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(Boston.com)   People going to doctor's office surprised to learn they were in a hospital operating room. Welcome to the wacky world of medical billing   (boston.com ) divider line
    More: Interesting, medical billing, American Hospital Association, teeth cleaning, anesthesia, Medicare Payment Advisory Commission, Cigna, former sovereign states  
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3758 clicks; posted to Business » on 27 Jan 2013 at 1:34 PM (3 years ago)   |   Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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Pud
2013-01-27 10:49:07 AM  
t3.gstatic.com
 
2013-01-27 11:27:47 AM  

Pud: [t3.gstatic.com image 232x217]


You must be pulling my leg.

/With a username like that, I sure hope it's my leg
 
2013-01-27 11:44:22 AM  
I wish I could say more about this, but HIPAA prevents me.
 
2013-01-27 12:31:20 PM  
That sort of thing is fraud, pure and simple.  People should be going to jail for shiat like that.
 
2013-01-27 12:51:04 PM  
I went in for a upper-GI and found out that I was billed the same as if I'd gone to the hospital. Like magic. The Propafol was kind of worth it, though. If you ever get a chance, ask for the Propafol.
 
2013-01-27 12:58:54 PM  
Nothing wrong with our health care system.

How convenient that these long-running problems can now be blamed on that black man.
 
2013-01-27 01:02:42 PM  

edmo: Nothing wrong with our health care system.

How convenient that these long-running problems can now be blamed on that black man.


I wonder just how out of whack it has to get before America decides single payer socialized medicine is the same good idea the rest of the first world thinks it is.
 
2013-01-27 01:35:14 PM  
Nope, everything is okay. Health care is just fine. Republicans told me so
 
2013-01-27 01:37:31 PM  
I thought we had laws against making people pay for things they don't ask for or receive.

But what do I know?
 
2013-01-27 01:41:14 PM  
Depends on what was done during the procedure. If it was just going in and talking about aches and pains and bullshiat, no, not cool.
But what he had done is a surgical procedure, so yeah. There's nothing wrong with this.
 
2013-01-27 01:42:24 PM  
If our medical system had 100% price transparency up front, costs would plummet. All the middle men exist to shuffle papers and pad bills.
 
2013-01-27 01:42:58 PM  
If he had gone to a "real hospital" You could add a 0 to each of those fees.
 
2013-01-27 01:49:13 PM  

cretinbob: If he had gone to a "real hospital" You could add a 0 to each of those fees.


Not to mention a separate bill for every single person that sees you.

Soon the janitor who sweeps the floor of your hospital room is going to send you a bill too.

/Sure the doctor saw you. It was 3 AM, don't you remember?
 
2013-01-27 01:49:21 PM  

Riche: That sort of thing is fraud, pure and simple.  People should be going to jail for shiat like that.


Not jail, hang them. The problem is solved. It won't take long before the others get the idea that fraud means death. You'll hang a few to save a whole lot more.
 
2013-01-27 01:54:05 PM  
Got to spread the indigent care cost over as large of a pool as possible.

Seriously, my former Cardiologist just retired because the hospital system he sold his practice to did this. He couldn't decide who was worse, the insurers or the hospital admin.
 
2013-01-27 01:57:07 PM  
Welcome to the wacky world of medical billing for-shareholder-profit medicine

That's more like it.
 
2013-01-27 02:01:20 PM  
You have to pay to see a doctor?


/British.
//I know it's only free at point of service.
///Still costs far far less.
 
2013-01-27 02:11:10 PM  
As someone who just got charged $1700 for a venous ultrasound on my leg, I am getting a kick out of this thread.
 
2013-01-27 02:13:55 PM  

Incontinent_dog_and_monkey_rodeo: If our medical system had 100% price transparency up front, costs would plummet. All the middle men exist to shuffle papers and pad bills.


I used to do EDI for health insurance.

Now there's a racket: $2500 just for the manual, which pretty much forces offices to deal with expensive clearinghouses with specialized personnel of their own.

EDI is ancient and clunky too. You could convert it to XML and save the industry billions, but why kill a cash cow?
 
2013-01-27 02:19:25 PM  
It's called Provider Based Billing. The healthcare company I work for uses it. It's been a pain in the ass when building our new system since not every facility is provider based.
 
2013-01-27 02:44:24 PM  
"Many doctors' practices are losing money and would be forced to close if a hospital did not step in to support them," said Timothy Gens, general counsel for the Massachusetts Hospital Association. "One of the greatest challenges for hospitals is to find the resources to subsidize physician practices so they stay in their communities".

Won't someone think of the poor doctors?

Without the help of the hospital stepping in they might be forced to have only one villa in Spain!
 
2013-01-27 02:53:24 PM  

doyner: I thought we had laws against making people pay for things they don't ask for or receive.

But what do I know?


Not much, apparently.

Facility fees, while bullshiat, are totally legal. Currently. Let's take Doyner's hospital. Doyner owns not just his hospital, but the clinic down the road. The clinic down the road charges the doctor's fee. Doyner's charges a facility fee for the "convenience" of using their facility. It doesn't make it right, it doesn't make it acceptable, but this is the way medical billing is done.

It's infuriating to me. It should be infuriating to EVERYONE. It's a LIE that doctors are losing money every year and have to be propped up by large hospitals. They make it sound like EVERYONE is on Medicare, and EVERYONE'S reimbursement rate is 14%. This just isn't true. The problem that you have is massive, MASSIVE fraud, ridiculous health insurance CEO compenseation (and here, too), and Americans are racking up more and more health care debt because they can't AND won't take control of their own health. The most commonly billed diagnoses? Diabetes, high cholesterol, and high blood pressure. Yes, people should be responsible for their own health, however, it would be much, much easier if shiat like HFCS was removed from our "diet". Food suppliers have zero incentive to provide you with the healthiest options (unless that's their niche) but they have EVERY incentive to provide you with the cheapest possible food. HFCS is much, much cheaper than sugar, and in an attempt to fight the consumers who are turning away from HFCS, they're changing the way ingredients read on packages, to HIDE the fact that it's in there.

1) Consumers should be responsible for their health.
2) Food suppliers should be honest about their ingredients. (Go through your kitchen and actually read the ingredients. HFCS is in DAMN NEAR EVERYTHING except milk, eggs, and flour.)
3) Fraud should be investigated more and dealt with harshly. It isn't.
4) CEO reimbursement should be capped. Your average Japanese CEO earns 16x their average worker, the average American CEO earns 319x their average worker.
5) Double dipped billing like this should be banned, and banned immediately.
6) Last but not least, health insurance should be sold on a larger sliding scale than it already is. If you're proactive about your health, you should pay less than the person who isn't. Our company already does this; more should follow.

/end soapbox
 
2013-01-27 03:08:54 PM  

finnished: cretinbob: If he had gone to a "real hospital" You could add a 0 to each of those fees.

Not to mention a separate bill for every single person that sees you.

Soon the janitor who sweeps the floor of your hospital room is going to send you a bill too.

/Sure the doctor saw you. It was 3 AM, don't you remember?


Or the nurse called the physician and got an order for acetaminophen. Ta-da!
 
2013-01-27 03:09:02 PM  
Your Average Witty Fark User: vitriol

But I don't own a hospital.  :-/
 
2013-01-27 03:10:25 PM  

doyner: Your Average Witty Fark User: vitriol

But I don't own a hospital.  :-/


No, not vitriol. Fact.

/you should own a hospital
//you didn't read a damn thing I wrote
 
2013-01-27 03:10:47 PM  

omnimancer28: As someone who just got charged $1700 for a venous ultrasound on my leg, I am getting a kick out of this thread.


As someone who just paid $275.00 co-pay for a pill (I kid you not), I'm getting a kick ... wait, no I'm not.
 
2013-01-27 03:11:22 PM  

Your Average Witty Fark User: doyner: Your Average Witty Fark User: vitriol

But I don't own a hospital.  :-/

No, not vitriol. Fact.

/you should own a hospital
//you didn't read a damn thing I wrote


Dude, I agree 100% with you.  It was sympathetic sarcasm.
 
2013-01-27 03:11:28 PM  

Spanky McStupid: Or the nurse called the physician and got an order for acetaminophen. Ta-da!


Part of it is that many places pander to the lowest-common-denominator of healthcare employee and refuse to provide them with standing order-driven protocols for common events and scenarios. In-hospital healthcare is very Mother-may-I in most places.
 
2013-01-27 03:11:29 PM  
My PCP is at Lahey and I know where the dermatology building is, so I'm getting a kick, etc.

Space is a bit of a premium there, so I can see why they'd move some people to another location and still consider it part of the hospital. Ophthalmology and allergy are the next building over from the main clinic/hospital with a different entrance and parking lot.
 
2013-01-27 03:15:20 PM  
This post disapprovaled by ricky.
 
2013-01-27 03:31:04 PM  

chumboobler: "Many doctors' practices are losing money and would be forced to close if a hospital did not step in to support them," said Timothy Gens, general counsel for the Massachusetts Hospital Association. "One of the greatest challenges for hospitals is to find the resources to subsidize physician practices so they stay in their communities".

Won't someone think of the poor doctors?

Without the help of the hospital stepping in they might be forced to have only one villa in Spain!


Fark. You.

Physician fees account for 12% of healthcare spending.
Insurance companies have been steadily cutting payments for a decade. Your rates have been going up and coverage has been going down. Where do you think the money is going?
As an example, from 2000 to 2011, reimbursement for a hip replacement has gone down 7% in real dollars. That's 32% adjusting for inflation. What's happened to your pay over the last 11 years?
The reason hospitals get paid more for the same procedure is all about power and lobbying. Why do they charge more? Because fark you, that's why.
Someone has a villa in Spain, and its not your doctor.
Want to keep cutting physician fees? Start learning Hindi so you can talk to you doctor.
 
2013-01-27 03:35:13 PM  

Your Average Witty Fark User: HFCS is much, much cheaper than sugar, and in an attempt to fight the consumers who are turning away from HFCS, they're changing the way ingredients read on packages, to HIDE the fact that it's in there.


Here's a related item you can use in future rants. Foods labeled "0 Trans Fats" may contain up to 0.5g of trans fat per serving, which is 1/4 of the American heart association's recommended daily limit.
 
2013-01-27 03:44:12 PM  

chumboobler: "Many doctors' practices are losing money and would be forced to close if a hospital did not step in to support them," said Timothy Gens, general counsel for the Massachusetts Hospital Association. "One of the greatest challenges for hospitals is to find the resources to subsidize physician practices so they stay in their communities".

Won't someone think of the poor doctors?

Without the help of the hospital stepping in they might be forced to have only one villa in Spain!


Your outrage is misplaced. While some specialists rake in millions, your average family doctor earns a mid-$100k income. It's a lot, and I won't claim otherwise, but there are a lot of other factors to consider. Doctors spend an entire extra decade after their undergraduate degree in some form of education. Considering lost income from that time period, massive medical school debt, and even more massive malpractice insurance, your primary care physician probably makes as much over his/her career as an engineer or IT guy. The real thieves are administrators, the businessmen in $5,000 suits working for the hospitals and the insurance companies.
 
2013-01-27 03:45:22 PM  

Heist: chumboobler: "Many doctors' practices are losing money and would be forced to close if a hospital did not step in to support them," said Timothy Gens, general counsel for the Massachusetts Hospital Association. "One of the greatest challenges for hospitals is to find the resources to subsidize physician practices so they stay in their communities".

Won't someone think of the poor doctors?

Without the help of the hospital stepping in they might be forced to have only one villa in Spain!

Your outrage is misplaced. While some specialists rake in millions, your average family doctor earns a mid-$100k income. It's a lot, and I won't claim otherwise, but there are a lot of other factors to consider. Doctors spend an entire extra decade after their undergraduate degree in some form of education. Considering lost income from that time period, massive medical school debt, and even more massive malpractice insurance, your primary care physician probably makes as much over his/her career as an engineer or IT guy. The real thieves are administrators, the businessmen in $5,000 suits working for the hospitals and the insurance companies.


Heist: chumboobler: "Many doctors' practices are losing money and would be forced to close if a hospital did not step in to support them," said Timothy Gens, general counsel for the Massachusetts Hospital Association. "One of the greatest challenges for hospitals is to find the resources to subsidize physician practices so they stay in their communities".

Won't someone think of the poor doctors?

Without the help of the hospital stepping in they might be forced to have only one villa in Spain!

Your outrage is misplaced. While some specialists rake in millions, your average family doctor earns a mid-$100k income. It's a lot, and I won't claim otherwise, but there are a lot of other factors to consider. Doctors spend an entire extra decade after their undergraduate degree in some form of education. Considering lost income from that time period, massive medical school debt, and even more massive malpractice insurance, your primary care physician probably makes as much over his/her career as an engineer or IT guy. The real thieves are administrators, the businessmen in $5,000 suits working for the hospitals and the insurance companies.


I think he might shiat himself if he learned what a fourth year resident makes.
 
2013-01-27 03:47:16 PM  

ecmoRandomNumbers: The Propafol was kind of worth it, though. If you ever get a chance, ask for the Propafol.


You know who else liked Propafol?

no... not him.... I meant Michael Jackson.


/I knew a CRNA who would always describe Propafol to his patients as the stuff that killed Jackson, wondered how he expected that to calm them down
 
2013-01-27 03:56:52 PM  
I'm about to graduate with my MD in May. Matching into OB/Gyn. I totally didn't know it came with a Villa in Spain. I'm so excited....

OH WAIT... FARK OFF I have one roommate who might make millions as a physician but he's going through 12 years of post-graduate training and delaying his entry into the workforce by 12 years. And he'll work a brazillian hours a week. As an OB/Gyn I will probably get to mid-200k but I'll be paying off 280k in loans and driving a used Nissan (good head room since I'm 6'7")
 
2013-01-27 03:59:40 PM  

BronyMedic: Heist: chumboobler: "Many doctors' practices are losing money and would be forced to close if a hospital did not step in to support them," said Timothy Gens, general counsel for the Massachusetts Hospital Association. "One of the greatest challenges for hospitals is to find the resources to subsidize physician practices so they stay in their communities".

Won't someone think of the poor doctors?

Without the help of the hospital stepping in they might be forced to have only one villa in Spain!

Your outrage is misplaced. While some specialists rake in millions, your average family doctor earns a mid-$100k income. It's a lot, and I won't claim otherwise, but there are a lot of other factors to consider. Doctors spend an entire extra decade after their undergraduate degree in some form of education. Considering lost income from that time period, massive medical school debt, and even more massive malpractice insurance, your primary care physician probably makes as much over his/her career as an engineer or IT guy. The real thieves are administrators, the businessmen in $5,000 suits working for the hospitals and the insurance companies.

Heist: chumboobler: "Many doctors' practices are losing money and would be forced to close if a hospital did not step in to support them," said Timothy Gens, general counsel for the Massachusetts Hospital Association. "One of the greatest challenges for hospitals is to find the resources to subsidize physician practices so they stay in their communities".

Won't someone think of the poor doctors?

Without the help of the hospital stepping in they might be forced to have only one villa in Spain!

Your outrage is misplaced. While some specialists rake in millions, your average family doctor earns a mid-$100k income. It's a lot, and I won't claim otherwise, but there are a lot of other factors to consider. Doctors spend an entire extra decade after their undergraduate degree in some form of education. Considering lost income from that tim ...

I think he might shiat himself if he learned what a fourth year resident makes who is 8 years out of college, graduated at the top of his class, and has an average of $162,000 in debt.


FTFU
 
2013-01-27 04:18:15 PM  
Fark Mr. Lahey and his dumbass scams.

www.headpins.net
 
2013-01-27 04:19:07 PM  
Well, I'm not surprised; I went in to this pleasant family clinic for a checkup when I needed a new PCP. Then the bills started arriving.

Most of them were for $0; insurance covered all but $138 of a rather thorough physical (yeah, over 40) and the bills were just there to remind me that I had been billed and the bill had been paid. But they kept arriving for MONTHS. This practice employed maybe three doctors and a small army in a large office just to handle billing. In all, there were maybe a dozen bills over about three months. i could check my files and see what i was billed for if I weren't so lazy. And since the practice was associated with a hospital, most of the bills were from that hospital. Someone walks into that private practice, five miles away a guy's eyes light up with dollar signs.

We can put that with the bill for $24,000 my roommate got when he went in to that hospital to find out why he was having dizzy spells. He didn't even get an MRI for that price.
 
2013-01-27 04:19:14 PM  
First world problems, America's laughable problem.
 
2013-01-27 04:20:29 PM  

enry: My PCP is at Lahey and I know where the dermatology building is, so I'm getting a kick, etc.

Space is a bit of a premium there, so I can see why they'd move some people to another location and still consider it part of the hospital. Ophthalmology and allergy are the next building over from the main clinic/hospital with a different entrance and parking lot.


My allergist is at Lahey! I wonder if they're gonna charge my insurance for a farking facility fee next time I go.

/at least my husband's employer has amazing insurance so all we have to do is pay a $20 copay
//remembers the shiatty days without nice insurance
 
2013-01-27 04:22:32 PM  

sno man: edmo: Nothing wrong with our health care system.

How convenient that these long-running problems can now be blamed on that black man.

I wonder just how out of whack it has to get before America decides single payer socialized medicine is the same good idea the rest of the first world thinks it is.


Without looking it up name 5 countries with single payer health care.
 
2013-01-27 04:30:56 PM  
For those of you outside the USA, here's how wacky healthcare is in this country, EVEN IF YOU HAVE INSURANCE:

1. You get sick
2. You go to doctor 1's office
3. You pay a small fee $25-$50 or so out of pocket to doctor 1
4. Doctor 1 tells you you need to have tests A, B, and C done and procedures D and E, all from some other doctor or labs, but he doesn't know how much they will cost or whether your insurance will cover them.
5. You ask your insurance company about A-E. They don't know what'll be covered, but submit a claim and we'll see.
6. You go to Labs A, B, C ask them whether your insurance will cover the tests, they have no idea so you pay them each $25-$50 out of pocket and get the tests done.
7. You go to doctors 2 and 3 to get procedures D and E done, you ask them whether your insurance will cover the procedures, and they don't know. Pay them each $25-$50 out of pocket.
8. You go home, felling better.
9. Wait.
10. The doctors and labs each bill the insurance company separately.
11. Wait.
12. Wait.
13. Your insurance company send you a notice. Here's what happened:

: Doctor 1 billed $500, and the insurance company paid $150. You owe $350
: Lab A billed $350, and the insurance company paid $50. You owe $300
: Lab B billed $1200, and insurance pays $200. You owe $1000
: Lab C billed $1500, and insurance paid nothing because the test was not needed. You owe $1500
: Doctor 2 billed $4000, and insurance pays nothing because procedure D is not covered. You owe $4000
: Doctor 3 billed $6500, and insurance pays nothing because the procedure was considered "experimental" by the insurance company, and is not covered. You owe $6500.

You owe a total of $9050. The good news is that you know what you owe now. You had no idea until the day that letter arrived whether it would have been $90, $900, $9000, or $90,000.

14. You shiat your pants
15. You get separate bills in the mail for the above amounts. You're now facing almost $10,000 in debt.
16. You call the doctors back to biatch and they are really sorry that you have crappy insurance but it's not their fault. Pay up.

This kind of shiat is routine for things like broken bones and moderate illnesses. This is why America's health care system is the laughing stock of the world.
 
2013-01-27 04:32:46 PM  
Oops, I got my math totally wrong there, but you get the point. It's a trainwreck.
 
2013-01-27 04:40:49 PM  

You're the jerk... jerk: sno man: edmo: Nothing wrong with our health care system.

How convenient that these long-running problems can now be blamed on that black man.

I wonder just how out of whack it has to get before America decides single payer socialized medicine is the same good idea the rest of the first world thinks it is.

Without looking it up name 5 countries with single payer health care.

 
Canada, Great Britain, France, Sweden, Finland, Norway, Spain, Italy, Germany, Brazil, even Venezuela and frikin Cuba. I could probably think of a few more given a few more minutes.
 
2013-01-27 04:46:48 PM  

sno man: You're the jerk... jerk: sno man: edmo: Nothing wrong with our health care system.

How convenient that these long-running problems can now be blamed on that black man.

I wonder just how out of whack it has to get before America decides single payer socialized medicine is the same good idea the rest of the first world thinks it is.

Without looking it up name 5 countries with single payer health care.

Canada, Great Britain, France, Sweden, Finland, Norway, Spain, Italy, Germany, Brazil, even Venezuela and frikin Cuba. I could probably think of a few more given a few more minutes.


Only 3 of those have single payer. Canada, UK and Cuba. The others do not. Good try though.
 
2013-01-27 04:48:41 PM  

Your Average Witty Fark User: 1) Consumers should be responsible for their health.


What does this mean? Am I responsible for my asthma?
 
2013-01-27 04:51:05 PM  

Heist: chumboobler: "Many doctors' practices are losing money and would be forced to close if a hospital did not step in to support them," said Timothy Gens, general counsel for the Massachusetts Hospital Association. "One of the greatest challenges for hospitals is to find the resources to subsidize physician practices so they stay in their communities".

Won't someone think of the poor doctors?

Without the help of the hospital stepping in they might be forced to have only one villa in Spain!

Your outrage is misplaced. While some specialists rake in millions, your average family doctor earns a mid-$100k income. It's a lot, and I won't claim otherwise, but there are a lot of other factors to consider. Doctors spend an entire extra decade after their undergraduate degree in some form of education. Considering lost income from that time period, massive medical school debt, and even more massive malpractice insurance, your primary care physician probably makes as much over his/her career as an engineer or IT guy. The real thieves are administrators, the businessmen in $5,000 suits working for the hospitals and the insurance companies.


This. They might have a villa in Spain at 55, but it's because they had several hundred thousand dollars in debt, and didn't actually start making money until their 30's.

Meanwhile, I'm making ~$70K at the age of 20 working 45-50 hour weeks as a software engineer, and could've been making $110K (or more. Some of that was stock options) straight out of college. Heck, if the company (and thus my percentage that has a 0 before but not after the decimal point (which is pretty good for an employee)) gets big, I'll be worth a couple million at 25.

/I don't think it'll happen. That would mean our 7-person company (current worth ~$10 million) would be worth nearly a billion dollars in 5 years.
//Also, San Francisco. $70K turns into about $40K takehome after all the taxes, fees, and other CA stuff, and then the rent on an ok studio is $1500-$2000 in the cheap South Valley burbs. (And everything else thus becomes more expensive, since even poor people in service industries had better be making $40-$50K household just to pay rent, transit, and food).
 
2013-01-27 04:56:04 PM  

You're the jerk... jerk: sno man: You're the jerk... jerk: sno man: edmo: Nothing wrong with our health care system.

How convenient that these long-running problems can now be blamed on that black man.

I wonder just how out of whack it has to get before America decides single payer socialized medicine is the same good idea the rest of the first world thinks it is.

Without looking it up name 5 countries with single payer health care.

Canada, Great Britain, France, Sweden, Finland, Norway, Spain, Italy, Germany, Brazil, even Venezuela and frikin Cuba. I could probably think of a few more given a few more minutes.

Only 3 of those have single payer. Canada, UK and Cuba. The others do not. Good try though.


Actually you're right about Germany, they have a more localized system that each follow the basic model, but not as a single entity.
Also Taiwan and Japan and Denmark...

Perhaps you could explain why you think France isn't on that list.
 
2013-01-27 04:56:50 PM  

You're the jerk... jerk: sno man: You're the jerk... jerk: sno man: edmo: Nothing wrong with our health care system.

How convenient that these long-running problems can now be blamed on that black man.

I wonder just how out of whack it has to get before America decides single payer socialized medicine is the same good idea the rest of the first world thinks it is.

Without looking it up name 5 countries with single payer health care.

Canada, Great Britain, France, Sweden, Finland, Norway, Spain, Italy, Germany, Brazil, even Venezuela and frikin Cuba. I could probably think of a few more given a few more minutes.

Only 3 of those have single payer. Canada, UK and Cuba. The others do not. Good try though.


Uh, I just looked up Norway as a random and they operate exactly like we in Canada do. The fark you smokin? Public funded healthcare but optional private shiat for the people who absolutely must pay more.

Either way, America's lack of public healthcare is at this point a joke, and its not even funny anymore.
 
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