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On 08/26/09 08:51, Tom Austin wrote:
> The provider charges $1000 for a procedure, yet the health insurance
> company pays only $200 and due to an agreement with the provider the
> difference ($800) is waived.
> The provider got only $200 for the service and somehow is able to stay
> in business.
> Yet, if I did not have insurance, the provider would charge $1000 and
> attempt to receive it from me - $800 more for the exact same procedure.
> If the provider is willing to accept $200 for the procedure, why do they
> charge $1000?
To make up for the amount they lost.
Many of the doctors/hospitals contend that they *cannot* stay in
business if they keep accepting the negotiated rates that insurers
demand. So they charge people who aren't insured to recover as much as
they can.
It's a well known "policy". They've admitted to it at various times.
> So what do I find disturbing?
> That there is such a LARGE difference between what the provider is
> willing to accept and what they try to charge.
It's not so much that they're happy to accept the reduced rates.
There's a bit of arm twisting by the insurance companies.
And then when a hospital gets big (top 10 in heart care in the country,
for example), the process is reversed and they twist the arms of the
insurance companies.
--
Feet Smell? Nose Run? Hey, you're upside down!
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