Charging Non-insured more than insured!! About time something was done!

[a12100]

I have never really noticed this before, but I never really had insurance where I saw the bills.. This is crazy. Hospitals should have never been allowed to do this, someone should have came forward a long time ago.. and I hope more people do!!

Recently I had a baby.. the bills came to about $8,000 and because our hospital was a provider in the network the hospital "agrees to accept a discounted amount as payment in full for services rendered" they paid about half and we do not owe anything else. Now if I didnt have insurance do you think they would have taken the $4,000 and said thanks you dont owe anymore. I don't!

http://www.staugustine.com/stories/080604/sta_2493624.shtml

Proposed class action suit against hospital group filed

Associated Press

MIAMI -- A Naples-based hospital chain gouged uninsured patients by charging them more than those with insurance, according to attorneys who sued the company Thursday.

The proposed class-action lawsuit was filed in Miami-Dade Circuit Court against Health Management Associates Inc. Two other lawsuits against Nashville, Tenn.-based HCA Inc. and King of Prussia, Penn.-based Universal Health Systems were set to be filed in Las Vegas late Thursday, attorney Archie Lamb said at a Miami news conference.

Hospitals violate unfair and deceptive trade practice laws when they charge higher rates to the uninsured since patients sign forms agreeing to pay a "reasonable and regular" rate, according to the complaint filed in Miami.

"This lawsuit is about changing the way health care and health care delivery dollars are spent in this country," Lamb said. "It's about accountability."

HCA spokesman Jeff Prescott said that he has not yet seen the details of the Nevada lawsuit, but he noted that the company currently has a discount program for the uninsured and is currently implementing a new program that would make rates more equitable. HCA is the nation's largest for-profit hospital chain, operating in 23 states.

Prescott said that plan is scheduled to be in place by the fall but noted the approximately 44 million Americans without health insurance is the issue that can't be overlooked.

"We can fix bills, we can give charity care, but we alone can't fix the problems of the uninsured," Prescott said. "That patient still doesn't have insurance, and that's the problem, and that's what we need to fix."

The lawsuit against Health Management Associates was filed on behalf of Jose Manuel Quintana, a Miami truck driver who went to Fishermen's Hospital in Marathon after he suffered chest pains last October.

According to the class-action complaint, HMA charged Quintana $3,060 for a three-hour visit.

That same visit for a person with insurance would cost around $900, said K.B. Forbes, executive director of Los Angeles-based Consejo de Latinos Unidos, an advocacy group that assists Hispanics.

HMA spokesman John Merriwether said he not yet seen the lawsuit, but noted that Quintana ultimately paid his bill with the help of a significant discount from the hospital, which he would not disclose.

[schsa]

Hospitals have contracted agreements with third parties to avoid being audited. Depending on how good a hospital is at keeping up with their equipment and the items used for any patient, an audit can cost them up to 25% of the total of the bill.

I agree that the uninsured should not be charged more than those with insurance. However I also understand that many people without insurance will never pay those high bills and the hospital will write the charges off as a loss. For a "for profit" hospital, this can be very expensive.

There are ways for a patient to negotiate any hospital bill including the discount that others get. All you need is a patient advocate and time to speak in person to the billing department. You can negotiate a discount on your bill as well and set up a payment plan. Hospitals are not so foolish as to think that the average person who is uninsured can come up with $20,000 or more at the drop of a hat. And the hospital bill is only part of what the patient will received from a hospital stay. There will be doctor's bills, anesthesologist, any lab or x-rays that were read by a radiologist or a pathologist and who knows if there was a consultant or two brought in to give an opinion. None of this is cheap.

Don't ever assume that the bill from the hospital or the doctor is the final amount until you have attempted to negotiate the bill. You can save a great deal if you make the effort.

[EMSnurse]

I know that when I admit someone who has insurance (I work for a home health agency), I have to negotiate our fee with them. For example, if our fee is normally 130.00 per visit, the insurance company will tell me they will give us 100.00. If we don't accept the lower rate the patient won't get the care. If we would see someone who is paying cash they would be billed the full amount. If we take the insurance case, the insurance gets billed less because that's all they will pay. We generally go ahead and accept the lower rate even when we lose money simply because it's not the patients fault that their insurance company doesn't care about anything but money. If we had a contract with the insurance company, as most hospitals and doctors do, they would pay us even less for the visits. Since we don't have contracts with them, most expect us to go out and do the care without telling us what we will be paid. Just last week I asked the insurance representative if she would consider going to work every day if she had no idea what she would be getting paid. Oddly enough, she refused to anser me. Many people don't get the care their dr has ordered because of their insurance company, and most never even know about it. I make sure I call the patient and let them know what their insurance company has told us, that way they can complain directly if they choose. I guess the point of this vent in response to a vent is this- don't blame the provider, blame the insurance companies, they are the ones who dictate what care you receive and what it costs, not your dr. They are out of control and have way too much power, in my opinion.

[Dizzyontheweb]

I work for a call center where we take calls for dr bills, usu ones from the ER.
I get a lot of people who say they are getting charged more cause they do not have ins. Actually, the insurance gets charged the same, it is just with the discounts because of the contracts that the dr does not get pd as much. The discounts or adjustments depend on the contracts negotiated between the providers and the inurance.
Charges are made according to many factors and are usu within state and federal guidelines. Many places will give prompt payment discounts or will work with a pt to set up payments. Just do not blame the dr's rep with the bill
we do not set the charges.

[evrita]

Well I am insured and fighting to see an out of network provider

[aneisu]

The flip side that you aren't mentioning is the insurance company pays that amount no matter what the provider bills. So lets say the insurance company contracts a $4,000 rate for a procedure and the provider only bills $2,000. They will be receiving $4,000 from the insurance company. The provider is typically paid less than they bill, but thatis a contracted rate. If you take away the contracted rates, you pretty much will make sure those people who can afford health insurance right now won't be able to afford it any longer.

[stresseater]

The insurance industry is one of the biggest scams that ever was. The medical industry isn't much better simply because they allow the insurance companies get away with it. The doctors are over a barrel. They can't effectivly utilize insurance policies unless they allow some guy in an office somewhere to dictate the method of care.It is wrong. We should totally abolish insurance and restructure it differently. That will never happen however because the insurance companies are in the pockets of the democrats and the doctors are in the pockets of the republicans. It's a lose-lose situation. All I can say is if you see a bill that appears wrong is to fight it. Good luck with that huh. lol :rolleyes: :rolleyes:

[amysusi]

Ooh, you guys! I just watched The Rainmaker last night... low-life insurance companies!!:mad:

[queenangie]

Our hospital is 'not for profit'....
lots of charity cases (free) or severely discounted
from the original cost for those folks without insurance.

I see this on a daily basis.
Is your hospital 'for profit?'