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proverbialwisdom

(4,959 posts)
Sun Jun 12, 2016, 01:54 AM Jun 2016

LA Times: Even if you have health insurance, you may want to pay cash [View all]

http://www.latimes.com/business/lazarus/la-fi-lazarus-healthcare-pricing-20160610-snap-story.html

Even if you have health insurance, you may want to pay cash

June 10, 2016
by David Lazarus


Five blood tests were performed in March at Torrance Memorial Medical Center. The hospital charged the patient’s insurer, Blue Shield of California, $408. The patient was responsible for paying $269.42.

If that were all there was to this -- which it’s not -- you’d be justified in shaking your head and wondering how it could cost more than $80 apiece for blood tests. These weren’t exotic procedures. The tests were for fairly common things such as levels of vitamins D and B12 in the blood.

It‘s what happened next, though, that this makes this story particularly interesting.

The patient, who for privacy reasons requested that I use only her first name, Caroline, was curious about why she needed to pay almost $300 for a handful of routine tests. So she called the hospital.

“I was completely surprised,” Caroline told me. “The woman I spoke with in billing said that if I’d paid cash, the prices would have been much lower.”

How much lower? Try this on for size: Tests that were billed to Blue Shield at a rate of about $80 each carried a cash price of closer to $15 apiece.

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Odds are Blue Cross approved $10 or less. If hospital is in network, they'd write off the rest. Hoyt Jun 2016 #1
So the insurer pays $10 and the insured is on the hook for $269 on top of their monthly premium? bluesbassman Jun 2016 #2
No. If it's an in network hospital, $269 is written off as a contractual adjustment. Hoyt Jun 2016 #10
It was abandoned primarily because the gov is an asshole.... glowing Jun 2016 #12
It'll happen nationally with a Public Option faster and with less fight. Hoyt Jun 2016 #13
Yes, and its needed now more than ever since the insurance companies are anything but affordable glowing Jun 2016 #16
I agree with that. But, even with public option or single payer, it won't be cheap. Hoyt Jun 2016 #21
My primary doc littlebit Jun 2016 #3
Same with drug pricing............ mrmpa Jun 2016 #4
Exactly. We have few medication and doctor bills so Hortensis Jun 2016 #20
Healthcare should be... ReRe Jun 2016 #5
The real question is why does Blue shield tolerate such over pricing practices? UCmeNdc Jun 2016 #6
It causes people to defer care. bemildred Jun 2016 #7
I think you are wrong about that last thing... ljm2002 Jun 2016 #17
I think you are right, but they would if they could. bemildred Jun 2016 #19
I wonder what Medicare or Medicaid would pay for the same test. n/t PoliticAverse Jun 2016 #8
I'm on Medicare, it paid 100%! B Calm Jun 2016 #15
100% of the allowable Sgent Jun 2016 #18
insurers don't want customers to use thier insurances, so KG Jun 2016 #9
It's a damn shame we were not allowed a public option on the ACA! B Calm Jun 2016 #11
Not to worry, the presumptive nominee is gonna fix all this with some pragmatic centrism Fumesucker Jun 2016 #14
This is why Clinton doesn't want single payer... TheProgressive Jun 2016 #22
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