Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

The fight between doctors and insurance companies over 'downcoding'

nbcnews.com

Post reply on HN
Print view View original

211–220 of 354 posts

Re: The fight between doctors and insurance companies over 'downcoding'

#211

Post by vjvjvjvjghv »

supportengineer wrote: post #68
3D30497420 wrote: post #46

This sort of thing gets to two critical problems of the American system: 1. It is largely designed to make money, not actually help patients. So every step in the healthcare chain that can extract a bit of value will do so, largely to boost profits. 2. Insane complexity with limited transparency. How much will something cost? Hard to tell. Will it be covered? Who knows? On the opacity, I have one informative anecdote…

Here are the magic words in US Health Care: "What is the cash price?" It's usually less than you think and often worth avoiding the insurance company hassle. Then you can just get reimbursed with your FSA or HSA anyway.

This is the magic endgame for insurers. Make your product so hard to use that people give up and don't even use insurance.

Re: The fight between doctors and insurance companies over 'downcoding'

#212

Post by cshokie »

malfist wrote: post #204
cogman10 wrote: post #190

Earlier quoted context omitted.

The issue is that it only kicks in when you itemize your deductions and it has something like a $10k cap. The standard deduction is 15k for a single and 30k married. Unless you have a bunch of other things to deduct, it's often the right choice to just use the standard deduction.

Unless your a homeowner with a mortgage, then it's almost always better to itemize

Not so much anymore. The standard deduction for a married couple is now above 30k. It would take a large mortgage to pay that kind of interest in a single year. (Principle is not deductible; only interest)

Re: The fight between doctors and insurance companies over 'downcoding'

#214

Post by db48x »

i80and wrote: post #70
supportengineer wrote: post #68

Earlier quoted context omitted.

Here are the magic words in US Health Care: "What is the cash price?" It's usually less than you think and often worth avoiding the insurance company hassle. Then you can just get reimbursed with your FSA or HSA anyway.

FSAs are insane, conceptually. "Guess how much money you're spending in a year on healthcare! But beee caaareful: if you guess too high, YOU LOSE IT" I still used mine while I still had access to one, but it was grumpy-making and was usually almost more trouble than it was worth.

Yea, FSAs are dumb. Luckily nobody forces you to have one. Just get an HSA like a sane person.

Re: The fight between doctors and insurance companies over 'downcoding'

#215

Post by adastra22 »

i80and wrote: post #70
supportengineer wrote: post #68

Earlier quoted context omitted.

Here are the magic words in US Health Care: "What is the cash price?" It's usually less than you think and often worth avoiding the insurance company hassle. Then you can just get reimbursed with your FSA or HSA anyway.

FSAs are insane, conceptually. "Guess how much money you're spending in a year on healthcare! But beee caaareful: if you guess too high, YOU LOSE IT" I still used mine while I still had access to one, but it was grumpy-making and was usually almost more trouble than it was worth.

I’ve only used HSAs. Can you reimburse prior year expenses from an FSA? If so, allocate the amount you sent last year, reimburse on Jan 1st.

Re: The fight between doctors and insurance companies over 'downcoding'

#216

Post by adastra22 »

malfist wrote: post #205
jimbokun wrote: post #128

Earlier quoted context omitted.

"What is the cash price?" magically puts you back in the land of Classical Capitalism, where the service provider wants to keep you as a customer and knows their internal costs and you as a consumer of the service can evaluate their reputation for quality and cost vs other providers. It's adding 3rd parties like "insurance" (which only works as insurance in very limited catastrophic circumstances) and government plan…

Are you calling it the magical land because it doesn't exist? I doubt your doctors office can commit a cash price for the lab they sent you blood too. And try doing that at a hospital and see where it gets you

The lab does the blood draw. You pick the lab and negotiate with them.

Re: The fight between doctors and insurance companies over 'downcoding'

#217

Post by adastra22 »

testing22321 wrote: post #166
supportengineer wrote: post #68

Earlier quoted context omitted.

Here are the magic words in US Health Care: "What is the cash price?" It's usually less than you think and often worth avoiding the insurance company hassle. Then you can just get reimbursed with your FSA or HSA anyway.

…. So you pay many thousands a year for insurance, but it’s easier not to use it? Ummm

It is cheaper not to use it.

Re: The fight between doctors and insurance companies over 'downcoding'

#218

Post by bobmcnamara »

vjvjvjvjghv wrote: post #210
i80and wrote: post #70

Earlier quoted context omitted.

FSAs are insane, conceptually. "Guess how much money you're spending in a year on healthcare! But beee caaareful: if you guess too high, YOU LOSE IT" I still used mine while I still had access to one, but it was grumpy-making and was usually almost more trouble than it was worth.

FSA makes no sense. The money should just go into an HSA and be available whenever needed. Nut just this year. It should just be abolished.

FSA exists in this strange no-mans land of many insurance plans where HSAs cannot go.

Re: The fight between doctors and insurance companies over 'downcoding'

#219

Post by adastra22 »

hintklb wrote: post #171
potatoicecoffee wrote: post #162

Earlier quoted context omitted.

In Australia I just take my blood test form to any pathology place and they do it for free (for me) and bill the government a set price from the medicare benefits schedule.

Hmm sure, but there must similarly be things that are denied right? I lived in both systems. In a single payer system, the state essentially decide what is allowed and what is not. And with the state as a single payer, they also go back and forth on price with the hospitals. It still is a better system overall but there is no places where you can just spend as much as you want on healthcare without some type of centr…

In sensible countries that decision isn’t made after the fact. You know going in if it is covered or not.

Re: The fight between doctors and insurance companies over 'downcoding'

#220

Post by adastra22 »

empressplay wrote: post #189
aduffy wrote: post #90

Earlier quoted context omitted.

I've had numerous encounters where doctors (and dentists) attempt to charge me for services they've already been reimbursed for from the insurance company. It's only after hours of scouring my EOBs and being on the phone with my insurance that I then come back to the practice's office with evidence in hand, and they dismiss the charges. I'm pretty sure this is just a racket because they expect most people not to put…

Where do you live, so people know not to move there? Jesus.

Sunnyvale, California.
Post reply on HN