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My experience is that hospitals have switched to a zero tolerance policy around this in the last few years. They'd rather make no concessions and sell bad debt

My experience is that hospitals have switched to a zero tolerance policy around this in the last few years. They'd rather make no concessions and sell bad debt for pennies on the dollar than set a precedent that there are alternative channels of payment. The one lifeline they give you is an interest free loan. From an economic standpoint, I'm sure this optimizes revenue. From a humanitarian standpoint, it's disturbing. I'm not arguing healthcare should be free or discounted, but when you receive a $500 bill because the on-call ambulance wasn't in network (though the others are in-network and would have cost you $50) it is hard to justify zero tolerance. We have a gold plan and I can't count the times we've been subject to loophole fees like this.

ethbro 8y ago
Caveat: All hospitals not managed identically. I'm sure there's a lot of varying billing policy, hospital to hospital. And varying ability to financially write off care. As a gut guess, I'd expect rural hospitals to be the worst about this and suburban the best.
- pcarolan 8y ago
  I'm sure this is true. We've (unfortunately) now experienced this at 4 different hospital systems. The customer service is alarmingly similar. Hospital: "Call your insurance company and ask for a break" Insurance Company: "Call the hospital and ask for a break" Also, 2/4 of these hospitals had outsourced their billing which means they can't even make decisions on behalf of the hospital (and have a disincentive to write anything off). Seems like a structural way of avoiding writedowns.
  - ethbro 8y ago
    Was going to ask about outsourcing. I don't know the market on provider billing, but I'd assume there are some companies that manage a number of facilities. And wow, does that search bring up a lot of astroturf: https://www.google.com/search?q=list+of+medical+billing+companies+by+size https://www.google.com/search?q=list+of+medical+billing+comp...

ethbro 8y ago

Caveat: All hospitals not managed identically. I'm sure there's a lot of varying billing policy, hospital to hospital. And varying ability to financially write off care. As a gut guess, I'd expect rural hospitals to be the worst about this and suburban the best.

pcarolan 8y ago
I'm sure this is true. We've (unfortunately) now experienced this at 4 different hospital systems. The customer service is alarmingly similar. Hospital: "Call your insurance company and ask for a break" Insurance Company: "Call the hospital and ask for a break" Also, 2/4 of these hospitals had outsourced their billing which means they can't even make decisions on behalf of the hospital (and have a disincentive to write anything off). Seems like a structural way of avoiding writedowns.
- ethbro 8y ago
  Was going to ask about outsourcing. I don't know the market on provider billing, but I'd assume there are some companies that manage a number of facilities. And wow, does that search bring up a lot of astroturf: https://www.google.com/search?q=list+of+medical+billing+companies+by+size https://www.google.com/search?q=list+of+medical+billing+comp...