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The high cost of doing biz, HCA style


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2014 Nov 11, 1:32am   6,827 views  17 comments

by elliemae   ➕follow (3)   💰tip   ignore  

I recently had a procedure at an HCA hospital. I received the following statement from my insurance (amounts rounded):

1) Billed Charges $13,000
2) Approved Charges $1,200
3) Duplicate (non-covered charges) $1,000

In other words (for ya'll playing the home game), if I were uninsured I would have been responsible for $13,000. Even if I negotiated the charges it would have been $5,000 or so out of pocket.

No, there's nothing wrong with out healthcare system.

Oh - btw, I get to go back for more cutting. This time from a specialist. Yay!

Comments 1 - 17 of 17        Search these comments

1   MAGA   2014 Nov 11, 2:07am  

As a former HCA employee (IT), the reason for the outrageous charges is that the hospital knows that they will only get a small percentage of the bill approved. This is per one of the billing managers.

2   justme   2014 Nov 11, 4:04am  

In addition to Obamacare/ACA, we need a law against fraudulent billing practices.

3   Tenpoundbass   2014 Nov 11, 4:25am  

justme says

In addition to Obamacare/ACA, we need a law against fraudulent billing practices.

And you thought of this when?

4   RWSGFY   2014 Nov 11, 4:56am  

elliemae says

In other words (for ya'll playing the home game), if I were uninsured I would have been responsible for $13,000. Even if I negotiated the charges it would have been $5,000 or so out of pocket.

No, there's nothing wrong with out healthcare system.

These numbers are meaningless without knowing what procedure are we talking about. Sure, it sounds way too expensive for wart removal, but dirt cheap for heart surgery.

5   justme   2014 Nov 11, 5:03am  

CaptainShuddup says

justme says

In addition to Obamacare/ACA, we need a law against fraudulent billing practices.

And you thought of this when?

Greater minds than mine have thought of this problem many times before. For example there is, from May 2011,

Medical Billing Proposal
By Patrick
Mon, 9 May 2011
http://patrick.net/?p=689824

Oh Captain, My Captain. You are so sore for being chastised that you (and Crazy) will jump on any chance to make your opponents look stupid. The problem is, you are the ones ending up looking stupid. Stop trying to score cheap points and see if you have anything of significance to contribute.

PS: if you are ACTUALLY interested in knowing before you speak, try a google search like this:

medical billing justme site:patrick.net

6   justme   2014 Nov 11, 5:08am  

Straw Man says

These numbers are meaningless without knowing what procedure are we talking about. Sure, it sounds way to expensive for wart removal, but dirt cheap for heart surgery.

Nonsense. There is no need for anyone to reveal their medical history. All that is needed is to see the obvious: a factor of 13x between the bill and the allowed payment (== the negotiated rate of the insurance company).

Strawman, indeed.

7   elliemae   2014 Nov 12, 12:34am  

Straw Man says

These numbers are meaningless without knowing what procedure are we talking about. Sure, it sounds way to expensive for wart removal, but dirt cheap for heart surgery.

So - it's okay to bill $13,000 for a heart transplant, even though they settled for $1,200. But if I had a wart removed, it's okay that they billed $13,000 and settled for $1,200?

If I had no insurance, the company would have billed the entire $13,000. Even if they settled for 1/3 of it, that's a helluva lot more than they would have received from my insurance company.

Regardless of the amount that they receive, the company will "adjust" thousands off the books and gain substantial tax advantages.

Despite the personal nature of the question, I will happily share my business with ya'll. FYI, it was for a surgery. I wanted to emulate my least favorite posters on patnet, so I had half of my brain removed.

8   Dan8267   2014 Nov 12, 2:05am  

elliemae says

In other words (for ya'll playing the home game), if I were uninsured I would have been responsible for $13,000. Even if I negotiated the charges it would have been $5,000 or so out of pocket.

And Obamacare does nothing to even address this.

Single Payer is the one and only solution to this problem.

Nationalizing health insurance would be another good step. Nationalizing health care providers, at least hospitals, would be yet another good step.

Hospitals screw doctors and patients.

9   RWSGFY   2014 Nov 12, 2:41am  

elliemae says

If I had no insurance, the company would have billed the entire $13,000. Even if they settled for 1/3 of it, that's a helluva lot more than they would have received from my insurance company.

We don't know what would they have settled for. You didn't ask what would it cost if you offered them cash upfront either. These "billed" numbers are meaningless. For example, I once saw $35K billed internally by Kaiser for one day hospitalization of 1 month old child (the only procedure performed was regular pumping of mucus from his nose). There was no other insurance involved, no out-of-pocket payments expected (not even a co-pay for children that young), so the number could have been $35 mil or $35 billion - no difference... It's some kind of mickey-mouse internal number. I wouldn't even think about them as real dollars, it's something else.

10   Tenpoundbass   2014 Nov 12, 5:21am  

elliemae says

I wanted to emulate my least favorite posters on patnet, so I had half of my brain removed.

Yeah but it doesn't work if you tell anybody.

11   Ceffer   2014 Nov 12, 5:35am  

elliemae says

Despite the personal nature of the question, I will happily share my business with ya'll. FYI, it was for a surgery. I wanted to emulate my least favorite posters on patnet, so I had half of my brain removed.

There you go, bragging again that you are still twice as smart as they are.

12   RWSGFY   2014 Nov 12, 5:39am  

Dan8267 says

elliemae says

In other words (for ya'll playing the home game), if I were uninsured I would have been responsible for $13,000. Even if I negotiated the charges it would have been $5,000 or so out of pocket.

And Obamacare does nothing to even address this.

Single Payer is the one and only solution to this problem.

Which "problem" are we talking about here? You all got your panties in a bunch over some meaningless "billed" number which in the end had nothing to do with what was really paid out of pocket.

13   Vicente   2014 Nov 12, 8:24am  

Call it Crazy says

justme says

In addition to Obamacare/ACA, we need a law against fraudulent billing practices.

Maybe if we had that FIRST, we wouldn't have needed Obamacare because healthcare would have been more affordable?

Why are you against innovation? Only by allowing the finance people FREEDOM, can they maximize profits. Any sophisticated consumer will of course take their business elsewhere, and eventually fraud will be naturally cleansed from the system. Glibertopia is right around the corner.

14   elliemae   2014 Nov 12, 7:24pm  

Call it Crazy says

elliemae says

I wanted to emulate my least favorite posters on patnet, so I had half of my brain removed.

Too bad, now you're left with none!

And yet, I'm still smarter than you...

15   justme   2014 Nov 12, 10:56pm  

elliemae says

Regardless of the amount that they receive, the company will "adjust" thousands off the books and gain substantial tax advantages.

I think this is a very important observation. It means that doctors (and hospitals) get to subtract large amounts of completely fake "losses" from their otherwise taxable income. I don't see how the IRS lets them get away with such practices. Is healthcare some kind of holy cow that must not be touched, tax-wise?

16   elliemae   2014 Nov 16, 12:23am  

I don't know - but I'm going back in to have more shit done while I'm on a roll. It sucks when my inspiration is that I've met my deductible for the year. However, this shit needs to happen so I can be my happy sunny self.

Next time around, I'll post a photo of the actual billed charges from my Explanation of Benefits. For you curious people out there, unfortunately it won't say what the procedure is.

I wouldn't bet on "lobotomy" if ya'll are starting a pool.

17   Vicente   2014 Nov 16, 12:44am  

elliemae says

I wouldn't bet on "lobotomy" if ya'll are starting a pool.

Dimpleplasty?

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