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“The hospital and its services are under no obligation to provide accurate pricing until ipso facto, and the pricing can often be changed because it doesn't sta

“The hospital and its services are under no obligation to provide accurate pricing until ipso facto, and the pricing can often be changed because it doesn't stand up when placed under scrutiny” That’s what’s driving me crazy. No other business can make up charges repeatedly and when found out, say “oops” and change them a little. In what way is this not fraud?

dfxm12 7y ago
In what way is this not fraud? In the way where you buy the legal definition of fraud from the senate.
cgriswald 7y ago
Try being uninsured. I had a woman come into my room (!) during my ER visit and ask for payment. I asked very clearly if this was covering the cost of the visit. I made it clear I understood the doctor and xrays would be billed separately. I paid. It wasn’t cheap. I got the bill from the doctor. It was reasonable and I paid promptly. I got the bill for the X-ray and it was ridiculously low to my surprise. It was paid immediately. In my mind, I was done. Then I started getting phone calls from a broken machine. Please call <actual silence> at <more silence> about your past due amount of <~$4000>. I assumed they were spam, but after about 10 of these calls over three days, the message variables were randomly filled or not on any given message. At no point was the message clearly about my hospital visit identified, but I figured it out by the phone number and the name of the parent company. At this point I hadn’t even been mailed a bill. And I know they have the right address because the other bills came and I’ve only ever lived at my current house since the first time I went to this hospital. So I went down to the hospital to sort it out. Well, they don’t have a billing department. They have “financial counseling” or something equally not what I need. And even though it was in the hours they are supposed to be there, everyone had gone home for the day. I still haven’t paid. I haven’t gotten a bill, and I’m not entirely sure the calls aren’t just a scam someone is running.
- bcassedy 7y ago
  Even when you're insured this happens. I had a woman come into my ER room and demand payment of my full deductible. They ended up refunding me 2/3 of it about a year later.
  - lowercased 7y ago
    yep, same thing happened here. I'd seen pictures, but.. yeah. Wife cut her hand Thanksgiving night - had to go to ER - bleeding pretty bad. Initial triage was a few minutes, then in to an ER room to 'wait'. Someone came in after about 10 minutes with a portable POS on wheels, saying we had to pay $450 for the ER visit. No explanation about anything, and... I paid, but... I was in no position to 'shop around', nor even be confrontational. If I make a scene, or refuse to pay, or ask for more details, will they make us wait 6 hours? Or 8? I wanted this addresses ASAP, and paid. And... we still ended up getting bills for around $3400 (total of 9 stitches on her hand). This is with 'full insurance', which, we pay $1k/month for for 2 people. That anyone defends this system as 'the best' is beyond me.
- Ididntdothis 7y ago
  I couldn’t even imagine going to a hospital uninsured. It means you are pretty much giving them a blank check to take all the money you have.
  - alistairSH 7y ago
    What's your other option? If you're critically ill/injured, the hospital/ER is where you go - that's who can treat your problem immediately.
  - code_duck 7y ago
    it can work out exactly the same later on if your insurance it decides that they don't agree with doctors about a procedure being necessary, putting you on the hook for whatever.
    - ajford 7y ago
      Yep. My wife was billed almost $500 for out-of-network pregnancy testing when she went in for an injury, as they needed to confirm before they could give her painkillers. She was certain that she wasn't pregnant, given she had seen her GYN just two weeks prior and was on implanted BC. We're still fighting the appeal and the hospital regarding the use of an out-of-network lab instead of the in-network lab then used for the rest of tests.
  - jasonjayr 7y ago
    I have read and been told repeatedly that if you are not insured, you can typically negotiate any fee down to a reasonable rate, so long as you are diligent about it.
    - Ididntdothis 7y ago
      “Reasonable” is relative. Also first try to pull this off yourself. It’s not a pleasant process and takes a long time.
  - protanopia 7y ago
    If you owe a bank thousands, you have a problem; owe a bank millions, the bank has a problem. It isn't in hospitals best interest to have people go bankrupt.
gotoeleven 7y ago
College prices are kind of like this, in that they follow the simple formula tuition cost = how much you can borrow + how much you can pay What is strange is why do we stand for huge price discrimination in college and medical care, but not for buying a candy bar?
- Ididntdothis 7y ago
  Somehow doctors and colleges have maneuvered themselves into a position where they act like greedy companies but have a reputation for working for the greater good and should be trusted more than regular companies . Also people still believe that non profits are dogooders which is completely untrue in the case of schools and medical facilities.
- Loughla 7y ago
  >tuition cost = how much you can borrow + how much you can pay I need this flushed out a little bit more. I have worked in higher ed for decades, and have never encountered a college that charges in that manner. They have a flat tuition, and the student fills that payment however they are able. But it's not like it changes based on how much capital they have access to. Can you please explain that statement?
  - big_chungus 7y ago
    No, the generous "financial aid" policies of many universities amount to perfect price discrimination. They meet "one hundred percent of demonstrated need"; their phrase, not mine. This means they calculate how much you can afford to pay and charge you that much. That' is every monopolist's/oligopolist's dream. Oh, and they don't show how they calculate that "demonstrated need". I got prices much higher than what I could afford.
  - KptMarchewa 7y ago
    It's not on the level of individual student, but overall market. As ability of whole group of students to pay goes up, the price also goes up.

dfxm12 7y ago

In what way is this not fraud? In the way where you buy the legal definition of fraud from the senate.

cgriswald 7y ago

Try being uninsured. I had a woman come into my room (!) during my ER visit and ask for payment. I asked very clearly if this was covering the cost of the visit. I made it clear I understood the doctor and xrays would be billed separately. I paid. It wasn’t cheap. I got the bill from the doctor. It was reasonable and I paid promptly. I got the bill for the X-ray and it was ridiculously low to my surprise. It was paid immediately. In my mind, I was done. Then I started getting phone calls from a broken machine. Please call <actual silence> at <more silence> about your past due amount of <~$4000>. I assumed they were spam, but after about 10 of these calls over three days, the message variables were randomly filled or not on any given message. At no point was the message clearly about my hospital visit identified, but I figured it out by the phone number and the name of the parent company. At this point I hadn’t even been mailed a bill. And I know they have the right address because the other bills came and I’ve only ever lived at my current house since the first time I went to this hospital. So I went down to the hospital to sort it out. Well, they don’t have a billing department. They have “financial counseling” or something equally not what I need. And even though it was in the hours they are supposed to be there, everyone had gone home for the day. I still haven’t paid. I haven’t gotten a bill, and I’m not entirely sure the calls aren’t just a scam someone is running.

bcassedy 7y ago
Even when you're insured this happens. I had a woman come into my ER room and demand payment of my full deductible. They ended up refunding me 2/3 of it about a year later.
- lowercased 7y ago
  yep, same thing happened here. I'd seen pictures, but.. yeah. Wife cut her hand Thanksgiving night - had to go to ER - bleeding pretty bad. Initial triage was a few minutes, then in to an ER room to 'wait'. Someone came in after about 10 minutes with a portable POS on wheels, saying we had to pay $450 for the ER visit. No explanation about anything, and... I paid, but... I was in no position to 'shop around', nor even be confrontational. If I make a scene, or refuse to pay, or ask for more details, will they make us wait 6 hours? Or 8? I wanted this addresses ASAP, and paid. And... we still ended up getting bills for around $3400 (total of 9 stitches on her hand). This is with 'full insurance', which, we pay $1k/month for for 2 people. That anyone defends this system as 'the best' is beyond me.
Ididntdothis 7y ago
I couldn’t even imagine going to a hospital uninsured. It means you are pretty much giving them a blank check to take all the money you have.
- alistairSH 7y ago
  What's your other option? If you're critically ill/injured, the hospital/ER is where you go - that's who can treat your problem immediately.
- code_duck 7y ago
  it can work out exactly the same later on if your insurance it decides that they don't agree with doctors about a procedure being necessary, putting you on the hook for whatever.
  - ajford 7y ago
    Yep. My wife was billed almost $500 for out-of-network pregnancy testing when she went in for an injury, as they needed to confirm before they could give her painkillers. She was certain that she wasn't pregnant, given she had seen her GYN just two weeks prior and was on implanted BC. We're still fighting the appeal and the hospital regarding the use of an out-of-network lab instead of the in-network lab then used for the rest of tests.
- jasonjayr 7y ago
  I have read and been told repeatedly that if you are not insured, you can typically negotiate any fee down to a reasonable rate, so long as you are diligent about it.
  - Ididntdothis 7y ago
    “Reasonable” is relative. Also first try to pull this off yourself. It’s not a pleasant process and takes a long time.
- protanopia 7y ago
  If you owe a bank thousands, you have a problem; owe a bank millions, the bank has a problem. It isn't in hospitals best interest to have people go bankrupt.

gotoeleven 7y ago

College prices are kind of like this, in that they follow the simple formula tuition cost = how much you can borrow + how much you can pay What is strange is why do we stand for huge price discrimination in college and medical care, but not for buying a candy bar?

Ididntdothis 7y ago
Somehow doctors and colleges have maneuvered themselves into a position where they act like greedy companies but have a reputation for working for the greater good and should be trusted more than regular companies . Also people still believe that non profits are dogooders which is completely untrue in the case of schools and medical facilities.
Loughla 7y ago
>tuition cost = how much you can borrow + how much you can pay I need this flushed out a little bit more. I have worked in higher ed for decades, and have never encountered a college that charges in that manner. They have a flat tuition, and the student fills that payment however they are able. But it's not like it changes based on how much capital they have access to. Can you please explain that statement?
- big_chungus 7y ago
  No, the generous "financial aid" policies of many universities amount to perfect price discrimination. They meet "one hundred percent of demonstrated need"; their phrase, not mine. This means they calculate how much you can afford to pay and charge you that much. That' is every monopolist's/oligopolist's dream. Oh, and they don't show how they calculate that "demonstrated need". I got prices much higher than what I could afford.
- KptMarchewa 7y ago
  It's not on the level of individual student, but overall market. As ability of whole group of students to pay goes up, the price also goes up.