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I love the passive aggressive stab at Sutter. "Modern Healthcare decided to see how long it would take to present the data in a more consumer-friendly format. It took less than two hours - with a break for lunch - to create the 29 PDF files linked below."
Those are not the real prices. Those are "chargemaster" prices, they are pretty much entirely irrelevant. The true price is usually going to be somewhere between 10-50% of the chargemaster: https://en.wikipedia.org/wiki/Chargemaster http://selfpaypatient.com/2014/01/03/insured-patients-can-sa...
Better to say the fair price is 10-50% of the chargemaster. But if you’re not an insurance company and the hospital refuses to negotiate it down then that is the price you face. (Source: we were billed $16,666.30 for 30g of IVIG after being told it would cost around $2,000 if insurance didn’t cover it. Actual insurance rate would be $2,850 but the hospital won’t negotiate.)
Or at least that's what I gleaned from the billing side during my stint in healthcare IT. Possible that we were an outlier, or (most likely) I just misunderstood.
Earlier quoted context omitted.
Nonsense. These are the prices they charge people who lack insurance. They're very real if you get a bill with them on it.
Nope. Those are the prices that they start with that your insurance claims they negotiated down to 50% or whatever on your bill from insurance for your copay. You can see the problem. Both the hospital and the insurance company are incentivized to keep that number artificially high.
They might negotiate with you, but they might not, in which case you are at the mercy of whatever your state's creditor laws are. Florida? Great laws protecting your primary residence and wages from garnishment if you're head of household. Missouri? Not so much.
Those are not the real prices. Those are "chargemaster" prices, they are pretty much entirely irrelevant. The true price is usually going to be somewhere between 10-50% of the chargemaster: https://en.wikipedia.org/wiki/Chargemaster http://selfpaypatient.com/2014/01/03/insured-patients-can-sa...
Nonsense. These are the prices they charge people who lack insurance. They're very real if you get a bill with them on it.
Which is a horrible system, but it has an interesting property. The more likely someone is to complain, the more likely the system will actually work for them. To me it seems like some perverse evolved survivorship trait, for the system itself. But then I don't work in the industry, so I could be wrong about all of this.
Now that this information is public, I'm looking forward to the startups that will aggregate this info and let you cross-shop hospitals to get the lowest price, like for flights
Edited to add: Plus, reality is you can't really know until you get all the bills. How are they going to code the million different things they have to choose between?
I took my son to prompt care once because he had split the webbing between two of his toes and it looked to me like it needed stitches. The doc swabbed it clean and said he couldn't stitch it. He put some superglue on it and sent us home. Paying on the way out they wanted like $450. I said no. They called the manager and told him I wanted a payment plan. I said, no I don't. I want a reasonable bill. He told them to recode it. They said they had looked for a different code and couldn't find one. They looked again. They had a coworker look again. Eventually they recoded from a laceration to a cut or something like that. Dropped the price to $120ish.
(The superglue came off in less than 24 hours.)
Now that this information is public, I'm looking forward to the startups that will aggregate this info and let you cross-shop hospitals to get the lowest price, like for flights
Earlier quoted context omitted.
Better to say the fair price is 10-50% of the chargemaster. But if you’re not an insurance company and the hospital refuses to negotiate it down then that is the price you face. (Source: we were billed $16,666.30 for 30g of IVIG after being told it would cost around $2,000 if insurance didn’t cover it. Actual insurance rate would be $2,850 but the hospital won’t negotiate.)
It was my understanding that the chargemaster prices are the ones defaulted to so that the insurers pay them, and that for individuals (e.g. uninsured) they'll be more willing to negotiate it down to 10-50%. Or at least that's what I gleaned from the billing side during my stint in healthcare IT. Possible that we were an outlier, or (most likely) I just misunderstood.
Uninsured rates of discount vary dramatically. From none to 90% or more.
Earlier quoted context omitted.
Nope. Those are the prices that they start with that your insurance claims they negotiated down to 50% or whatever on your bill from insurance for your copay. You can see the problem. Both the hospital and the insurance company are incentivized to keep that number artificially high.
They (hospitals, out of network specialists) are also under no obligation to negotiate with you. You are on the hook for whatever your insurance refuses to pay, which can be substantial regardless of what your deductible is. They might negotiate with you, but they might not, in which case you are at the mercy of whatever your state's creditor laws are. Florida? Great laws protecting your primary residence and wages f…
Maybe that’s been taken down?
Always seemed like a reasonable place to start.