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The cost of two weeks in an pediatric/infant ICU

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Re: The cost of two weeks in an pediatric/infant ICU

#41

Post by IG_Semmelweiss »

jzwinck wrote: post #3

A quarter million US dollars. Of course the hospital never expects to receive this amount of money. Either they will negotiate it down for uninsured patients, or they will accept a lesser amount from the insurance company. Insurance companies like this over representation of costs because: 1. If you have a percentage copay (edit: "coinsurance"), say 10%, they will tell you to pay $25k because it's 10%, but they might…

that's not correct.

Coinsurance is calculated on the contracted amount / allowable amount. The latter is the negotiated amount that insurance will pay

SOURCE: Medical billing experience

(Edited for typos).

Re: The cost of two weeks in an pediatric/infant ICU

#42

Post by jzwinck »

jtbayly wrote: post #31
jzwinck wrote: post #3

A quarter million US dollars. Of course the hospital never expects to receive this amount of money. Either they will negotiate it down for uninsured patients, or they will accept a lesser amount from the insurance company. Insurance companies like this over representation of costs because: 1. If you have a percentage copay (edit: "coinsurance"), say 10%, they will tell you to pay $25k because it's 10%, but they might…

I'm seriously doubting claim #1. Can you back it up?

It happened to me in the US and I asked a friend who was a practicing medical doctor at the time, plus another person who worked at a major insurance company. They both confirmed it can be done.

Re: The cost of two weeks in an pediatric/infant ICU

#43

Post by shados »

jzwinck wrote: post #3

A quarter million US dollars. Of course the hospital never expects to receive this amount of money. Either they will negotiate it down for uninsured patients, or they will accept a lesser amount from the insurance company. Insurance companies like this over representation of costs because: 1. If you have a percentage copay (edit: "coinsurance"), say 10%, they will tell you to pay $25k because it's 10%, but they might…

How does #1 work in practice? I've went through several insurance providers over the years, and they always have "Amount billed by the provider", "amount negotiated", "co-insurance" which is on the amount negotiated.

Re: The cost of two weeks in an pediatric/infant ICU

#44

Post by Rucadi »

_huayra_ wrote: post #2

I don't understand how people can be so anti-universal healthcare in the US. When you have an $8k deductible, your insurance is basically a gift to the CEO's yacht fund.

There are countries with private healthcare that works (And IS better than public healthcare).

The problem is specific to USA.

Re: The cost of two weeks in an pediatric/infant ICU

#45

Post by hef19898 »

Jenk wrote: post #24
tiahura wrote: post #10

Earlier quoted context omitted.

Your comment misses the point. There are two reasons why this bill is so high: 1. Some doctors and some hospitals are make tremendous amount of money - hospital revenue is about $1T and doctor revenue is about .5T. 2. This country has an insatiable demand for expensive healthcare. There’s no country with universal coverage where a child with little chance for survival would have received this level of care.

The UK gives this level of care to many people routinely.

As do France and Germany.

Re: The cost of two weeks in an pediatric/infant ICU

#46

Post by minikites »

sumthinprofound wrote: post #9

my sibling was born premature and spent 78 days in the hospital when born. I was a young child myself so I haven't a clue as to cost but it put my parents into bankruptcy.

Your story is very common in the USA. Medical bankruptcy is a menace and should be made illegal. This is a completely avoidable issue, we just need to make the choices to change our system.

https://www.nasdaq.com/articles/medical-bankruptcy-is-killin...

>When it comes to bankruptcy, the study cited court records of bankruptcy filers from 2013 to 2016, with the end result showing that 66.5 percent were tied to medical issues.

Re: The cost of two weeks in an pediatric/infant ICU

#48

Post by arethuza »

tiahura wrote: post #10
_huayra_ wrote: post #2

I don't understand how people can be so anti-universal healthcare in the US. When you have an $8k deductible, your insurance is basically a gift to the CEO's yacht fund.

Your comment misses the point. There are two reasons why this bill is so high: 1. Some doctors and some hospitals are make tremendous amount of money - hospital revenue is about $1T and doctor revenue is about .5T. 2. This country has an insatiable demand for expensive healthcare. There’s no country with universal coverage where a child with little chance for survival would have received this level of care.

A quick google led be to this example of a child receiving 5 months care after being born 18 weeks premature in an NHS hospital:

https://www.lancsteachinghospitals.nhs.uk/latest-news/happy-...

Re: The cost of two weeks in an pediatric/infant ICU

#49

Post by PragmaticPulp »

axiosgunnar wrote: post #5
jzwinck wrote: post #3

A quarter million US dollars. Of course the hospital never expects to receive this amount of money. Either they will negotiate it down for uninsured patients, or they will accept a lesser amount from the insurance company. Insurance companies like this over representation of costs because: 1. If you have a percentage copay (edit: "coinsurance"), say 10%, they will tell you to pay $25k because it's 10%, but they might…

> If you have a percentage copay, say 10%, they will tell you to pay $25k because it's 10% [of $250k], but they might only pay $75k [after negotiating the $250k down to $75k]. That's fraud.

> That's fraud.

Yes, exactly, which is why it doesn’t actually happen. I’m not sure where the OP got this idea, but this isn’t how insurance billing works in the United States.

Re: The cost of two weeks in an pediatric/infant ICU

#50

Post by cheaprentalyeti »

My mom was in an ICU quality rehab hospital for six weeks while recovering from covid. The nominal cost was some 200,000.00, which they settled with medicare as per a long-running contract for 60,000.00.

Somewhere in the medical cost bureaucracy is a lump of pitchblend hooked up to a geiger counter being used as a random number generator.

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