Comments: 1844 • Responses: 55 • Date: 2019-11-26 20:42:13 UTCsource
GayBoxofScreams983 karma2019-11-26 22:38:46 UTC
My Medicine cost $147k a year, so Im pretty much fucked no matter what right?
View HistoryShare Link
Its_All_Totally_Fine872 karma2019-11-26 22:40:49 UTC
Jesus. I mean, I dont want to say yes to that, but like
openskeptic476 karma2019-11-27 01:18:42 UTC
I work with someone who never pays her medical bills and hasn’t for years. She claims she has a credit score in the high 700’s and that none of her medical collections show up on her credit reports. Is that possible?
Its_All_Totally_Fine97 karma2019-11-27 01:34:55 UTC
I've never heard of it. I know ours show up in a couple days
sasquatch_melee19 karma2019-11-27 03:56:58 UTC
Do the providers keep letting her make new appointments?
I would think you would be banned from everything except the ER after much of that.
Its_All_Totally_Fine25 karma2019-11-27 05:49:49 UTC
They sell it off. Doesnt make a difference to them most of the time
Picomanz374 karma2019-11-27 01:33:03 UTC
This is a fascinating AMA for the rest of the the world outside of the USA. My question is, why does the USA cling so desperately to their healthcare system in defiance of evidence from the rest of the world?
thendawg541 karma2019-11-27 01:41:05 UTC
Like many things in the world, because people make a lot of money off things staying the way they are, and said people also have a lot of power to keep things the way they are.
Its_All_Totally_Fine203 karma2019-11-27 01:57:42 UTC
And the winner is...
RaisinsB4Potatoes350 karma2019-11-27 01:16:17 UTC
How long after a visit can I be billed? I got one from over a year ago. Can I contest it?
Its_All_Totally_Fine424 karma2019-11-27 01:39:36 UTC
Your insurance legally has up to 2 years to reprocess your claims before issuing final billing
Serri330238 karma2019-11-27 01:12:39 UTC
I recently had bloodwork done to determine if I had signs of potential cancer, after a 25cm ovarian cyst was discovered. I received a letter from my insurance stating that the claim for coverage of those tests was denied, as they considered it "unnecessary for treatment/investigational". I'm pretty sure it's necessary to know if I potentially have cancer, but I digress.
I am in my mid 20s and have never had anything medically wrong with me. No stitches, no broken bones, no hospital visits. I have used insurance purely for routine yearly checks, dentists visits, and eye exams. Therefore, I have no idea what to do about making insurance cover this, as I can't afford the $600 after paying $2,000 for the surgery to remove this cyst. Any advice on appealing the decision and how that process even works?
Its_All_Totally_Fine212 karma2019-11-27 01:42:51 UTC
You might be able to get the clinic that performed the procedure to notify the insurance of medical necessity and provide medical records, but if that already been done you might be out of luck. As far as the appeals process goes, your best option is always to talk regularly with the clinic and keep them informed that you're appealing, trying to stay on top of it, etc.
WinterText211 karma2019-11-26 21:07:33 UTC
are bills negotiable?
Its_All_Totally_Fine116 karma2019-11-26 21:10:28 UTC
It depends on the facility. In mine, we're "non-profit" (as if) so we have various discounts and financial assistance. I know of one other facility in my state that actually offers "pay off" discounts for paying in full. Some, the prices are set and that's too bad if you dont like it.
WinterText14 karma2019-11-26 21:11:03 UTC
Its_All_Totally_Fine29 karma2019-11-26 21:20:03 UTC
No problem. You can also always ask someone at the facility how they do their billing. Usually they'll tell you.
SantasDead71 karma2019-11-26 23:36:52 UTC
I've been in the hospital a lot. Every time I call after I get a bill and ask how much if I pay in full. They always take 40% if I pay them. Doctors, hospitals, services, everyone.
Its_All_Totally_Fine82 karma2019-11-27 00:48:14 UTC
Not every facility does that, but I'm glad you can afford to do that.
Aeladon171 karma2019-11-26 20:50:18 UTC
Block out the bar code btw.
What type of nonsense codes should we be looking for in our billing statements that hospitals have added to line their pockets that don't relate to actual care?
How can we counter bills from doctors who "consult" on a case but never actually see the patient but expect a huge fee (many times not covered by insurance)?
If you receive a bill from a doctor for a bullshit exam how can you fight the bill? (Real world example: My sister went into the doctors for a checkup because she has some on going health issues. The doctor walked in and asked her if she'd had a period recently. She said yes, 2 weeks ago. Doctor walked out and sent her a bill for $600 with no explanation and no help with her medical issues.)
Its_All_Totally_Fine211 karma2019-11-26 21:19:18 UTC
The thing about codes is that they're all essential in one way or another. The shittiest ones are those for Medicare and Tricare because their rules change so often and they're both very picky. My employer does facility based billing as opposed to provider based because we're non profit, so all our codes will say 'hospital' or 'outpatient'. The problem there is that some insurances wont pay certain procedures if they're outpatient.
As far as consulting physicians, you can try requesting the ranking physician because that's typically who consults, but it's unlikely you'll get your pick. The best choice there is to avoid large facilities. More docs = more residents = more consults.
On the bullshit charges... exasperated sigh
Doctors have no idea how billing works. They don't know that every single thing they enter becomes a charge, and if a patient has existing conditions, they will almost certainly charge for 'maintenance' of that condition. If you're following up on that specific issue, only schedule a consultation for that, and do NOT let the doctor change the subject. Anything else? Say no. They're required to write down anything discussed, and as a result, coders are required to turn every word in to coding.
Pro tip; talk to your insurance about what's covered and NEVER the doctor. They have no clue, and will 100% tell you its covered to get you to come in.
EDIT FOR CLARIFICATION:
I am NOT saying you shouldn't discuss issues with your doctor. You absolutely should. What I'm trying (and failing) to say here is that your appointment's status is not set in stone until its entered in coding. If you go for a wellness exam but discuss your diabetes/former cancer diagnosis/menstrual cycle, the visit will no longer be considered annual wellness. If you discuss an issue other than the original reason for scheduling, the coding can/will change. Absolutely discuss medical issues with your doctor.
RenaldoCamacho68 karma2019-11-26 21:26:44 UTC
Dude I hate it too. I am in your same kinda boat. Texas, MRI Outpatient facility... we are freestanding but owned by a hospital so it’s all outpatient based. Used to work for an in house MRI place where an MRI would be $350 Physicians rate. But outpatient it’s a $3000 MRI for no reason other than greedy scum.
Its_All_Totally_Fine65 karma2019-11-26 21:33:16 UTC
My favorite thing on that garbage is when I have to explain that the cost is higher 'because we're a level 1 trauma center, and our rates are comparable to other centers for the same care across the country'
BanditaIncognita10 karma2019-11-27 04:11:37 UTC
My local world-renowned hospital told me they charge more because they're "a teaching hospital". Yet the other hospital system that is also very much a teaching hospital manages to not only charge less, but also create mostly straightforward bills.
Its_All_Totally_Fine6 karma2019-11-27 05:27:16 UTC
DtheMoron14 karma2019-11-27 01:24:57 UTC
My dad had both his knees replaced (separate) and each one was outpatient. If they can hack open his leg and replace a major joint, then send him home 4 hrs later, what major life saving things could be out patient with modern medicine?
Its_All_Totally_Fine12 karma2019-11-27 02:01:55 UTC
It's more of an office visit vs outpatient issue. Like freezing a wart off, but then it getting billed as an outpatient procedure.
ImNotTheZodiacKiller85 karma2019-11-26 21:41:42 UTC
Wait, you're telling me the corporations profiting from sick and diseased people is not a good thing? Well that sounds too close to socialist propaganda for me to listen to. I'm going to lock myself in a closet and blast Tucker Carlson until I forget about this post.
Its_All_Totally_Fine98 karma2019-11-26 21:43:09 UTC
What other response could I expect from NotTedCruz?
namrog8441 karma2019-11-27 03:08:40 UTC
Do you want to keep your anonymity?
FYI. What you've blurred out, isnt nearly enough if you don't want to be identified easily. You might want to edit the ibb image further. I know its kinda late for the 6 hours, but you should consider removing even more. show 0 of photo, and 0 of barcode.
I used to work with a variety of data and I could probably identify you with whats there in probably less than 1 hour and I was a junior engineer when I used to work in that area, and that was almost 5 years ago. I'd imagine its only even easier now.
FlyingBanshee2344 karma2019-11-27 03:29:56 UTC
I am 99% sure what hospital OP is at just based on the lettering and font on the top of the ID card.
stevedp8618 karma2019-11-27 03:48:57 UTC
He will probably be fired tomorrow morning.
Emartyr17 karma2019-11-27 04:10:11 UTC
Yeah OP is definitely getting fired.
Its_All_Totally_Fine31 karma2019-11-27 06:14:33 UTC
Thanks for the support guys lol
Claysloth39 karma2019-11-27 00:44:35 UTC
Thanks for doing this!!! I have a question, because I'm in a bit of a pickle myself. I had a standard surgery go wrong, and now I owe the hospital a whole fuckton. But they did this to me....is there any point in arguing with them? My insurance company already shelled out 5 figures at least...at what point do they cover it because they fucked up?
Its_All_Totally_Fine62 karma2019-11-27 00:55:14 UTC
Malpractice suits and quality of care issues are really the only ways to get it back to them. They'll do everything they can to fight it though. Truly, best of luck.
schapmo39 karma2019-11-26 23:53:17 UTC
It sounds like you work at a not for profit and still encounter a bunch of issues. Why do you think for profit is the issue as opposed to the design of the system itself?
Its_All_Totally_Fine66 karma2019-11-27 00:31:54 UTC
The system itself is for profit, which is why it still presents us with so many issues. Getting private insurers to pay is more difficult a lot of times because they come up with fun new ways to deny every time. Medicare's biggest problem, honestly, is how impossible it is to keep costs standardized when the market fluctuates like crazy. They change constantly because they have to keep up with the market.
seattle-diarrhea-dad14 karma2019-11-27 00:25:31 UTC
What does the last a stand for in AMAA?
Its_All_Totally_Fine40 karma2019-11-27 00:39:39 UTC
Anything. But the second one stands for Almost.
jupiterfolf5 karma2019-11-27 01:15:18 UTC
What are the profit margins at hospitals actually like?
Its_All_Totally_Fine11 karma2019-11-27 01:39:58 UTC
222double2224 karma2019-11-26 21:52:54 UTC
How much do you make and should I get a degree in medical coding?
Its_All_Totally_Fine19 karma2019-11-26 22:00:44 UTC
I make $16.50/hour, personally, but our department has two operating systems to keep track of, a shitload of incoming calls, and we're the gobetween for a lot of other departments.
My MIL has a coding degree, and i know a few of the coders at my facility. I can say that they all seem to have a pretty 'medium' opinion of their jobs. The pay is decent, the hours are decent, and they're some of the only people able to work from home, but their work is VERY closely analyzed and nit-picked, so if you're not in to criticism or review, maybe not.
thetruthseer4 karma2019-11-27 00:49:01 UTC
What are, if any, possible ways to fix this disgusting broken system?
Its_All_Totally_Fine14 karma2019-11-27 00:59:37 UTC
But also, letting doctors do their jobs without pinching every penny and regulating the system in to single payer. That's my suggestion.
tommygunz0073 karma2019-11-27 01:32:14 UTC
What is the best way then to create a system that offers quality health care to communities where it's not like the VA, in which you wait forever to be seen by a doctor? I think of Canada in which you could theoretically die waiting for a doctor?
Its_All_Totally_Fine7 karma2019-11-27 01:46:42 UTC
You can do the same here, and then they'll bill your family. My suggestion is single payer with no market, but regulation through lack of profit margins. Cut the red tape. It's that barrier that makes it so most people can't get in to a doctor, and can't get one to talk to them for more than 10 minutes.
Jao_R2 karma2019-11-27 01:40:56 UTC
Why do you think The U.S. cannot simply adopt the healthcare system of other countries who have universal healthcare?
Its_All_Totally_Fine6 karma2019-11-27 01:47:46 UTC
Because of people like Stellarspace1234. They think helping people needs to be about profits instead of just like... about helping people.
thereisnoendgame1 karma2019-11-27 02:15:29 UTC
How would you do it differently? If you had the power to reform the system, how would you tear it down and rebuild?
Its_All_Totally_Fine0 karma2019-11-27 02:20:18 UTC
Single payer, merits in the form of time off, eliminate the profits factor
bravotipo0 karma2019-11-26 21:50:42 UTC
I am european so I am not into US system but I am curious.
who do you bill to? the patient or the insurance?
if the hospital is no profit does it mean that his that costs are equal to income?
which is the highest voice of cost?
how much does a physician is paid by the hospital?
Its_All_Totally_Fine7 karma2019-11-26 21:57:53 UTC
Billing goes to insurance first, then the patient, unless the patient was involved in a third party incident (worker's compensation, car wreck, etc.)
My employer is listed as non-profit, which is supposed to mean we operate with charges at a low profit level to compensate cost of operations and employee pay.
I'm not sure what you mean by voice of cost
Physicians at our facility all make at least 100k/year, and they are also given division bonuses based on their divisions cash collections every quarter.
DaBIGmeow8880 karma2019-11-26 23:45:53 UTC
How do private insurers pay for inpatient hospitalizations if they don't use MS-DRGs (Medicare) codes?
why does Medicare pay less than Private insurance for inpatient hospitalizatoins?
Its_All_Totally_Fine2 karma2019-11-27 00:29:43 UTC
It seems to be a benefit/drawback situation. Part A literally ONLY pays for inpatient, and since they're what's called a guaranteed payer and they're nation wide, they get superb rates. Part B covers most everything else, but their clinic costs usually adjust UP not down, to $103.86 if memory serves.
The supplemental do a lot of the work too, which reduces the top line on medical charges a lot. Privates like United and BCBS have higher deducties, which is how they get away from having worse rates than Medicare gets on procedures.
jlin02-6 karma2019-11-26 23:43:58 UTC
Is it not evil to force doctors to work minimum wage to reduce health care costs?
Its_All_Totally_Fine6 karma2019-11-27 00:17:30 UTC
I mean... nobody said they should?
Dante472-8 karma2019-11-26 23:30:16 UTC
I'd be very interested in why you think that?
I swear I just came from the hospital where my mother died and I'm almost certain they made her sicker so they could load up on medical billing. I can't help but feel doctors/hospitals try to make people sick so they can make more money.
But I'd love to see proof.
Its_All_Totally_Fine1 karma2019-11-27 00:13:09 UTC
Money is the name of the whole game. That's all any of us are to these people. I see it at slavery wlquarterly financial meeting.
Copyright © 2014 BestofAMA.com, All rights reserved.
reddit has not approved or endorsed BestofAMA, reddit design elements are trademarks of reddit inc.