Medical Billing

xoxoxoBruce · 03-13-2019, 05:17 AM

I get a monthly report from my insurer and this one has the year end totals.
It shows the bills, then what the "plan" approved which was a tick over 30%.
Next it shows what the "plan" paid which was a tick under 30% leaving almost a grand difference.
Subtracting what I paid from that difference leaves $763 agreed but unpaid.
Adding the $763 to the 70% billed but not agreed to(read unpaid) amounts to $110,731 billed but unpaid.
This amount just evaporates, vanishes into the ether, supper for birds and beasties.
I wonder if the bill sender can write it off as a loss? Otherwise why bill for more than had already been agreed with the insurance company.
Maybe it's to legally establish their price for people who don't have insurance, or more coverage.

Griff · 03-13-2019, 06:31 AM

My (step) FiL was sat up in bed by a PT. This is apparently a trigger for halting insurance, now he has to go to a nursing home and his insurance company washes its hands of him. That pushes him off onto medicare after they eat his assets. You ever get the idea that tax-payers are already paying for the most expensive care?

Spexxvet · 03-13-2019, 07:34 AM

Quote:

Originally Posted by xoxoxoBruce

...
Maybe it's to legally establish their price for people who don't have insurance, or more coverage.

Ed Zachary

Gravdigr · 03-13-2019, 08:29 AM

Momdigr's hospital stay many years ago came to ~$65k, after all was said and done (and billed multiple times) her part came to just over $1000.

Popdigr's bypass was something like $55k (I'm not 100% on that number), his part came to about $1800.

Insurance is a money pit, and money thrown away...until you need that first time.

03-13-2019, 05:17 AM	#1
xoxoxoBruce The future is unwritten Join Date: Oct 2002 Posts: 71,105	Medical Billing I get a monthly report from my insurer and this one has the year end totals. It shows the bills, then what the "plan" approved which was a tick over 30%. Next it shows what the "plan" paid which was a tick under 30% leaving almost a grand difference. Subtracting what I paid from that difference leaves $763 agreed but unpaid. Adding the $763 to the 70% billed but not agreed to(read unpaid) amounts to $110,731 billed but unpaid. This amount just evaporates, vanishes into the ether, supper for birds and beasties. I wonder if the bill sender can write it off as a loss? Otherwise why bill for more than had already been agreed with the insurance company. Maybe it's to legally establish their price for people who don't have insurance, or more coverage. Attached Images __________________ The descent of man ~ Nixon, Friedman, Reagan, Trump.

03-13-2019, 06:31 AM	#2
Griff still says videotape Join Date: Feb 2001 Posts: 26,813	My (step) FiL was sat up in bed by a PT. This is apparently a trigger for halting insurance, now he has to go to a nursing home and his insurance company washes its hands of him. That pushes him off onto medicare after they eat his assets. You ever get the idea that tax-payers are already paying for the most expensive care? __________________ If you would only recognize that life is hard, things would be so much easier for you. - Louis D. Brandeis

03-13-2019, 08:29 AM	#4
Gravdigr The Un-Tuckian Join Date: Apr 2007 Location: South Central...KY that is Posts: 39,517	Momdigr's hospital stay many years ago came to ~$65k, after all was said and done (and billed multiple times) her part came to just over $1000. Popdigr's bypass was something like $55k (I'm not 100% on that number), his part came to about $1800. Insurance is a money pit, and money thrown away...until you need that first time. __________________ These statements have not been evaluated by the FDA, EPA, FBI, DEA, CDC, or FDIC. These statements are not intended to diagnose, cause, treat, cure, or prevent any disease. If you feel you have been harmed/offended by, or, disagree with any of the above statements or images, please feel free to fuck right off.

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