Man gets $90,000 hospital bill for snake bite treatment
- Thread starter Responsible Allen Iverson
- Start date
MidwestD
Clyde Frog's Shooter
iceberg_is_on_fire
Wearing Lions gear when it wasn't cool
All are complicit to some extent. Everyone is making money in the end.
Government has gone on in a great way of tightening their belts. If you have like 95% of your patients with Medicare only or primary, you aren't making money as a business. The business model is to have roughly 1-2 patients per 10 to have commercial insurance. Commercial insurance is what you get from an employer or that of an individual plan when you are like a barber or something that insurance isn't offered through a company.
Healthcare companies don't actually get back what they bill. It's very customary for say on this 90,000 bill, they actually billed for 100,000 of services but the insurance company said that they were only going to pay 90,000. So, assuming at 20% co-pay, dude is stuck with 18 racks to come up with. From there though, it would be worth it to look at his plan. A lot of people, with their employer, myself included, take on the cheapest insurance that you can obtain, though if something like this were to happen, you screw yourself in the long run. Not knowing if this is the case here, but I'm going to assume that is it. The fee schedule for the hospital and the insurance company does not change. The fee schedule is how much a service is going to cost and has been negotiated on by hospital and insurance company and that is associated with the DRGs or diagnostic related group. What would change is how much you'd be responsible for in relation to the insurance company. A lot of times, hospitals practice what is called "defensive medicine" What that means is that they will run all these tests for you, to cover their asses, when you really don't need it. Have you ever gotten a bill or an explanation of benefits and noticed that an x-ray or something was not covered? If you have, it was deemed by the insurance company that this test was excessive. Remember, they have doctors working for them too, scouring claims sent by businesses to make sure that they aren't overpaying. As aforementioned, DRGs are the groupings of services when you go into a doctor or for a procedure. Say for instance you go to the doctor for a wellness checkup, what is going to happen. Blood pressure check, respiratory check, weight, urine, temperature. It's the same for everyone so supplies and energy exerted should stay the same, so the cost will be the same. That is what a DRG is, they have them for virtually every type of situation.
Above all, both hospital and insurance company are laughing to the bank. An insurance company is a company of risk and they do very well at forecasting so that they don't hurt themselves. Hospitals and the like get all of this money for R&D and stuff. It gets put to great use, but at what cost? Look around your area at billboards, aren't a large portion of them healthcare related? The loser here is obviously the patient though, unless you are covered 100% then you are good.
Mr. Somebody
Friend Of A Friend
The justification for the high prices are the salaries of everyone involved?
iceberg_is_on_fire
Wearing Lions gear when it wasn't cool
Malpractice insurance is usually paid for by the hospital in addition to many other things. There isn't a justification, I'm just telling where money goes. A lot of money goes to R&D
- Joined
- Jul 22, 2012
- Messages
- 36,636
- Reputation
- 3,835
- Daps
- 54,852
- Reppin
- #Targset,#Heatgang,#Byrdgang
Europeans stay eating. I can't benefit but dudes I know only paying 200 bucks for CT scans and shyt 
snake bite? That shyt would be, 20 bucks and they'd sent you home 
snake bite? That shyt would be, 20 bucks and they'd sent you home