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I've commented on HN specifically about Stanford billing in the past. I will stick my neck out and say that I believe it is straight up fraudulent. I am convin

by zaroth 8y ago

I've commented on HN specifically about Stanford billing in the past. I will stick my neck out and say that I believe it is straight up fraudulent. I am convinced, although I have no evidence, that there is a kickback somewhere along the line back to the insurance company for approving the inflated bill, knowing that they can kick 20% of it over to the customer as co-insurance. I had my own Stanford bill for a child's ER visit which included a basic blood chemistry and a single shot of insulin that turned into a 5-figure bill of which they wanted me to pay 20%. They "coded" the visit as intensive care, even though my child never left a basic exam room, and the only treatment was a subcutaneous injection. The good news is that after a year of fighting they wrote it off and I paid nothing. But it took about 100 hours of calls, letters, and threats. Patients should not have to go through this. I blame the regulators. I blame the insurance company. But most of all, I blame Stanford Hospital. They should have their non-profit status revoked, because in fact, they are one of the most profitable hospitals in the country.

pkaye 8y ago
This is why I prefer the Kaiser Permanente system. It has its drawbacks but there is much better out of pocket cost certainty. When I go to ER, I know exactly what it will cost. $100 if not admitted or $0 if admitted. My blood tests are $20 per draw as are my doctor visits. I'm also on dialysis so use them a lot. However they set it up to exclude copay for 1 visit and blood draw per month. So my OOP costs are pretty low despite my health situation.
mitchell_h 8y ago
Check your credit. My second son was born a month early and spent 3 days in the NICU. 3 years later I was getting fresh bills from doctors I couldn't remember. Spent another year arguing with the hospital, the doctors and the facilities people(hospital and floor space and doctors all are different bills!!!!!). After a year they "wrote off the bills" what they actually did was stopped chasing me or accepting my calls, and put a knock on my credit report for the debt. it was another year of fighting those.
- zaroth 8y ago
  If they told you they were crediting the bill and then slammed your credit, that's just more fraud. Probably a felony, but IANAL. Of course, nearly nothing you can do about it except take them to small claims court? At least in my case it never went to collections or hit my credit report. This was 5 years ago, I guess it's never too late for them to try. Makes me wish I recorded the call when I finally was told they were crediting the bill.
sonnyblarney 8y ago
It doesn't have to be fraud. The industry is smart, it could just be implicit collusion. It's like the prisoners strategy game ... except they are not prisoners - the are the wardens and we are the prisoners. All they have to do is 'not compete against each other' and just play the 'price game'. People love Musk and Bezos for their little boy rocket experiments, sure I'm glad they're doing it, but that's easy, it's so aspirational anyone would want to do it. They're doing what NASA can't seem to do - great. You know who'd have actual big balls? A billionaire that took on Healthcare and started putting insurance companies out of business, started scaring the crap out of fraudulent hospitals etc.. Who started class-action lawsuits against hospitals for lack of clarity in billing etc.. I would actually respect Wallmart or Amazon if they got into the healthcare business - both of them exist to wipe out costs in the value chain as a natural modus operandi, they might have the power to do it.

by zaroth 8y ago

pkaye 8y ago

This is why I prefer the Kaiser Permanente system. It has its drawbacks but there is much better out of pocket cost certainty. When I go to ER, I know exactly what it will cost. $100 if not admitted or $0 if admitted. My blood tests are $20 per draw as are my doctor visits. I'm also on dialysis so use them a lot. However they set it up to exclude copay for 1 visit and blood draw per month. So my OOP costs are pretty low despite my health situation.

mitchell_h 8y ago

Check your credit. My second son was born a month early and spent 3 days in the NICU. 3 years later I was getting fresh bills from doctors I couldn't remember. Spent another year arguing with the hospital, the doctors and the facilities people(hospital and floor space and doctors all are different bills!!!!!). After a year they "wrote off the bills" what they actually did was stopped chasing me or accepting my calls, and put a knock on my credit report for the debt. it was another year of fighting those.

zaroth 8y ago
If they told you they were crediting the bill and then slammed your credit, that's just more fraud. Probably a felony, but IANAL. Of course, nearly nothing you can do about it except take them to small claims court? At least in my case it never went to collections or hit my credit report. This was 5 years ago, I guess it's never too late for them to try. Makes me wish I recorded the call when I finally was told they were crediting the bill.

sonnyblarney 8y ago

It doesn't have to be fraud. The industry is smart, it could just be implicit collusion. It's like the prisoners strategy game ... except they are not prisoners - the are the wardens and we are the prisoners. All they have to do is 'not compete against each other' and just play the 'price game'. People love Musk and Bezos for their little boy rocket experiments, sure I'm glad they're doing it, but that's easy, it's so aspirational anyone would want to do it. They're doing what NASA can't seem to do - great. You know who'd have actual big balls? A billionaire that took on Healthcare and started putting insurance companies out of business, started scaring the crap out of fraudulent hospitals etc.. Who started class-action lawsuits against hospitals for lack of clarity in billing etc.. I would actually respect Wallmart or Amazon if they got into the healthcare business - both of them exist to wipe out costs in the value chain as a natural modus operandi, they might have the power to do it.