2 ms·
How does that work? Who paid the rest of the 200K? Seems like a crazy amount for something that mostly goes ok in the modern world.
by lordnacho 5y ago
How does that work? Who paid the rest of the 200K? Seems like a crazy amount for something that mostly goes ok in the modern world.
- marcinzm 5y agoIt's a negotiation. The $200k is simply the starting/maximum ask by the hospital to the insurance company. A bunch of automated and (sometimes) manual systems go back and forth until a price is agreed upon. Eventually everyone agrees on paying $50k. Like any negotiation you want to start high rather than low.
- gccs 5y agoNobody. You aren't ment to pay the price they charge.
- gilbertbw 5y agoThe insurance company negotiated a lower bill.
- ceejayoz 5y agoNo one. The rest just evaporates. The original bill has little relation to the actual costs the hospital has to recoup.
- css 5y agoIn the above example, the remaining balance gets accounted for as a loss to maintain the fiction of the facility’s not-for-profit status. It also provides the basis for a kickback the federal government sends to this hospital called Disproportionate Share Hospital payments [0]. In medical parlance, this is called uncompensated care or uncompensated revenue. The Center for Medicare and Medicaid provides a ton of detail [1]. [0]: https://en.wikipedia.org/wiki/Disproportionate_share_hospital https://en.wikipedia.org/wiki/Disproportionate_share_hospita... [1]: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Paper-Based-Manuals-Items/CMS021935 https://www.cms.gov/Regulations-and-Guidance/Guidance/Manual...