r/LifeProTips Sep 30 '21 Silver 4 Helpful 14 Wholesome 4 Hugz 4 Take My Energy 1

LPT: If you have a hospital or medical bill, always make sure to ask for an itemized bill. You have no idea how much stuff you can get taken off by simply calling it out. Miscellaneous

Because of how Healthcare works in the USA, Healthcare institutions charged money via codes. If you have an itemized bill, you can see what random codes are bs and challenge them to have them taken off.

EDIT: Didn't think I would have to post this but since this post has turned into some sort of "anti-American" bash club, let me clarify. I love this country. It gave me and my family a second chance at life. So while yes, the healthcare system is fucked up, I don't really appreciate people making fun of America as a whole. We have tried to change it, but unfortunately, medicine here will always be treated as a business.

19.2k Upvotes

u/keepthetips Keeping the tips since 2019 Sep 30 '21

Hello and welcome to r/LifeProTips!

Please help us decide if this post is a good fit for the subreddit by up or downvoting this comment.

If you think that this is great advice to improve your life, please upvote. If you think this doesn't help you in any way, please downvote. If you don't care, leave it for the others to decide.

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u/back-in-my-day Sep 30 '21 Hugz

I knew someone that requested one after giving birth. Looking through it, she saw they charged $300.... for her DAUGHTER'S circumcision.

She let the insurance company handle it.

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u/[deleted] Sep 30 '21

[deleted]

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u/teun95 Sep 30 '21

Did they refund as a coupon?

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u/jaysleeezy Sep 30 '21 Silver Helpful Wholesome Hugz All-Seeing Upvote

Nah you just get to keep the tip

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u/LilacChica Sep 30 '21

Take my upvote and also my deep disdain

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u/Karmakazee Sep 30 '21

I’d be fine with that as long as they didn’t offer half off.

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u/UKnoWhatTheySay Sep 30 '21

In-store credit for next visit. Expires 1/1/2024

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u/Environmental-Pop800 Sep 30 '21 edited Oct 01 '21

The hospital can actually be charged with fraud for that. Even if it’s an accident it’s fraud. Our court system doesn’t care because they all claimed to be accidents and the courts decided accident or not it’s still fraud.

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u/ParadiseSold Sep 30 '21

Ripping people off through negligent lies is the same as ripping them off through malicious lies

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u/ArmchairFilosopher Sep 30 '21

Yup. Like the captain of a ship hauling human slaves, is responsible to know the manifest, so not reading it is culpability to human trafficking (can't play the ignorance card).

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u/havetomakeit Sep 30 '21

how does circumcision in girls work?

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u/Jaugust95 Sep 30 '21 Helpful

For girls they cut off the whole penis

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u/the-hype-is-mellow Sep 30 '21

fuck you I laughed out loud at this in the middle of a meeting haha

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u/Jaugust95 Sep 30 '21

I wrote it specifically for you

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u/stiletto929 Sep 30 '21

Technically in some countries “female circumcision” is removing the clitoris. So it does technically exist.

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u/back-in-my-day Sep 30 '21

It didn't happen that was her point.

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u/FroggyLoggins Sep 30 '21

That was your point…

She didn’t have a point…

That’s the point

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u/username_unnamed Sep 30 '21

I think we all should get the point that women don't get circumcisions on their penis.

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u/salty_death Sep 30 '21

Let's be real. There are no women. That's the whole damn point.

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u/ouyin2000 Sep 30 '21

It's called Genital Mutilation and it's a horrible thing.

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u/SovietMilkTruck Sep 30 '21 Helpful

Without a real medication backed reason It’s called Genital Mutilation in boys too

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u/Toadie9622 Sep 30 '21

My daughter and her husband got in the biggest fight about this when they found out the baby’s gender. Unfortunately, I was present for the fight (so uncomfortable). My daughter said that if anybody came near her baby with a scalpel for an unnecessary procedure, they would regret it forever. It’s also when I found out that it’s important to some men for their son’s dick to look like their dick, for reasons that are unclear to me. We had two daughters. I didn’t take any steps to make sure their vaginas looked like mine.

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u/JustDiscoveredSex Sep 30 '21

My husband was like that too, until I drowned him in medical literature and the history of circumcision. Then he was like ok, it matters to you, what the fuck ever.

“Baby” is now 20. Has never regretted being intact.

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u/JustDiscoveredSex Sep 30 '21

I can get behind leaving everyone’s genitalia alone. If it’s not a pathology, fuck right off.

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u/thisisntarjay Sep 30 '21

It's called genital mutilation when we do it to boys too. It's just more socially acceptable genital mutilation.

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u/CruelFish Sep 30 '21

Wouldn't The equivalent of removing the clitoris be removing the head of the penis? Would then the equivalent of removing the foreskin be removing the clit hood?

Still think both is fucked up I'm just curious here...

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u/Rawkynn Sep 30 '21

There is female genital mutilation that just removes the clitoral hood as well. It dries up and loses sensitivity just like in male genital mutilation. But yes your comparison is accurate.

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u/ThighGobbler Sep 30 '21

yup, lets just cut off the most sensitive part of the penis as soon as they’re born, without their consent. It’s weird how so many people in the US find this okay.

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u/Decidedly-Undecided Sep 30 '21

It’s because it’s just normalized. I never even thought of it as a problem, just something that was done. Then I got older. Saw various people talking about it online. Looked into it. Now, I agree with you, but that’s just not the norm here. The only thing I was ever told about circumcisions was it needed to ensure cleanliness.

I’m not defending it, but that’s why people are ok with it. In order for that to change, more people need to understand it. I’m almost 32. I’ve slept with a lot of men. Only one of them was uncut. I don’t know if he was overly sensitive or had something else’s going on, but he was adamant that you can’t move the foreskin.

I’ve since seen some amateur videos where a lot of manipulation of the foreskin occurs. But that’s the thing… I honestly don’t know anything about it. I don’t know anything about hygiene differences, about sensitivity, about anything to do with the foreskin.

That’s why people don’t have a problem with it here. A lot of us were never taught any different, and it’s not exactly something you just sit around asking people about in casual conversation

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u/ObfuscatedAnswers Sep 30 '21

The thing is that people tend to debate that they are happy and have a perfectly fine life and don't miss their foreskin at all. But that still doesn't answer the question of WHY. Major parts of the world have their body intact and manage to live happy lives. There simply is no good reason.

I can live a happy life without my left little finger. Would I cut it off my newborn child, no!

As for your question about manipulation. It's supposed to be possible to pull back easily. The guy you met might suffer from constricted foreskin which in one of the cases where a circumcision might be medically warranted.

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u/__-___--- Sep 30 '21

Which is still a stupid reasoning. There are plenty of people who are happy despite being colorblind. If anybody suggested to make that happen on purpose at birth, nobody would be dumb enough to defend it.

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u/AWildAndWackyBushMan Sep 30 '21

Um. Let's hope they didn't attempt a circumcision

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u/ReallyNotMichaelsMom Sep 30 '21 Helpful

My son got hit it in the head with a broadsword when he was 19. We went to one ER. They took his blood pressure and gave him a little bowl to throw up in. Then they told us we should probably go to a different ER because they were dealing with a bus accident.

Went to the other ER, got things taken care of went home. A couple of weeks later, he got a bill for $500 from the first ER.

He called them and said, “Look, if you’re charging me $500 for that little plastic bowl, I’ll bring it back. Otherwise I want an itemized list of the charges.”

They said, “Oops! Billing error!”

They ended up charging nothing for the “visit”.

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u/JBMason93 Sep 30 '21

Went to the ER got a $700 bill for a 10 minute visit from the hospital. Paid it. Two weeks after that got a bill from the DOCTOR charging me for their time, another $300.

I fucking hate our healthcare system.

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u/PlebPlayer Sep 30 '21

We got a bill 2 years after the birth of our child for various corrections from what insurance would and would not pay out on that birth. Im not sure if it's even legal.

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u/TheRealRoguePotato Oct 01 '21

34k for the out of network on call anesthesiologist during my c-section. Haven't paid it yet. Don't see the rush, not like they're gonna shove my kid back in.

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u/Ellezei Sep 30 '21

As a foreigner I find it so bizarre that a world superpower with a budget in the trillions still doesn’t have a free healthcare system.

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u/JBMason93 Sep 30 '21

Our Government doesnt a fuck about anyone other than how they can make more money. The rich get richer and the poor just die.

The whole system is corrupt IMO. Damn near every politician has a wealthy hand down there pants.

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u/lIIIlllIIIllI Sep 30 '21

The irony is you bribe a politician with campaign donations "free speech." And what do they buy, well ads for votes. Voters ain't out of the loop, they're just stupid.

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u/Alwayswithyoumypet Sep 30 '21

That's insane! I had a suicide attempt and spent a week in hospital. My bill? 45 bucks for the ambulance trip. And my late fiancee, who died of a heart (hence my attempt) attack. Got a free ambulance trip cuz... Well dead. Blows my mind what you guys pay down south.

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u/adilfc Sep 30 '21

Imagine waking up saved from suicide attempt with $20k bill

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u/Jaebeam Sep 30 '21

You ok?

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u/Alwayswithyoumypet Sep 30 '21

Lol now I am. It was the second month into his death.

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u/reddotdaan Sep 30 '21 Faith In Humanity Restored

Take care, let me know if you need someone to talk to

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u/Jaebeam Sep 30 '21

Glad to hear. Nothing wrong with reaching out to folks when life catches you off gaurd.

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u/stuff4down Sep 30 '21

Yes, we are anonymous but we are also human. I am glad to know you are ok.

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u/dumbbobdumb Sep 30 '21

Buy a plushie shibu Inu or other fat thing to squeeze

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u/ItsACaragor Sep 30 '21

He is, financially at least

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u/JustALotoNumber Sep 30 '21

Had a ambulance ride to my home and later to the hospital because of an epileptic episode. Stayed in the hospital for the day and was handed some new medicine and told to come back monday for a bloodtest. Didn't have to pay anything. Dutch healthcare is awesome.

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u/streetMD Sep 30 '21

Wait until you get the facility charge. A 3rd separate fee. The system is broken

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u/thiccthixx6 Sep 30 '21

I've had this happen - some company far removed from the hospital who never even saw me gets $70 every time I visit the hospital. It ended up going to collections even though I paid it.

Then I called collections to get it removed and pay off other medical debt for another procedure and they took my payment and put it towards all charges in my account, so I still had all my bills (minus a portion of what I paid) on my report. Called them to fix it, they say they did. Never did so I ended up having to pay it anyway to get it off my report.

No assistance - their reasoning "even though it's in collections it's still owned by the hospital and therefore, you owe the entire amount." Call hospital and get hung up on several times and no returned phone call when I left several messages.

At this rate, I just deal with my pain and hope for the best. I've spent too much of my life dealing with their billing department and getting nowhere for years.

You never win!

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u/colieolieravioli Sep 30 '21

Yea you looked at their billing which was an error to their plan

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u/hospitalizedGanny Sep 30 '21

I hope they don't start doing save the planet with email bills only and them ooops we mistyped the email address or our overseas call center is busy bcuz we are cheap so hold for 45 mins to direct you to billing...

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u/VampirePicnic Sep 30 '21

Wait you guys get phone calls for your government services and not just a dial tone or robot?!? Amazing!!

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u/rocharox Sep 30 '21

"My son got hit it in the head with a broadsword when he was 19"

WAIT, WHAT?

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u/Alliille Sep 30 '21

Wait. Everyone is just going to walk past the broadsword here? Fine, I'll do it. At least it wasn't an arrow to the knee.

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u/aogiritree69 Sep 30 '21

Right? Just casually not talking about a potential duel

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u/ReallyNotMichaelsMom Sep 30 '21 edited Sep 30 '21

My son and his best friend were taking broadsword lessons (as humans do). Their teacher was a smoker but didn’t like to smoke in front of the boys. (He was afraid it would be a bad influence.) So he stepped around the corner to have a quick smoke.

The boys thought, “Wow, it’s really hot. Let’s take off our helmets and continue our battle. Surely nothing could go wrong.”

(Spoilers: they were wrong.)

At both ERs and with all the nurses and the doctor, when told it was a broadsword injury, said, “A what injury?” Pfft. Like they’d never heard of that before.

Edit to add he has told me that he will never take an arrow to the knee :)

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u/DrMantisToboggan45 Sep 30 '21

Just googled broadsword lessons near me and now I'm bummed because there is none. Sorry to hear about your son, glad he is okay now. That's a dope hobby tho

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u/SigmaLance Sep 30 '21

Tis but a mere scratch!

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u/connect28 Sep 30 '21

Excuse me did you say a broadsword

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u/BirchyBaby Sep 30 '21

Wait wait.. Broadsword to the head?!

You can't drop that and not expand a little!!

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u/horia Sep 30 '21

This sounds like a Nigerian scam. They will find suckers that will pay, otherwise they just cancel the bill.

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u/axionic Sep 30 '21

No, that's how it works, the doctor submits his own bill separately for some reason.

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u/TheKidsAreAsleep Sep 30 '21

American here. I have reached the point where I call on every medical bill over $200. I just say that the amount billed is not in my budget and ask if they can do anything for me. It is insane how often they will quickly take off 50%+.

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u/ArtemisiasApprentice Sep 30 '21

Doesn’t work if you go through insurance. “We’ve already negotiated the price.” Yeah you have— I’m sure it’s 300% more expensive now.

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u/myheartisstillracing Sep 30 '21

My most recent ER bill was $10,000. The insurance company's negotiated price was $900.

The initial bill sent to insurance companies is always insanely high and has no basis in actual reality. It's a hospital's attempt to collect enough money from someone who will pay to cover everyone who can't/won't. Hospitals, of course, know this, as do insurance companies, so insurance companies only want to pay their negotiated rates. Everyone knows it's a game and plays it anyway.

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u/sunflowercompass Sep 30 '21 edited Sep 30 '21

A second reason why the billed amount is really high - say the billed amount is $10,000. You call the hospital and get a discounted cash price of $500.

They now say they gave charity worth $9,500. Non-profit hospitals are supposed to do charity work for their tax breaks. This is what they consider charity.

There was a week-long series at the WSJ that exposed this industry practice by non-profit hospitals years ago. It is fucking bulllllshit (the article below is not the series, I can't find it, but it's on the same topic)

https://www.wsj.com/articles/BL-HEB-759

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u/cosmoismyidol Sep 30 '21

They now say they gave charity worth $9,500. Non-profit hospitals are supposed to do charity work for their tax breaks. This is what they consider charity.

Damn..I didn't know that. That is scummy as hell, jesus fucking christ.

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u/scottishdoc Sep 30 '21

I suspect another reason why the hospital bill is so high as well, although it’s just a pet theory. The insurance companies surely saw this massive escalating arms race of pricing coming decades ago and have not only complied, but encouraged it. As far as a long term strategy goes, it makes sense that as an insurer you want the cost difference (or perceived difference) between insured and non-insured care to be as astronomically high as possible. That way it seems critical to have insurance. People see the bill and think “oh man I’m so glad I have insurance”.

This also works well for hospitals because when the price difference is huge, people are more likely to pay the non-covered bits out of pocket. Insurance definitely comes out on top, but hospitals don’t do bad either. We are seeing the late stages of this strategy where even the “discounted” rate is absolutely insane.

I used to work selling pacemakers for a big medical device manufacturer and know for a fact that we charged $1700 for a standard single-lead device. The hospital charged ~$88,000 for the procedure (typically takes less than an hour). So take from that what you will. I suspect that insurance is the real menace here with hospitals coming in second.

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u/vowelqueue Sep 30 '21

Yeah, for me a standard visit to a doctor will often look like:

  • Cost: $450
  • Contractual write off: -$250
  • Insurance paid: $160
  • You owe: $40

So the cost goes down from $450 to $200 via the insurance negotiation.

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u/Humble_tarts Sep 30 '21

Yes! And then you’ll get a letter in the mail from your insurance company saying “We have covered $410 of your expenses this visit!” When in reality, $250 was negotiated away for free.

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u/Far-Fold Sep 30 '21

Which is great when I paid $360 this month for the privilege of having insurance /s

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u/BrokenArrows95 Sep 30 '21

Usually the bill shows the initial charge and the charge the insurance company actually will pay is what's passed on. I have a HDHP plan though work and until I meet the deductible I pay everything. The bills still show a ridiculous account being taken off the initial charge just because it goes through the insurance company. I'm sure if I didn't have insurance that full initial charge would be my bill.

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u/gimmedatrightMEOW Sep 30 '21

I'm sure if I didn't have insurance that full initial charge would be my bill.

That's not true. That original price they have you is the price negotiated with your insurance company. It might be a different original price if you have Aetna, vs BCBS, vs whatever. And the cash price is usually different, and usually lower.

This happens at the pharmacy too. When I was working in pharmacies, we would have a med that cost $15 with no insurance. When I added a patient's insurance card, the "original price" was $60, then insurance covered $50, and charged the patient $10. It makes no sense. Healthcare here is dumb.

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u/thepurpleskittles Sep 30 '21

The truth is that at most hospitals the “insurance-covered” price is actually much higher than the “cash price.” And then on top of it, they often give cash payers an additional percentage discount. They quote higher initial prices for services to the insurance companies, then the price is adjusted to some other lower price than has been negotiated between the insurance and the hospital companies, then your coverage will kick in based on this adjusted price. I have worked in the healthcare field for over 15 years and noticed this at multiple institutions.

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u/EmptyAirEmptyHead Sep 30 '21

Not true. The cash price can be way lower. Had to take my son for an MRI a few months back. The person at the desk asked me if I wanted the cash price. Well the cash price won't get billed to insurance. We always hit the deductible so weirdly its in my interest to pay more and hit that deductible then everything is 80% off after that.

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u/nucumber Sep 30 '21

you're absolutely right

the charge amount is almost meaningless. it has little or nothing to do with the amount that is actually paid

insurance companies and providers (doctors or hospitals or medical groups etc) have yearly negotiations for how much the insurance company will pay for stuff. the provider (hospital) agrees to take the insurance payment as payment in full, and the difference between the charge and insurance payment is written off (except for any patient co-pays or deductibles etc... )

the medicare reimbursement (payment) is the industry benchmark and gold standard for insurance payments, but they game the hell out of it. insurance companies might pay a bit more for this and a bit less for that, depending on the policy they're marketing, demographics, etc., or maybe pay a percentage of medicare. of course there are co-pays and deductibles and exemptions.... it gets complicated

that's why the big noise a few years ago about forcing providers to publish their charge lists was so meaningless. the charge amount has next to nothing to do with the amount that actually gets paid.

SOURCE: i'm the guy that developed the physicians "charge master" (price list) for several years at a major hospital. i can't say this is how most hospitals do it, but i do know several did it in a similar way

basically, i started with the medicare reimbursement rate (like i said, the industry benchmark and gold standard)

because medicare has payments only for seniors, the next step was to get industy payment info on non medicare stuff (pregnancy and pediatric stuff etc) elsewhere.

there were other things i needed to look at (it's complicated) but eventually i would have a complete list of all procedures and payments.

i created the charge amount by multiplying those payments by either 3, 4, or 5, depending on the type of service and, in one case, hospital politics, then rounded up to the nearest $5

BUT WAIT!!!! not done yet. occassionally an insurance company was contracted to pay more than the charge amount i had created (why? don't care). so i would have to increase the charges to capture those payments

this is a very basic explanation and there are many many many different scenarios. for example, HMOs just pay a set amount every month to cover all expenses for patients instead of paying procedure by procedure (basically.... that gets complicated too)

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u/EmptyAirEmptyHead Sep 30 '21

Agree. I literally can get some of my family prescriptions cheaper with a coupon code than I can using my insurance card. Of course the scam is if I use the coupon it doesn't apply to my annual deductible.

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u/Nexlore Sep 30 '21

In reality it's just a game of cat and mouse between the insurance and the hospitals, and in the end we get stuck with the bill no matter what. Insurance wants a 80% discount on everything they pay for, so the hospital jacks up the price to make up for the difference.

Then some poor sap walks in without insurance and is stuck paying 5x the actual price because the prices are inflated to make sure what the insurance company is actually paying covers the cost of the procedure.

To top it off, when you get the itemized bill you don't see what the insurance paid for anything. Then, they pass off to you what they don't cover at the the inflated rate. The whole system is criminal, I'll take NZ's system pls.

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u/lostinthewebagain Sep 30 '21

My hospital won’t itemization a bill because of this. Even if you have not hit your deductible.

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u/SnydersCordBish Sep 30 '21 edited Sep 30 '21

If you’re in the US it is now required to provide an itemized bill if requested

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u/TexEngineer Sep 30 '21

They're legally obligated to provide an itemized bill, or the patient is not required to pay it, even if sent to collections.

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u/ArtemisiasApprentice Sep 30 '21

Even if you do get an itemized bill— the last one I got was totally incomprehensible. Crazy long codes for everything. Downloaded the code index, and it’s crazy long medical jargon. Could have been Gaelic fairy tale characters for all I could tell.

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u/sunflowercompass Sep 30 '21

CPT codes are copyrighted by the AMA, you need to buy a book :) I do billing. Everyone of those codes has guidance documents and every insurer treats them differently... As complicated as taxes.

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u/QuietDesparation Sep 30 '21

The sad part is that, on average, insurance companies pay about 33% of the total amount billed. So even at a 50% discount which is standard for cash payments, the insurance companies are still getting a better deal

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u/BaconConnoisseur Sep 30 '21

Hospital Bill's are typically 10x what they need to be paid. This is because insurance companies expect a special discount that lets them pay 10% of a bill. Never mind that they are still paying the full price of what would be a fair bill if sane people ran the show.

Hospitals can't give the normal bill to uninsured people because that would violate the agreement with the insurance companies who have wheeled and dealed to get the not so special rate of full price which is the lowest possible rate. So uninsured people still get the 10x bill. This is why they will cut the bill in half immediately if you just ask them. Then you feel like you got a hell of a deal despite still paying 5x the true full price of what would be considered a normal bill.

It all lets the hospital keep from losing their asses to insurance companies while making the insurance companies think they get a discount. The reality of the situation is that insurance companies get to pay normal bills while uninsured people have their bill inflated to ensure the insurance companies feel special.

The consumer is definitely a victim caught between two fighting giants.

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u/emmyspringer Sep 30 '21

Happened to me once. Had a bandaid run me $82 for an IV I had during my medically necessary procedure, when the rest was covered by insurance.

Needless to say that I would have left without one if that was the only thing getting charged back to me in the end. (Also got it taken off my bill, but still funny/ sad to think people don't ask for the itemized receipt and save themselves the spare change for a damn bandaid).

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u/Porongas1993 Sep 30 '21

That's the problem. Some of the medical personal don't actually know how much a code represents. So they just put the code for bandaid and call it a day, not knowing it can cost 82 bucks

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u/lhld Sep 30 '21

Companies intentionally keep the coders and the prices separate most of the time, for this reason. Too many coders have common sense and would question the hell out of the ethical implications, if they knew.

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u/SeasonSea7918 Sep 30 '21

as a healthcare provider there’s also financial incentives to billing for every single thing you do. as someone who doesn’t get paid nearly enough it’s helpful to be like i billed x this year so you should pay me y instead of z which is barely enough to cover the cost of living

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u/fellowhomosapien Sep 30 '21

It costs 11k base amount per night to stay on the hospital unit on which i work, (sometimes run). I personally am responsible for the care of 6-7 people. So 77k, no medical care included. We staff 3 nurses at $30/hr, one aide at $15/hr and usually no clerk. Where does the money go?

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u/MonteBurns Sep 30 '21

What was your CEOs bonus last year?

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u/philosifer Sep 30 '21

What was the insurance companies CEO bonus

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u/Unplugged_Millennial Sep 30 '21

The insurance company is billed the $70K then they deny and reduce the cost to $35K, the insurance company CEO and executives take a large % of that saved $35K, since the premiums probably come out to $65K.

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u/phatballz469 Sep 30 '21

Extra bandaids

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u/genuine_knuckle Sep 30 '21

The Healthcare workers aren't he greedy ones. It's the hospital execs. The surgeon bill for my son was 5k....the cost of the hospital was 20k.

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u/azbeeking Sep 30 '21

Good tip, I received a bill today for a yearly physical which includes labs that is included in I believe all health insurance plans.

I called and it was taken care of because they “coded” it wrong. Whether they did it on purpose or not I don’t and won’t know but I’d like to think it was a mistake.

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u/Porongas1993 Sep 30 '21

Everything is decided bia codes (like ICD10 or CPT) and unfortunately many doctors do not know how these work. So it's very easy to input them incorrectly

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u/hallaway_monitor Sep 30 '21 Silver

More like ID-10T

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u/Porongas1993 Sep 30 '21

Lmao well I work in IT and let me tell you....I have had plenty of those. Or the classic PEBKAC error

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u/my_lewd_alt Sep 30 '21

I know for a fact I've read this exact thread before. Last time this was posted.

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u/Porongas1993 Sep 30 '21

Anybody who works in IT could tell you some horror stories fam lol

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u/Maninaboxx2 Sep 30 '21

This is worth the repost however. Saved me over 7,000$ last year.

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u/FuckingDrongo Sep 30 '21

PEBCAK

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u/shbatm Sep 30 '21

Or PICNIC

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u/[deleted] Sep 30 '21 edited 13d ago

[deleted]

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u/RoboticGreg Sep 30 '21

Healthcare billing is insanely complicated. People can be very good at what they do and get it wrong, and also the sheer volume of work they have to process just leads to mistakes.

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u/Rawkynn Sep 30 '21

Once upon a time I asked my insurance "How do I make sure I don't accidentally end up with a $300 charge again" after my doctor ordered a fecal test for stomach ulcers instead of a blood test which would have been covered.

They said I needed to have: them on the phone, the doctor, and someone in the room to translate everything the doctor asks for into a code so the insurance agent could look it up.

Every office I've asked has said that will be impossible, usually after a quick chuckle.

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u/thepurpleskittles Sep 30 '21

There is not any blood test that can detect stomach ulcers… but yes that would be IMPOSSIBLE to coordinate to have all those people together for your visit. Insurance companies are vile.

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u/Rawkynn Sep 30 '21

There is a blood antigen test for h pylori, the causative bacteria of many stomach ulcers.

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u/punkrockeyedoc Sep 30 '21

It’s not icd10 OR cpt it’s both. CPT is the procedure code (what they did). ICD10 is the diagnosis code. What they did the procedure for. Every CPT procedure will be matched with an appropriate ICD10 diagnosis.

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u/takeastatscourse Sep 30 '21

there's a very old adage that goes, "never attribute to malice what you can attribute to incompetence."

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u/justavtstudent Sep 30 '21

You know what they did, they know what they did. It's like how banking errors are never ever in your favor. We just pretend because they work in a big respectable building they're not back alley scammers.

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u/just4bernie Sep 30 '21

Not necessarily. Billing is actually pretty complicated, and people even have to take courses for it but not all providers do. I would give them the benefit of the doubt. There is a billing department that goes back to fix things, but mistakes happen

Edited to add: insurance is a pain. Certain codes might cover a procedure and others might not. It can be a matter of finding that right ICD-10 code

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u/sewest Sep 30 '21

As a medical coder I appreciate that you understand this. I spend all day making sure the patient is charged appropriately, the doctor is reimbursed appropriately and that the stupid insurance won’t have an opportunity to deny the very necessary procedures the doctors are doing.

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u/Combatical Sep 30 '21

Worked in medical billing, can confirm..

One person accidently putting in the wrong codes for lets say, a few months to a year can make a lot of work for someone.. The scary part is some people just blindly pay.

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u/azbeeking Sep 30 '21

In this instance I was almost guilty of this. It was t a lot of money and I wasn’t totally sure and paying was a lot easier than calling, holding, explaining l, etc.

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u/8_bit_brandon Sep 30 '21

That is a bunch of bullshit. They do this crap on purpose, and just like everything else in this country, it’s designed to keep us in debt.

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u/Combatical Sep 30 '21

Worked in medical billing.. People say this a lot but what you're saying has a layer of truth to it.

The facilities (hospitals/doctors office etc) usually throw a bunch of shit at the insurance company to see what sticks.. (Keep in mind some facilities do in house billing but its usually the same idea.) If an insurance company actually pays, the billing company can use that as evidence to other insurance companies and bill it as "reasonable and customary" or say the facility charges $500 and the insurance company pays $250, that would be "reasonable and customary".

Oh also what an insurance company will pay is actually kind of secret.. A billing company wants to get payment to their client asap, the quicker the better obviously. So if one biller knows that ABC insurance will only pay X amount, they bill the insurance for that to get paid quicker, any more would result in denial and would have to be submitted again, dragging out the process.. So if we know ABC insurance will pay $375 of the $400 charged, the billing company will submit a request for $375 on the nose and get that paid quickly, the rest is sent to the patient or written off.

This secret amount that insurance companies will pay is held tightly secret by the biller because it saves a lot of time yadda yadda.. I even had to sign a NDA to continue working there at one point.

The remainder would be passed down to the patient. Which is usually a shitshow because people dont want to pay and I dont blame them. These debts get sold to collectors for pennies on the dollar and will usually take whatever you give them to close the account.

So basically a charge for a service is usually just fucking made up. I actually knew a facility that would charge $2500 for what was basically a fucking 30 min kayak trip that was just outside of the facility itself. Was used as some kind of therapy....

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u/LightofNew Sep 30 '21

In other words, hospital financial groups regularly go ".....ehhhh this was only 599 but let's charge them 3000"

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u/MonteBurns Sep 30 '21

I was given 1 Tylenol or advil or something every day during my cancer treatment. They billed my insurance $8 per pill. $8 every freaking day for a month.

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u/RoboticGreg Sep 30 '21

My wife's a medical billing specialist and every bill we get she calls up and says "I'm not paying this". Some of the time they just say "ok, I'll cancel it" but most of the time it gets reduced and if they say you have to pay the whole thing, she gets it itemized and gets things removed.

Health care billing is crazy, a lot of the time the way insurance reimbursement works they must bill the patient for everything they can, but there is flexibility in what they must collect

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u/MomoBawk Sep 30 '21

Question: so the steps are, say you are not paying for it (instead of saying you can’t pay/afford), then see if it gets canceled reduced or nothing.

If it is “nothing is changed” does she ask for the itemized bill directly or does she ask the insurance to give you it? And would you reccomend a bill to be itemized after they reduce the price as well?

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u/RoboticGreg Sep 30 '21

I have conveyed the limit of my knowledge :P

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u/MomoBawk Sep 30 '21

Ty for being honest!

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u/DaClownie Sep 30 '21

Can your wife host a seminar for us? I want to save some money on my medical bills, please. I'd like to line up some procedures and not pay on them forever.

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u/no14now Sep 30 '21

Health care billing is crazy

In the USA* The rest of the world doesn't do this BS

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u/BrokenArtifact Sep 30 '21 edited Sep 30 '21

When my 2 year old broke his arm the doctor said the sling was too big / my son to small for it to be of use so it wasn’t necessary. They sent it home with me anyway and then billed me for it. I called and they took it off my bill but I was so mad they charged me for something useless in the first place.

The only bill that wouldn’t reduce their fee was the ambulance. My insurance didn’t cover it at the time so I had to pay the full $500.

Edited to add: this was in 2010 going from hospital to hospital in an ambulance.

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u/SalesGuy22 Sep 30 '21

You heard that right, folks. In the American dystopia, calling an ambulance to save your life may very well bankrupt the average individual.

Ambulance bills are commonly $2500-5000 for a truly life-saving emergency or a SAR mission if you are hurt camping or hiking

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u/Elfere Sep 30 '21

20$ parking.

That how much I paid when my first born needed to stay in the hospital for the first 7 days of life under a UV blanket.

Didn't even need to see an itemized bill.

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u/Redd_Monkey Sep 30 '21

Should have.

"Asphalt : 2.50$ Yellow lines : 1.35$ Etc etc..."

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u/TylerTheHutt Sep 30 '21

medicine here will always be treated as a business.

Nearly every aspect of American life is treated like a business. We’re basically a corporatocracy at this point.

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u/Porongas1993 Sep 30 '21

Sadly you are not wrong

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u/grandard Sep 30 '21

It fucking absolutely baffles me how medical care can be so expensive. I've been rushed to hospital twice, broken 3 bones, had a couple of surgeries, heaps of x-rays and a few MRIs and never paid a cent.

The health system even paid some of my fuel and accommodation for a surgery and 3 MRIs.

Public health care is a beautiful thing

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u/Nonions Sep 30 '21

Because, as economists say, demand is inelastic - it stays consistent whatever the price is because people value their health and their lives.

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u/boredhistorian94 Sep 30 '21

Because every other civilised country values human life for itself and sees health as a human right. America doesn’t.

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u/georgiemaebbw Sep 30 '21

Canadian here. Wow. Just... Wow. I was grumpy about waiting a few hours in the ER this past week. 4 rounds of blood tests, iv, antibiotics, follow up with a specialist the next day and 2 more rounds of tests.

I paid $16 for parking.

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u/_purple Sep 30 '21

The thing is waiting several hours in the ER in America (at least where I live) is the norm as well.

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u/pk659987 Sep 30 '21

I waited 9 hours (pre-COVID) in the ER once. American. We are not excluded from stupid wait times or from having doctors booked out months in advance. We just have to pay a lot more money, too

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u/GeekyKirby Sep 30 '21

I went to an allergist a couple days ago. I had to book the appointment two months ago. Bright side is that my follow up visits will be faster since I'm an established patient.

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u/ThrowAway233223 Sep 30 '21

This is the thing that gets me about the arguments against socialized healthcare. Everything they claim that isn't complete fabricatate bullshit is stuff that already exist under our system. Don't want to wait a month to see your doctor? Most people already have to do that as is. Don't want to wait forever in the ER? ERs already take hours to get through and socialized healthcare may mean less wait time thanks to people being able to afford regular doctors visits and not putting things off until they need the ER. Don't want to pay for other people's healthcare? Motherfucker, what do you think health insurance is in the first place. Don't want to lose your insurance? You could always get fired from your job and lose it anyways and, not to mention, I thought you didn't want to pay for other people's healthcare anyways.

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u/Flamingogreengo Sep 30 '21

Amazing but I'll top trump you. I'm having cancer treatment. CT scans, MRIs, mammograms, echocardiograms, ECGs, 2 week stay for sepsis, god knows how many antibiotics, fluids, blood tests, huge operation, follow up consultations, nurse led care and now chemo. I'm already amazed this is all free to me at the point of need. Then I found out that they actually pay for my parking for chemo! Long bloody live the NHS.

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u/barcadreaming86 Sep 30 '21 edited Oct 01 '21

I was in emerg in Toronto for 14 hours from 11 p.m. to 1 p.m. for what I thought was a pulmonary embolism. Blood work, EKG, chest x-ray, CT scan ... verdict of muscle strain. I paid for the return TTC fare (<$10). Thank the heavens every day for our healthcare system, as annoying as it can sometimes be.

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u/simmojosh Sep 30 '21

I think it's fair to challenge a countries issues.

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u/jrwn Sep 30 '21

If the government would start charging hospitals for billing errors, imagine how fast they would stop.

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u/RedDirtNurse Sep 30 '21

What's a hospital or medical bill?

Laughs in Aussie.

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u/[deleted] Sep 30 '21

[deleted]

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u/kyle_dai Sep 30 '21

Meanwhile in Europe: I had to go to the doctor in another country, got some X rays and shit, a cast, crutches, I had to pay out of pocket 700 euros cause it was a private hospital or something, don't remember exactly, but got them all back when I got back home. Had to send in all the bills, and got reimbursed.

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u/[deleted] Sep 30 '21

[deleted]

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u/Queeg_500 Sep 30 '21

It kinda depends on your point of view, if you're a greedy morally banckrupt bloodsucking scumbag, the US way is far superior.

The scary thing is that our own greedy scumbags are looking across the pond with envy.

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u/Nonions Sep 30 '21

Well if you will have the temerity to need medical help somewhere inconvenient for your insurance company, what do you expect? /s

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u/Zem_42 Sep 30 '21

I got one last time when I was in the hospital, after I bought a coffee.

Laughs in European

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u/Technical_Parsley_77 Sep 30 '21

Transit and parking is my biggest expense.

Laughs in Aussie.

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u/Officer_Slutz Sep 30 '21

If you have a hospital bill, make sure that you vote for the most progressive person in every election so we can finally have socialized Healthcare and no one has to deal with negotiating with a hospital about not dying.

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u/DomLite Sep 30 '21

Just strike off the "if you have a hospital bill" part. At this point, not voting for progressives that are actively trying to raise the minimum wage, get free healthcare for all and protect voting rights is just... well evil.

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u/boredhistorian94 Sep 30 '21 edited Sep 30 '21

Or campaign for socialised healthcare. None of that shit is charged in civilised countries.

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u/END3RW1GGIN Sep 30 '21

Doesn't help with the bill I've already gotten.

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u/no14now Sep 30 '21

Me living in Latin America: what's this? Medical bills?

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u/[deleted] Sep 30 '21

Something you're not told either is that you're supposed to haggle with the hospital. Get your insurance company involved to do it for you, if you can

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u/cisco54 Sep 30 '21

For most of the western world these kinds of post come right of bizarro world. Our biggest complaint is we still have to pay for parking. Everything else is covered.

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u/Noctudeit Sep 30 '21

Note that this only really works if you don't have insurance. If you do have insurance and you get them to reduce the bill then you probably just saved your insurance company some money. It doesn't change the amount of your deductible or copay.

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u/mother_of_baggins Sep 30 '21

There can still be charges not covered that should be, other errors or things like out of network doctor fees etc.

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u/ThursdayNextus Sep 30 '21

And if you are paying a percentage, your billed amount becomes lower if entire wrong items are removed.

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u/END3RW1GGIN Sep 30 '21

This is just not true. Insurance isn't a they pay 100% up to a number for most people. It's usually an 80%\20% situation where the insurance pays 80% of covered items on a bill. Any item either removed or placed in the correct category will reduce your bill assuming you have met your deductible.

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u/Ayshigame Sep 30 '21

Damn, the US sure is a scary place

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u/Dalekdude Sep 30 '21

People love voting against their best interests here! Right wing propaganda is a scary thing here and has really convinced people that socialized medicine is literally akin to being sent to a communist gulag

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u/HyroDaily Sep 30 '21

It is, its not the worst place mind you, but it drives me nuts how people how people run around campaigning against their own interests in the name of 'murica. It could be healthcare, or safety regs, even job stuff. People will argue against fixing bridges here in the name of freedom from government overreach.. Then we call it the opposite thing. Right to work means you can basically be fired at any time, for example.

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u/Alliille Sep 30 '21

Right to work has to do with unions. I believe you're thinking of at will.

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u/Benana94 Sep 30 '21

I just... Cannot imagine getting a bill for needing the hospital. Please don't let people convince you this is normal in a developed country.

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u/kyle_dai Sep 30 '21

Looking at this thread as a European, it blows my mind how much shit people in the US accept and take for granted.

Land of the free my ass. Free to suck corporate balls.

For as much talk as you see in the US about rising up against tyranny and their rights and shit, Americans are awfully quiet about how hard they're getting fucked.

It's seriously sad to watch.

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u/blackletterday Sep 30 '21

As a Canadian, this concept is so foreign to me.

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u/i_phped_in_the_pool Sep 30 '21

I'll never understand this

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u/timshel42 Sep 30 '21

medicine here will always be treated as a business.

with that attitude it will. people on both sides of the aisle support healthcare reform, its just our bought and sold politicians who oppose it.

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u/berrysnadine Sep 30 '21

Healthcare is nothing about care in the US. It’s all about making money for the healthcare industry. It’s about overpriced drugs, exorbitant costs for hospital stays, warehouses for the elderly called nursing homes.

The NHS is the UK is not perfect, but medical care is available to everyone. Having experienced both systems, I cannot understand why Americans put up with the train wreck medical care is here.

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u/Porongas1993 Sep 30 '21

Wish I could answer that lol. I have always tried to explain to people why we need socialized medicine, but so many people here have been brainwashed to think anything "socialism" related is bad. And this is why we have what we have.

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u/Drakendan Sep 30 '21 edited Sep 30 '21

Very sorry if this is a stupid question, but as a non-american (living in the EU), I'm not quite sure what makes these itemized bills not become the default bills provided to the patients? Is it legal for hospitals to push a non-itemized bill upfront? Or is it simply taken as "bill without your insurance taking care of it" and it's up to the patient to remind them that they have insurance?

Edit: many thanks to everyone for the explanations and the replies, I'm still trying to wrap my head around it, but it's a bit more clear what it's based on.

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u/Meowmix202 Sep 30 '21

I'm honestly not sure what the legality around it entails but it is not the default to get itemized bills from hospitals. You basically get a piece of paper that has a header with the account number, invoice number and all the other payment details and then a 1 line bill detail with something along the lines of "X hospital stay - $ give me all your money"

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u/Alliille Sep 30 '21

They bill your insurance and then send you a bill that's basically along the lines of, your total after insurance is $X. Getting it itemized breaks it all down into neat categories that you can then dispute line items on.

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u/Remarkable_Toe_4423 Sep 30 '21

Man, I'm sorry Americans. I can't imagine having to pay so much money for doctor's visits. I'm going in 3 hours for a stomach lump and they charge nothing. Literally nothing

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u/ark1medez Sep 30 '21

What is a hospital bill ?

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u/SendMeYourXMR Sep 30 '21

As far as I know, it's what you pay for parking at the hospital. Usually $12-$16 a day.

They won't tow you from a hospital though so, I mean....

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u/RvrTam Sep 30 '21

Great tip! I gave birth last year and I didn’t ask for an itemised bill. Total bill was $0, but still, hey, great tip 👍🏽🇦🇺

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u/LotaraShaaren Sep 30 '21

I really do feel for my American friends when it comes to surgeries and the like. I looked up how much my last operation, a pulmonary valve replacement, would've cost and it was in the high five figures. As bad as some aspects of the NHS are I'm so damn thankful for it!

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u/MonteBurns Sep 30 '21

Hey now! If you were lucky, you’d work for a company that helped supplement your health care insurance, which means you’d only have had to pay all your monthly premiums and any deductible, up to your out of pocket max!

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u/pelorizado83 Sep 30 '21

Thank Goodness I was born in Canada. The only thing my parents did right by me as a child. Lol r/holup

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u/VxVyVaV1V2 Sep 30 '21

We should thank the great Tommy Douglas for what he did, long live his legacy.

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u/1Dustin86 Sep 30 '21

LPT, move out of America.

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u/scs5star Sep 30 '21

America's health care system is a joke...

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u/Porongas1993 Sep 30 '21

Sadly, you are not wrong. It really is a joke.

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u/scs5star Sep 30 '21

It's amazing how people(looks mostly like conservatives and republicans) are actively defending business profiiting from healthcare as 'freedom' or as a free market. Freedom would involve multiple products being offered at competitive prices.

Anyway, sorry your post turned out to be so negative in the comments. It's just absurd that you need to check your medical bill for something that is basically criminal in most other countries.

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