7 ms·

Indecipherable Medical Bills Are One Reason Health Care Costs So Much

48 points by aaronbrethorst 10y ago

teslabox 10y ago
Doctors want to bill insurance for as much as they can. Insurers don't really care about medical costs either, because the percent they keep as profit grows as they spend more. Patients are the victims in the trench warfare between doctors and payers.
- misja111 10y ago
  Isn't there any competition between health insurers in the US? If it's a free market and consumers care about costs, then you'd expect that at least some health insurer would start looking for ways to put their insurance premium down.
  - xena 10y ago
    Under the ACA you can't even go out and buy insurance at any point in the year (from a large number of companies) unless you meet a minimal list of conditions that most people won't.
    - tdb7893 10y ago
      This problem existed far before the ACA so while some stuff in it really needs to be changed I don't think it's fair to blame it for this scenario
  - pjc50 10y ago
    The market is riddled with adverse selection problems. The easiest way to reduce costs is to reduce coverage!
  - mathgeek 10y ago
    Consolidation quickly takes care of any smaller company that tries to compete, in addition to the other issues mentioned here.
  - garethsprice 10y ago
    Most health insurance is provided via subsidized employer plans so consumers can either take the plan they're offered or pay 2-3x as much on the open market. The healthcare system in the US is fundamentally broken, overpriced and cruel. It is one of the worst things about living in this country.
    - kgwgk 10y ago
      Employers are the "consumers" in that case, and they do switch plans if they get a better offer.
johan_larson 10y ago
It sounds like there's a niche for a non-insurance insurer. It wouldn't actually pay for procedures, but in return for a low monthly membership fee, it would negotiate on behalf of the members for their bills, just like an insurance company does.
- creaghpatr 10y ago
  Patient billing advocates are a real service now. For let's say $500 they go to war with the billing dept of a hospital; the hospital will almost always knock 50% of the price off because they don't want to fight the battle. So many patients default on their bills it's a financial crisis for most hospitals outside of the large major chains. That billing department is going to take what they can get, even if it's only 20% of the amount the patient owes. Pretty nuts.
  - drewg123 10y ago
    But apparently that strategy doesn't always work. The lady in the article offered the hospital what her experts said was a reasonable price, including a profit margin & they turned down the offer.
    - creaghpatr 10y ago
      I think the hospitals jack up their list prices with these adjustments presumed. Of course, they don't tell the patient to negotiate a discount that's the last thing they want to deal with. And you're right, it doesn't always work it depends on the context and financial health of the provider.
- awongh 10y ago
  whoa it already exists: https://disputebills.com/ https://disputebills.com/
  - tboyd47 10y ago
    Thank you for sharing this.
zelos 10y ago
Is the situation described for the woman in the article common? It sounds completely insane, I don't see how anyone could defend it. Minimum wage is $7.25, so at a guess say $20k/yr net? $800/month insurance is $9,600, nearly 50% of her income for insurance that would still have left her with a $70k bill after the haemorrhage? Edit: I realise that's kind of the point of the article, but seeing those figures I don't see how _anyone_ below the middle class could get decent insurance.
- TheAdamAndChe 10y ago
  This is why healthcare is such a huge political issue in the US right now. Tons of people are going into bankruptcy over medical bills, and tons of people are dying that shouldn't be. Many democrats want a single-payer system, and many republicans want a free market. Since we have a two-party political system that is behaving more and more partisan with each year, everyone is just yelling at each other and no solution is being found.
- creaghpatr 10y ago
  In theory she's mandated to have insurance to prevent this type of thing from happening. If she couldn't afford it the government would subsidize her on the exchanges. In practice, she paid the ACA penalty to have the privilege of not buying insurance and then she got screwed for not having it.
  - TheAdamAndChe 10y ago
    After the subsidies, chances are good that the amount she would still have to pay is prohibitively expensive. There is a baseline amount you have to make to get by, and at minimum wage in the US, chances are good you're hitting that baseline amount.
jenkstom 10y ago
The Republicans are (and have been for almost a decade) trading human suffering for political gain. Keeping up with medical bills for a serious illness can be a full-time job. It's tragic, and until everybody after the baby boomers wakes up and bothers to vote we're stuck with it.
- dantheman 10y ago
  The article is discussing the runaway costs of healthcare -- its both a republican and a democrat issue. The current system is unsustainable.
- creaghpatr 10y ago
  Is this a comment about the article? The patient experienced her accident in 2013 after the ACA was in effect, which famously not a single republican voted for. Patients are being screwed under the current system right now, regardless of politics. Providers are having trouble remaining financially solvent bc most patients end up not paying their bills; providers rely on private insured or self pay patients to stay afloat because Medicare/Medicaid don't reimburse enough to cover costs. If we put everyone on Medicare the system would shut down, everything else remaining equal- unless we subsidized providers with even more money from taxpayers to replace the insurance companies.
  - maxerickson 10y ago
    If Virginia had taken Medicaid expansion, she likely would have been covered, or had access to less expensive insurance.
    - sjg007 10y ago
      And this is why people should move if at all possible to states that took the medicare/medicad expansion. You can either vote out the government or move to a state that offers a better deal. It's almost an impossible choice but it is your life and your families lives. With respect to health care there are a lot of Americans leaving the US (who can) for other countries with health care.
awongh 10y ago
Wow. Every time I read a story about how the business of health care in america really works, it makes me really angry. It seems to me that one of the central issues is, how all these hospitals and providers can continue to get away with keeping these billing codes proprietary information- how can the prices for your services be a trade secret?? If I receive a hospital bill how is it that I, the customer paying that bill, not receive an itemized list of the procedures done, with prices? I wonder what the legal reasoning behind keeping them from your customer could possibly be? It also strikes me that the companies that aid in coding/billing for providers are an example of software with unintended evil consequences. If you are a developer at one of these companies, how can you justify your role in making healthcare more unaffordable for everyone? I'm now incredibly curious about how this ecosystem really works and how all these perverse incentives are setup and perpetuated. Who are all these software vendors / training course providers / coding specialists / lawyers who maintain this system? A while ago I remember reading stories like these: http://www.nbcnews.com/health/health-care/u-s-health-care-prices-are-all-over-map-new-n563661 http://www.nbcnews.com/health/health-care/u-s-health-care-pr... which compared costs on a geographical level vs. this story where the costs are compared system-by-system, and similar procedure vs. other procedure. Neither makes any sense at all.
- humbleMouse 10y ago
  "It also strikes me that the companies that aid in coding/billing for providers are an example of software with unintended evil consequences. If you are a developer at one of these companies, how can you justify your role in making healthcare more unaffordable for everyone?" 6 figure salary and recession proof employment?
- cmurf 10y ago
  It's derived from a perverse combination of cowboy era "git the F away from me, I will do it myself!" individualism; and classist aristocracy "I am better than you because of bloodline, family name, and money, I can pay to get better health care and I'm not waiting in a line with the likes of the rest of you." A third group genuinely believes an inherently anti-competitive business, with deeply irrational and price inelastic buyers, can magically squirt out unicorn poop in a free market. And they've succeeded at getting the above two groups to use this "choice" and "free markets" nonsense as their messaging, whether they believe it or not, it gets them what they ultimately want. And what we have now, is a highly protected industry that whether before or after ACA, is in no possible way approximating either a free market, or socialized care. It is a legalized cartel, with a massive economic momentum such that even if the politics were to turn on a dime, the health care economic system would resist the changes. There's also conflation between insurance and payment plans. Insurance is risk management for random, unpredictable events like cancer. It wouldn't cover having a baby, that's predictable. Free market health care would mean you pay out of pocket, or out of savings, or you get a loan and have a payment plan. What we have from our health care "insurance" industry, is all the peasants and serfs are on a payment plan. Adding to the amusement is Medicare, after age 65, covers only 64% of the bill. You're on the hook for the rest. And it covers 0% dental, and old people have lots of on-going dental maintenance. If you're dying of a dental related brain disease, you can just go die if you can't pay. And people do. It cannot be understated how classist this system is. And it's a box canyon, near as I can tell.
1_2__3 10y ago
We should remember the only reason in many states buying a car is a transparent process is because the government realized this kind of billig/invoicing is exploitative and unfair. Almost every argument applied to the "one page" car buying rules apply to cell phones, medical treatment, you name it.
patrickg_zill 10y ago
How to fix USA healthcare IMHO: 1. Pharma: drugs must be sold to American people at the same price as the other developed countries such as Canada, Germany, etc. 2. Prices must be published, and, the lowest paid by any insurer must be available as a cash option if you pay at the time of service. That is, an MRI scan with a retail price of $3k but which the insurer pays only $1100 for, must be available for $1100 if you pay at time of service, that same $1100. 3. Repeal EMTALA.
- Mendenhall 10y ago
  Its a dissapointing thing (usa) that both republicans and democrats cant simply agree to make them declare prices etc. Its like all these "acts" have no intention of addressing the real issues at all. Then its amazing to see both parties argue over their plans which will never work because none of them address it from bottom up.
  - patrickg_zill 10y ago
    A poster on another forum I frequent made the point that "regarding the political parties, there are no actual ideologies, only, different interests they represent" and that does seem to ring true some of the time...
  - greeneggs 10y ago
    California publishes Medi-Cal rates [1]. Unfortunately, not all codes are explained, e.g., 99282 (according to the NY Times article, E.R. "examination and treatment of a patient with a finger fracture") and 99283 ("a narcotic painkiller was also prescribed") are both described as just "EMERGENCY DEPT VISIT". California also has a website comparing costs and quality for treatments across hospitals and regions [2]. [1] https://files.medi-cal.ca.gov/pubsdoco/Rates/rates_range_display.asp https://files.medi-cal.ca.gov/pubsdoco/Rates/rates_range_dis... [2] http://www.cahealthcarecompare.org/cost_detail.jsp?region=16&service_id=212&cost_cat=cancer&cost_cat_name=Cancer http://www.cahealthcarecompare.org/cost_detail.jsp?region=16...
- KZeillmann 10y ago
  If I recall, EMTALA is the law that states that hospitals must provide emergency medical care to someone regardless of their ability to pay. Do we really want to live in a society where people are refused treatment for medical care just because they can't pay at that time?
bluetwo 10y ago
Transparency in healthcare billing was actually a point Trump ran on but it disappeared from his website and his agenda as soon as he was elected.
moo 10y ago
A woman's hospital bill for delivering her baby showed "SKIN TO SKIN AFTER C-SEC $39.35". She could of saved some money if she refused to hold her baby right after he was born.
- Graham24 10y ago
  What? Is that like normal practice, that women can be charged $40 for holding their babies immediately after a c-section?
  - johan_larson 10y ago
    An ob-gyn had some stuff to say about it here: http://www.slate.com/blogs/xx_factor/2016/10/05/hospitals_charge_new_parents_for_skin_to_skin_contact.html http://www.slate.com/blogs/xx_factor/2016/10/05/hospitals_ch...
drewg123 10y ago
A few years ago, my wife hurt her back when we were moving. She went to the local urgent care center, and saw a doctor. We have insurance, and that was mostly the end of it for us. We later found out that the urgent care center had coded her visit as something like "surgical consultation" when it was nothing of the sort. I think the insurance company actually contacted my wife and inquired about the visit. We then got curious, and interested in the bill, and discovered that the codes are copyrighted. My wife actually was able to translate the codes using something she found in the local university library (which is how we realized that the visit was upcoded, and suddenly things made sense). We had thought that urgent care chain was just shady, but after reading this, I guess that this upcoding is a common practice.
- coldcode 10y ago
  Optimizing coding to maximize income is a major consultancy in the industry. The key is knowing what an Insurance company will accept without questions otherwise there will be a delay in getting your money or maybe you get nothing. Recently the coding system changed to a much more detailed version (which I think was in use internationally long before the US adopted it). I don't know if it's better but there are way more ways to code things today.
  - awongh 10y ago
    I never realized all this existed! I'm still not clear from the article why the codes used inside the hospital are proprietary. copyrighted information- what kind of legal hoop jumping allows them to claim this? What kind of domain knowledge do you need to be able to code a procedure? Is it knowledge just of the insurance system, or is it also deeper medical knowledge / cultural knowledge of how doctors perceive / deal with one procedure over another?
    - coldcode 10y ago
      The codes are standardized but the interpretation by insurance companies isn't so clear. For the coding look at http://www.medicalbillingandcoding.org/qnas/what-are-the-different-types-of-medical-coding-classification-systems/ http://www.medicalbillingandcoding.org/qnas/what-are-the-dif...
maxerickson 10y ago
I have this paranoid theory that insurance company coders work a lot harder on bills that are after the deductible. A sort of gentleman's agreement to inject as many of those sweet deductible dollars into the system as possible.
- sjg007 10y ago
  Well that or they just deny the claim for some random reason.
nsxwolf 10y ago
I wonder what groceries would cost if we didn't buy them with cash or credit but instead a "Foodcare plan". I also wonder what the bills would look like in that case. If I went to the deli, I imagine there'd be all kinds of interesting blade sharpening fees and glove disposal fees and whatnot.
- wilde 10y ago
  I mean, Comcast does the same sort of thing without any insurance model involvement.
deleted 10y ago
[deleted]

Doctors want to bill insurance for as much as they can. Insurers don't really care about medical costs either, because the percent they keep as profit grows as they spend more. Patients are the victims in the trench warfare between doctors and payers.

misja111 10y ago
Isn't there any competition between health insurers in the US? If it's a free market and consumers care about costs, then you'd expect that at least some health insurer would start looking for ways to put their insurance premium down.
- xena 10y ago
  Under the ACA you can't even go out and buy insurance at any point in the year (from a large number of companies) unless you meet a minimal list of conditions that most people won't.
  - tdb7893 10y ago
    This problem existed far before the ACA so while some stuff in it really needs to be changed I don't think it's fair to blame it for this scenario
- pjc50 10y ago
  The market is riddled with adverse selection problems. The easiest way to reduce costs is to reduce coverage!
- mathgeek 10y ago
  Consolidation quickly takes care of any smaller company that tries to compete, in addition to the other issues mentioned here.
- garethsprice 10y ago
  Most health insurance is provided via subsidized employer plans so consumers can either take the plan they're offered or pay 2-3x as much on the open market. The healthcare system in the US is fundamentally broken, overpriced and cruel. It is one of the worst things about living in this country.
  - kgwgk 10y ago
    Employers are the "consumers" in that case, and they do switch plans if they get a better offer.

johan_larson 10y ago

It sounds like there's a niche for a non-insurance insurer. It wouldn't actually pay for procedures, but in return for a low monthly membership fee, it would negotiate on behalf of the members for their bills, just like an insurance company does.

creaghpatr 10y ago
Patient billing advocates are a real service now. For let's say $500 they go to war with the billing dept of a hospital; the hospital will almost always knock 50% of the price off because they don't want to fight the battle. So many patients default on their bills it's a financial crisis for most hospitals outside of the large major chains. That billing department is going to take what they can get, even if it's only 20% of the amount the patient owes. Pretty nuts.
- drewg123 10y ago
  But apparently that strategy doesn't always work. The lady in the article offered the hospital what her experts said was a reasonable price, including a profit margin & they turned down the offer.
  - creaghpatr 10y ago
    I think the hospitals jack up their list prices with these adjustments presumed. Of course, they don't tell the patient to negotiate a discount that's the last thing they want to deal with. And you're right, it doesn't always work it depends on the context and financial health of the provider.
awongh 10y ago
whoa it already exists: https://disputebills.com/ https://disputebills.com/
- tboyd47 10y ago
  Thank you for sharing this.

zelos 10y ago

Is the situation described for the woman in the article common? It sounds completely insane, I don't see how anyone could defend it. Minimum wage is $7.25, so at a guess say $20k/yr net? $800/month insurance is $9,600, nearly 50% of her income for insurance that would still have left her with a $70k bill after the haemorrhage? Edit: I realise that's kind of the point of the article, but seeing those figures I don't see how _anyone_ below the middle class could get decent insurance.

TheAdamAndChe 10y ago
This is why healthcare is such a huge political issue in the US right now. Tons of people are going into bankruptcy over medical bills, and tons of people are dying that shouldn't be. Many democrats want a single-payer system, and many republicans want a free market. Since we have a two-party political system that is behaving more and more partisan with each year, everyone is just yelling at each other and no solution is being found.
creaghpatr 10y ago
In theory she's mandated to have insurance to prevent this type of thing from happening. If she couldn't afford it the government would subsidize her on the exchanges. In practice, she paid the ACA penalty to have the privilege of not buying insurance and then she got screwed for not having it.
- TheAdamAndChe 10y ago
  After the subsidies, chances are good that the amount she would still have to pay is prohibitively expensive. There is a baseline amount you have to make to get by, and at minimum wage in the US, chances are good you're hitting that baseline amount.

jenkstom 10y ago

The Republicans are (and have been for almost a decade) trading human suffering for political gain. Keeping up with medical bills for a serious illness can be a full-time job. It's tragic, and until everybody after the baby boomers wakes up and bothers to vote we're stuck with it.

dantheman 10y ago
The article is discussing the runaway costs of healthcare -- its both a republican and a democrat issue. The current system is unsustainable.
creaghpatr 10y ago
Is this a comment about the article? The patient experienced her accident in 2013 after the ACA was in effect, which famously not a single republican voted for. Patients are being screwed under the current system right now, regardless of politics. Providers are having trouble remaining financially solvent bc most patients end up not paying their bills; providers rely on private insured or self pay patients to stay afloat because Medicare/Medicaid don't reimburse enough to cover costs. If we put everyone on Medicare the system would shut down, everything else remaining equal- unless we subsidized providers with even more money from taxpayers to replace the insurance companies.
- maxerickson 10y ago
  If Virginia had taken Medicaid expansion, she likely would have been covered, or had access to less expensive insurance.
  - sjg007 10y ago
    And this is why people should move if at all possible to states that took the medicare/medicad expansion. You can either vote out the government or move to a state that offers a better deal. It's almost an impossible choice but it is your life and your families lives. With respect to health care there are a lot of Americans leaving the US (who can) for other countries with health care.

awongh 10y ago

Wow. Every time I read a story about how the business of health care in america really works, it makes me really angry. It seems to me that one of the central issues is, how all these hospitals and providers can continue to get away with keeping these billing codes proprietary information- how can the prices for your services be a trade secret?? If I receive a hospital bill how is it that I, the customer paying that bill, not receive an itemized list of the procedures done, with prices? I wonder what the legal reasoning behind keeping them from your customer could possibly be? It also strikes me that the companies that aid in coding/billing for providers are an example of software with unintended evil consequences. If you are a developer at one of these companies, how can you justify your role in making healthcare more unaffordable for everyone? I'm now incredibly curious about how this ecosystem really works and how all these perverse incentives are setup and perpetuated. Who are all these software vendors / training course providers / coding specialists / lawyers who maintain this system? A while ago I remember reading stories like these: http://www.nbcnews.com/health/health-care/u-s-health-care-prices-are-all-over-map-new-n563661 http://www.nbcnews.com/health/health-care/u-s-health-care-pr... which compared costs on a geographical level vs. this story where the costs are compared system-by-system, and similar procedure vs. other procedure. Neither makes any sense at all.

humbleMouse 10y ago
"It also strikes me that the companies that aid in coding/billing for providers are an example of software with unintended evil consequences. If you are a developer at one of these companies, how can you justify your role in making healthcare more unaffordable for everyone?" 6 figure salary and recession proof employment?
cmurf 10y ago
It's derived from a perverse combination of cowboy era "git the F away from me, I will do it myself!" individualism; and classist aristocracy "I am better than you because of bloodline, family name, and money, I can pay to get better health care and I'm not waiting in a line with the likes of the rest of you." A third group genuinely believes an inherently anti-competitive business, with deeply irrational and price inelastic buyers, can magically squirt out unicorn poop in a free market. And they've succeeded at getting the above two groups to use this "choice" and "free markets" nonsense as their messaging, whether they believe it or not, it gets them what they ultimately want. And what we have now, is a highly protected industry that whether before or after ACA, is in no possible way approximating either a free market, or socialized care. It is a legalized cartel, with a massive economic momentum such that even if the politics were to turn on a dime, the health care economic system would resist the changes. There's also conflation between insurance and payment plans. Insurance is risk management for random, unpredictable events like cancer. It wouldn't cover having a baby, that's predictable. Free market health care would mean you pay out of pocket, or out of savings, or you get a loan and have a payment plan. What we have from our health care "insurance" industry, is all the peasants and serfs are on a payment plan. Adding to the amusement is Medicare, after age 65, covers only 64% of the bill. You're on the hook for the rest. And it covers 0% dental, and old people have lots of on-going dental maintenance. If you're dying of a dental related brain disease, you can just go die if you can't pay. And people do. It cannot be understated how classist this system is. And it's a box canyon, near as I can tell.

1_2__3 10y ago

We should remember the only reason in many states buying a car is a transparent process is because the government realized this kind of billig/invoicing is exploitative and unfair. Almost every argument applied to the "one page" car buying rules apply to cell phones, medical treatment, you name it.

patrickg_zill 10y ago

How to fix USA healthcare IMHO: 1. Pharma: drugs must be sold to American people at the same price as the other developed countries such as Canada, Germany, etc. 2. Prices must be published, and, the lowest paid by any insurer must be available as a cash option if you pay at the time of service. That is, an MRI scan with a retail price of $3k but which the insurer pays only $1100 for, must be available for $1100 if you pay at time of service, that same $1100. 3. Repeal EMTALA.

Mendenhall 10y ago
Its a dissapointing thing (usa) that both republicans and democrats cant simply agree to make them declare prices etc. Its like all these "acts" have no intention of addressing the real issues at all. Then its amazing to see both parties argue over their plans which will never work because none of them address it from bottom up.
- patrickg_zill 10y ago
  A poster on another forum I frequent made the point that "regarding the political parties, there are no actual ideologies, only, different interests they represent" and that does seem to ring true some of the time...
- greeneggs 10y ago
  California publishes Medi-Cal rates [1]. Unfortunately, not all codes are explained, e.g., 99282 (according to the NY Times article, E.R. "examination and treatment of a patient with a finger fracture") and 99283 ("a narcotic painkiller was also prescribed") are both described as just "EMERGENCY DEPT VISIT". California also has a website comparing costs and quality for treatments across hospitals and regions [2]. [1] https://files.medi-cal.ca.gov/pubsdoco/Rates/rates_range_display.asp https://files.medi-cal.ca.gov/pubsdoco/Rates/rates_range_dis... [2] http://www.cahealthcarecompare.org/cost_detail.jsp?region=16&service_id=212&cost_cat=cancer&cost_cat_name=Cancer http://www.cahealthcarecompare.org/cost_detail.jsp?region=16...
KZeillmann 10y ago
If I recall, EMTALA is the law that states that hospitals must provide emergency medical care to someone regardless of their ability to pay. Do we really want to live in a society where people are refused treatment for medical care just because they can't pay at that time?

bluetwo 10y ago

Transparency in healthcare billing was actually a point Trump ran on but it disappeared from his website and his agenda as soon as he was elected.

moo 10y ago

A woman's hospital bill for delivering her baby showed "SKIN TO SKIN AFTER C-SEC $39.35". She could of saved some money if she refused to hold her baby right after he was born.

Graham24 10y ago
What? Is that like normal practice, that women can be charged $40 for holding their babies immediately after a c-section?
- johan_larson 10y ago
  An ob-gyn had some stuff to say about it here: http://www.slate.com/blogs/xx_factor/2016/10/05/hospitals_charge_new_parents_for_skin_to_skin_contact.html http://www.slate.com/blogs/xx_factor/2016/10/05/hospitals_ch...

drewg123 10y ago

A few years ago, my wife hurt her back when we were moving. She went to the local urgent care center, and saw a doctor. We have insurance, and that was mostly the end of it for us. We later found out that the urgent care center had coded her visit as something like "surgical consultation" when it was nothing of the sort. I think the insurance company actually contacted my wife and inquired about the visit. We then got curious, and interested in the bill, and discovered that the codes are copyrighted. My wife actually was able to translate the codes using something she found in the local university library (which is how we realized that the visit was upcoded, and suddenly things made sense). We had thought that urgent care chain was just shady, but after reading this, I guess that this upcoding is a common practice.

coldcode 10y ago
Optimizing coding to maximize income is a major consultancy in the industry. The key is knowing what an Insurance company will accept without questions otherwise there will be a delay in getting your money or maybe you get nothing. Recently the coding system changed to a much more detailed version (which I think was in use internationally long before the US adopted it). I don't know if it's better but there are way more ways to code things today.
- awongh 10y ago
  I never realized all this existed! I'm still not clear from the article why the codes used inside the hospital are proprietary. copyrighted information- what kind of legal hoop jumping allows them to claim this? What kind of domain knowledge do you need to be able to code a procedure? Is it knowledge just of the insurance system, or is it also deeper medical knowledge / cultural knowledge of how doctors perceive / deal with one procedure over another?
  - coldcode 10y ago
    The codes are standardized but the interpretation by insurance companies isn't so clear. For the coding look at http://www.medicalbillingandcoding.org/qnas/what-are-the-different-types-of-medical-coding-classification-systems/ http://www.medicalbillingandcoding.org/qnas/what-are-the-dif...

maxerickson 10y ago

I have this paranoid theory that insurance company coders work a lot harder on bills that are after the deductible. A sort of gentleman's agreement to inject as many of those sweet deductible dollars into the system as possible.

sjg007 10y ago
Well that or they just deny the claim for some random reason.

nsxwolf 10y ago

I wonder what groceries would cost if we didn't buy them with cash or credit but instead a "Foodcare plan". I also wonder what the bills would look like in that case. If I went to the deli, I imagine there'd be all kinds of interesting blade sharpening fees and glove disposal fees and whatnot.

wilde 10y ago
I mean, Comcast does the same sort of thing without any insurance model involvement.

deleted 10y ago

[deleted]