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I have read elsewhere, but cannot find a reference right now, that insurers typically pay only a percentage of any bill and expect the provider to accept it in
by rlpb 7y ago
I have read elsewhere, but cannot find a reference right now, that insurers typically pay only a percentage of any bill and expect the provider to accept it in final settlement. The percentage gets negotiated around.
If this is true, then it makes sense that the providers inflate their original bills so that when they get the proportional settlement, the amount they receive is reasonable.
The claim was that individuals settling directly are merely caught in the crossfire.
If this is true, then it's not the providers being unreasonable.
- nonbel 7y agohttps://en.wikipedia.org/wiki/Chargemaster https://en.wikipedia.org/wiki/Chargemaster
- refurb 7y agoThere a few different drivers of the ridiculous list prices at hospitals. 1. The gov't forces them to disclose a price and they can't charge higher than it. Thus, they have every incentive to make it really high, then give preferred customers (insurers) a discount. 2. The system is firmly locked into a cycle of "percent of charges". Basically the insurer says "I know your chargermaster prices are inflated, so let's agree on 20% of that". The following year the hospital jacks up the chargemaster prices during negotiation so they start from a higher initial point.
- deleted 7y ago[deleted]