Medical Bills and Being an informed consumer - vent

[pamjb]

1.
5. I contacted the hosp and found there is a discount 5% is I pay the bill in its entirety in 30 days...soo, maybe that will at least save a little.

This typically is for non-insured patients. My youngest was a patient at Children's Hosp in Philadelphia last year and my portion was $1800. They have the same note on the bills about the 5% discount, but that applies to non-insured patients.

I have a $3200 ded 80/20 plan for participating providers. I have a pretty good handle on this, due to the fact that I work for the insurance company. But all of them have different rules. As for the drug, some chain pharmacies have a negotiated rate with the insurance company for certain scripts. So a drug could be cheaper if you pay without an insurance. I know, it makes no sense to me either. I only follow the rules of the insurance, I don't make up the rules. But you also have to remember that sometimes it is the policyholder (your employer) that makes up the rules.
It depends on what type of contract arrangement that the hospital has with your insurance company. Some are paid based on a percentage of the charges. In which case you can dispute certain charges on the bill. Other hospitals are paid based on a case rate for a certain procedure. Which means, that for a c-section the insurer pays $xxx.xx no matter what. So when you speak to the billing dept, you can ask that. If it is a case rate, than you will know what you will be responsible for. If it is a percentage, really, there is no way of telling.

 

[ccgirl]

This typically is for non-insured patients. My youngest was a patient at Children's Hosp in Philadelphia last year and my portion was $1800. They have the same note on the bills about the 5% discount, but that applies to non-insured patients.

I have a $3200 ded 80/20 plan for participating providers. I have a pretty good handle on this, due to the fact that I work for the insurance company. But all of them have different rules. As for the drug, some chain pharmacies have a negotiated rate with the insurance company for certain scripts. So a drug could be cheaper if you pay without an insurance. I know, it makes no sense to me either. I only follow the rules of the insurance, I don't make up the rules. But you also have to remember that sometimes it is the policyholder (your employer) that makes up the rules.
It depends on what type of contract arrangement that the hospital has with your insurance company. Some are paid based on a percentage of the charges. In which case you can dispute certain charges on the bill. Other hospitals are paid based on a case rate for a certain procedure. Which means, that for a c-section the insurer pays $xxx.xx no matter what. So when you speak to the billing dept, you can ask that. If it is a case rate, than you will know what you will be responsible for. If it is a percentage, really, there is no way of telling.

Actually, you would be surprised...I used to work in a Billing Office of a hospital. Many have financial incentives for paying your bill even if you're not self-pay. As long as the patient owes a portion...they want the $$ and they will offer incentives to get the money as quickly as possible.

OP - the cashier's office should definitely help you. As someone said, ask them what their standard charge for a C-section is and the associated cost. They should have a bundle of CPT codes they use for C-sections and they should be able to give you their associated charge.

Good luck!

 

[NYEmomma]

This typically is for non-insured patients. My youngest was a patient at Children's Hosp in Philadelphia last year and my portion was $1800. They have the same note on the bills about the 5% discount, but that applies to non-insured patients.

We've got insurance coverage and with DH's recent appendectomy, the hospital bill that arrived said that we'd get a 10% discount if we paid in full within 30 days.

The same thing also happened when we got bills from the Children's Hospital for my high risk pregnancy appts with Maternal Fetal Medicine. It didn't mention a discount on the bill, but when DH called to request an itemized bill (their bill just lists "forwarded amount" and the $ amount that is due) they said that if he paid within 10 days, we got a 10% discount.

 

[dragonfly57005]

What irked me when I had DD was that there were some state mandated tests we had to have before the hospital would release our daughter. There was only one doctor/company that does the test (the hearing test) in the hospital. Apparently, even though the hospital was in-network, the doctor that works in that hospital wasn't, and we had to pay for the stupid test. (After paying $25k for the fertility treatments, the cost for that test was minor, but it was the principle of the matter...)

I hate health care plans! (Although so far I'm not totally loathing the plan we're on now - they actually covered our fertility treatments for #2 so far!!)

You should be able to decline their testing. Ask for proof that they can't release the baby.

 

[teacup princess]

Getting a discount from the hospital for paying quickly or upfront really depends on the hospital. I tried that after my dd was born and was told no-way no-how. They were willing to set up a financing plan with no interest for basically any dollar amount per month so .

And at the pharmacy there really is no hidden agenda there. Pharmacies do their billing in real-time online so it takes them some time to input the information into the computer and get a price. You definately don't have to buy it once it's filled.