costs $200

#79

Post by djsumdog » Fri, Sep 13, 2019, 11:24 PM UTC

opportune wrote: post #65

rwcemergency wrote: post #53

Earlier quoted context omitted.

I just got an emergency room bill. I had a severe sore throat and fever for 2 weeks, step tests came back negative. Then at night my back side started hurting so I went to the ER. I paid $850 at the ER and today I received another bill for $850. The only thing on the Bill just says > "Charges": $11,680 > "Adjustmnets: $9,980 I just got off the phone with them and they say that it will take 10 business days to receive…

I am not a lawyer or financial advisor. But I’ve heard that you can’t be sent to collections if you make a good faith attempt to pay your (medical) bill. Which in practice might mean you just pay $5 while you wait for the itemization

Insurance companies negotiate a lot of this stuff away. The poster needs to call them first, see if they can arrange a $5 payment without addition interest while the itemized bill comes in (honestly, there is legal ground here for not even being willing to honor any of the bill with itemization).

Get on the phone, try to keep cool, but realize you're probably going to yell at some poor customer service rep at some point. Apologize, keep going and get the full bill before you agree to pay anything. Then you gotta do the same thing with the full bill on ever bullshit charge, over and over again.

Honestly, how the fuck can they admit you and treat you and then bill you without telling you what the prices are up front? That's fucking madness right there. Imagine having to agree to having car or bicycle service without an estimate? Imagine the total cost being $2000 over the estimate? Would people pay? Of course not; it's worth it at that point to call a lawyer.

Re: Medical equipment pricing is completely broken when a sling costs $200

#80

Post by dhdudxbeub » Fri, Sep 13, 2019, 11:24 PM UTC

When my wife was 25 weeks pregnant she started feeling ill and we noticed her blood pressure kept going up. We went to the hospital. Turns out she was pretty sick she so they made her stay for 4 days.

A few weeks later we had our son’s ashes and a $148,000 bill.