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> The short answer is they can't tell you because they don't know. Bingo. My partner works in revenue cycle management (arguing with insurance companies to pa
by mywittyname 7y ago
> The short answer is they can't tell you because they don't know.
Bingo. My partner works in revenue cycle management (arguing with insurance companies to pay their bills) for a large hospital chain, and even she can't get accurate prices for procedures. She can walk down the hall to the finance department, and ask them, but even they can't figure it out.
I found this out after asking her why they don't prioritize cases with the largest bills, and she said it's because the billed price of the procedure has no relation to the actual priced paid. They could review a $800,000 cancer case and only recover $750.
- notyourday 7y ago> Bingo. My partner works in revenue cycle management (arguing with insurance companies to pay their bills) for a large hospital chain, and even she can't get accurate prices for procedures. She can walk down the hall to the finance department, and ask them, but even they can't figure it out. That's because they are not properly incentivized. It is very simple to solve this problem: charge them with fraud. Same way as a doctor who overbills Medicare would be charged with fraud. We had this kind of things before Enron - CEOs pretended that they cannot possibly know if the numbers in the accounting documents were correct because it was oh so complicated. Now, however begrudgingly, they do sign off on the books and since they are personally responsible they have all the needed incentives.
- stevep98 7y agoThis is one of the reasons that medical pricing is out of control. If nobody knows the pricing for anything, how can anybody (not just patients, but anybody else involved with the system) make rational decisions?