3 ms·

I wonder if bitten by duck is more expensive that bitten by chicken.

chimeracoder 3y ago
> I wonder if bitten by duck is more expensive that bitten by chicken. They're diagnosis codes, so they're mostly irrelevant for determining cost. You don't get charged for "having the flu" - you get charged for the various services or treatments you received in the course of your illness. Diagnosis codes do factor into claims reimbursement indirectly. For example, some services can be done either as treatment or for preventive purposes, and insurance is legally required[0] to cover the latter at no cost to the patient, whereas insurers can require that the patient pay for the former. But that's pretty indirect - by and large, the payment agreements between insurers and in-network providers apply to services rendered, which doesn't really factor in diagnoses codes (assuming that the service was appropriate for the diagnosis in the first place). That's assuming fee-for-service: capitation is a whole other model, although in that case it's still typically determined independent of the diagnosis, because the whole point of capitation is to minimize care delivered. But getting bitten by a duck vs. a chicken is unlikely to cause any difference in the price you pay, unless: (a) the injuries from the duck bite were significantly different from the injuries from a chicken bite, or (b) one was considered an occupational exposure and the other wasn't (in which case worker's compensation would be billed for it). [0] well, until March of this year, when a judge in Texas overturned that clause of the ACA
btown 3y ago
Not even ironically, this all smells of insurers wanting sufficient data to raise rates on different types of farmers and breeders. It might be scandalous if they didn’t collect the data and then were biased against, say, chicken farmers. But if they do collect the data, they can say they analyzed it, whether or not they did, to support any kind of tactic they desired.
- lotsofpulp 3y ago
  You are smelling something that is not there because, in the US, health insurers are only allowed a few factors to determine someone’s premium. https://www.healthcare.gov/how-plans-set-your-premiums https://www.healthcare.gov/how-plans-set-your-premiums > Five factors can affect a plan’s monthly premium: location, age, tobacco use, plan category, and whether the plan covers dependents.
  - btown 3y ago
    True for marketplace insurance, but private plans (which companies would provide to employees at enticingly lower premiums than public options) vary considerably. See, for but one example, https://www.lgbtmap.org/img/maps/citations-nondisc-insurance.pdf https://www.lgbtmap.org/img/maps/citations-nondisc-insurance...

> I wonder if bitten by duck is more expensive that bitten by chicken. They're diagnosis codes, so they're mostly irrelevant for determining cost. You don't get charged for "having the flu" - you get charged for the various services or treatments you received in the course of your illness. Diagnosis codes do factor into claims reimbursement indirectly. For example, some services can be done either as treatment or for preventive purposes, and insurance is legally required[0] to cover the latter at no cost to the patient, whereas insurers can require that the patient pay for the former. But that's pretty indirect - by and large, the payment agreements between insurers and in-network providers apply to services rendered, which doesn't really factor in diagnoses codes (assuming that the service was appropriate for the diagnosis in the first place). That's assuming fee-for-service: capitation is a whole other model, although in that case it's still typically determined independent of the diagnosis, because the whole point of capitation is to minimize care delivered. But getting bitten by a duck vs. a chicken is unlikely to cause any difference in the price you pay, unless: (a) the injuries from the duck bite were significantly different from the injuries from a chicken bite, or (b) one was considered an occupational exposure and the other wasn't (in which case worker's compensation would be billed for it). [0] well, until March of this year, when a judge in Texas overturned that clause of the ACA

btown 3y ago

Not even ironically, this all smells of insurers wanting sufficient data to raise rates on different types of farmers and breeders. It might be scandalous if they didn’t collect the data and then were biased against, say, chicken farmers. But if they do collect the data, they can say they analyzed it, whether or not they did, to support any kind of tactic they desired.

lotsofpulp 3y ago
You are smelling something that is not there because, in the US, health insurers are only allowed a few factors to determine someone’s premium. https://www.healthcare.gov/how-plans-set-your-premiums https://www.healthcare.gov/how-plans-set-your-premiums > Five factors can affect a plan’s monthly premium: location, age, tobacco use, plan category, and whether the plan covers dependents.
- btown 3y ago
  True for marketplace insurance, but private plans (which companies would provide to employees at enticingly lower premiums than public options) vary considerably. See, for but one example, https://www.lgbtmap.org/img/maps/citations-nondisc-insurance.pdf https://www.lgbtmap.org/img/maps/citations-nondisc-insurance...