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Hospitals pledge to fight admin price transparency plan in court

healthcaredive.com

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Re: Hospitals pledge to fight admin price transparency plan in court

#121

Post by stefan_ »

Thriptic wrote: post #71
istjohn wrote: post #22

I spent 45 minutes at the hospital where I was to get a lab test done, trying to get a quote for said test. Prescribing doctor didn't know the cost. Lab tech didn't know. Billing department told me I needed a procedure code. Lab tech who was ready to draw blood couldn't tell me the needed code even after spending five minutes at a computer looking for it. Prescribing doctor gave me the code. Called back billing. They…

Lab tests are particularly complicated to price because usually they are being processed by someone else. Usually labs won't even try to get an authorization from insurance until they get your sample and start working on it as it affects their turnaround time which is one of their main differentiators, and each insurer will have different rules about what they will pay for under what conditions (insurers also have se…

None of this has anything to do with lab tests, which are an absurdly routine procedure. It's entirely divorced from the subject matter. It's not "complicated" out of necessity, but for profit.

Re: Hospitals pledge to fight admin price transparency plan in court

#123

Post by lotsofpulp »

noelsusman wrote: post #85
lotsofpulp wrote: post #73

Earlier quoted context omitted.

Is it illegal to write “we will bill your insurance for procedure codes x y z for your visit”? They don’t need to tell you the cost, but they know what they’re going to charge you beforehand. They should be able to tell you the codes so you can give it t your insurance company to find out how much it will cost. The reason healthcare providers don’t give out codes for known predictable procedures is it would enable cu…

Yes, it is illegal to send that information to your email account or your mailbox. These days most providers have services that enable them to communicate with patients electronically, but it's a totally separate system that you have to login to. Your private health information will never show up in your email inbox.

They won't reply via online accounts either. I will send them messages via the portal, and I always get generic responses. And doctors will never respond, it's always second hand from nurses, but they will just ask to call the office.

Re: Hospitals pledge to fight admin price transparency plan in court

#124

Post by noelsusman »

mavhc wrote: post #112
njharman wrote: post #89

Earlier quoted context omitted.

HIPPA and privacy laws. Communications have to be secure.

So only send it to email services that support TLS, ie 99% of them

Not secure in the sense that it's encrypted, though that's part of it. Secure in the sense that you know you're communicating with the patient and only the patient, not their spouse, or their grandson, or Google's servers.

Re: Hospitals pledge to fight admin price transparency plan in court

#125

Post by [deleted] »

Berobero wrote: post #98
istjohn wrote: post #22

I spent 45 minutes at the hospital where I was to get a lab test done, trying to get a quote for said test. Prescribing doctor didn't know the cost. Lab tech didn't know. Billing department told me I needed a procedure code. Lab tech who was ready to draw blood couldn't tell me the needed code even after spending five minutes at a computer looking for it. Prescribing doctor gave me the code. Called back billing. They…

I was in Japan two years ago; got pneumonia and needed antibiotics. Went to a hospital with no insurance and no appointment. I was being seen by a doctor within 30 minutes. Doctor wanted to do some additional labs just to rule other things out, but he was worried that it would be expensive for me given the lack of insurance. He called up billing with me still in the room and had a price within a couple minutes: ~$70…

[deleted]

Re: Hospitals pledge to fight admin price transparency plan in court

#126

Post by bluGill »

topicseed wrote: post #64
KukicAdnan wrote: post #2

We need price transparency! Went to a quick care the other day because of a flu that would not go away, was seen and diagnosed with bronchitis in less than 5 minutes. The quick care billed my insurance $1,840, which they talked down to $300, and had me pay $115. What?

From the UK. Health care cost stories in the US seem incredibly dreadful. Hard to grasp how a huge power like the US can't get itself around decently-priced healthcare.

It is incentives. Most people get their heath care from insurance, which is subsidized by their job. I can legally buy my own insurance, but it will cost a lot more than what I pay through work so of course I don't. My boss wants me to keep working, and so high medical costs keep me from quiting to start my on competitive business. I can live for a couple years on cheap food and little else, but I need at least emergency health coverage as a just in case.

Lack of transparent prices is one tool the system has to ensure I don't have any other option.

Re: Hospitals pledge to fight admin price transparency plan in court

#128

Post by mehrdadn »

sam36 wrote: post #81

My uncle wrecked his motorcycle once. He ended up in a ditch unconscious. Someone called 911. For what ever reason a life flight helicopter was then called and picked him up and took him to a local county hospital. He woke up there a few hours later. After they had already ran all kinds of tests. They had a large list of all the problems from busted spleen, broken bones, head concussion, etc. After a day of rest in t…

Confused, so they flat out lied about broken bones? Something doesn't seem right.

Re: Hospitals pledge to fight admin price transparency plan in court

#129

Post by mywittyname »

bloopernova wrote: post #24

I'm being offered $550 by my insurance in "gift cards" if I use certain facilities for any MRIs or other diagnostics. I think that shows just how wildly variable different locations charge, and how much they get away with. I'd love to see a published price list for standard procedures, because I think hospitals have become too used to being cash cows for administrators and CEOs. This isn't to say I think nurses or do…

> This isn't to say I think nurses or doctors are overpaid

The probably are. Clearly hospital executives and administrators are raking in most of the money, but we can't sit here and pretend that caregivers don't directly benefit from such an arrangement as well.

There's a reason urgent care centers and small clinics pay their doctors less than most of us make, or skip employing doctors at all in favor of nurse practitioners, and their nursing staff makes ~1/3 what they would be earning in a hospital setting. Labor is expensive; specialized labor is even more so.

Re: Hospitals pledge to fight admin price transparency plan in court

#130

Post by munk-a »

mavhc wrote: post #112
njharman wrote: post #89

Earlier quoted context omitted.

HIPPA and privacy laws. Communications have to be secure.

So only send it to email services that support TLS, ie 99% of them

HIPAA compliance is a very complicated thing. Sending PHI over a non-encrypted channel would probably be acceptable in response to a patient request - while sending PHI over a heavily encrypted channel in an unsolicited manner would likely be a violation.

HIPAA is complicated and a lot of the things it is concerned with are far less technical than they may appear on the tin.

Also, IANAL - nothing in this post should be considered sound advice for any reason in any context.

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