Text 12342, 101 rader
Skriven 2010-11-19 06:50:10 av Bob Ackley (1:300/3)
  Kommentar till text 12316 av mark lewis (1:3634/12.0)
Ärende: Credit/debit
====================
Replying to a message of mark lewis to Bob Ackley:

 ml> [trim]

 ml>> sure i could have raised my prices across the board and then given
 ml>> cash discounts but isn't that the same damned thing???

 BA>> Yeah.

 BA>> FWIW my sister has discovered that some health care providers in
 BA>> her area give *large* discounts to people who pay by cash or check.
 BA>> Large defined as up to 50% of the billed amount.  

 ml> you know what this is called, don't you?? they call it "giving a
 ml> discount" but i see it as exhorbenent markup for insurance charges
 ml> and that it tantemount to insurance fraud... the ugly thing is that
 ml> it is apparently legal if a business does it...

It could be eliminated overnight if insurorrs - specifically including Medicare
-
were required to pay the bills in full within 30 days.  Medicare is infamous
= and has been infamous for over 30 years now - for disallowing every charge
it thinks it can get away with and writing itself a huge discount on the
remaining
bal;ance.  I presume other insurors do the same thing.  Just because insurors
refuse
to pay costs doesn't mean they go away, they get shifted to somebody who will
pay
them - usually the poor schmuck that doesn't have insurance.  I noted this
nearly
30 years ago when I was working on my BS in healthcare administration.  No,
it's
not fair, and I realize that - but if insurors couldn't screw the providers as
badly 
as they do the providers wouldn't have to charge the prices they do.

Years ago I was referred to an Omaha orthodontist who had an outstanding
national
reputation.  He was a one-doctor practice with one administrative assistant. 
His
prices were very reasonable - and he did not accept any insurance of any kind
nor
did he accept credit cards; cash or check only and due at the time of service.
- no
exceptions.

 BA>> That's apparently what it's worth to them to not have to hassle 
 BA>> with insurance companies and/or Medicare in order to get paid.  

 ml> that's the story they tell but i think it is more than that... see
 ml> above ;)

That's a fact, Mark.  If insurors didn't fight tooth and nail to avoid paying
anything
and didn't grant themselves huge discounts on the bills they do pay it wouldn't
be
a problem.  Forty years ago it wasn't a problem, then Medicare started refusing
to
pay costs (such as the allocated cost of charity care given by the provider)
and demanding
huge discounts.  Note that when Medicare started writing itself those discounts
the
providers simply billed the patients (or their estates) for the unpaid
balances; the
patitnts screamed to their congresscrooks and those congresscrooks quickly made
it
a crime for providers to bill patients for any unpaid portions of Medicare
patients' bills.

There was an article in the Omaha fishwrapper the other day noting that next
month
Medicare will cut its reimbursement rates to providers by about 23 percent.  No
pay,
slow pay, and low pay are the guiding principles of Medicare - and some people
wonder
why providers are bailing out of the Medicare system.  In many areas it is
nearly 
impossible for a newly eligible Medicare patient to find a primary care
provider that 
will accept them as a new patient.  Note that in my immediate four-county area
there
is precisely one primary care provider that sees Tricare (Medicare for the
military)
patients.

 BA>> Note that most insurors and especially Medicare discount their 
 BA>> payments \by about the same amount so I guess it's a wash.

 ml> it may be a wash but it is also a scam and a half... charge twice as
 ml> much but give 50% discount? it must only be worth the 50% to start
 ml> with... seriously! what they are doing it not right but at the same
 ml> time, they're giving everyone a reach around feel good grope to make
 ml> them think they are getting something good...

As I said, require insurors to pay the bills in full within 30 days and this
sort of thing won't happen.  Fraud investigation can come later, and if
detected
the perp should be severely punished.

--- FleetStreet 1.19+
 * Origin: Bob's Boneyard, Emerson, Iowa (1:300/3)