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Please do upfront pricing. It’s so annoying getting a bill afterwards how the fully covered treatment was actually not covered and multiple thousands. Leading t

Please do upfront pricing. It’s so annoying getting a bill afterwards how the fully covered treatment was actually not covered and multiple thousands. Leading to haggling with the insurance company and hospital.

toomuchtodo 3y ago
> Starting in 2022, there are new protections that prevent surprise medical bills. If you have private health insurance, these new protections ban the most common types of surprise bills. If you’re uninsured or you decide not to use your health insurance for a service, under these protections, you can often get a good faith estimate of the cost of your care up front, before your visit. If you disagree with your bill, you may be able to dispute the charges. Here’s what you need to know about your new rights. https://www.cms.gov/newsroom/fact-sheets/no-surprises-understand-your-rights-against-surprise-medical-bills https://www.cms.gov/newsroom/fact-sheets/no-surprises-unders... https://www.cms.gov/NOSURPRISES https://www.cms.gov/NOSURPRISES https://www.consumerfinance.gov/about-us/blog/no-surprises-act-how-we-are-protecting-people-from-side-effects-surprise-medical-bills/ https://www.consumerfinance.gov/about-us/blog/no-surprises-a...
- darth_avocado 3y ago
  The problem is that disputing claims is hard and puts an unnecessary burden on the patient at a time when they are struggling elsewhere. Companies operate in bad faith and more needs to be done to regulate companies (hospitals and insurers).
- Auracle 3y ago
  Why the hell shouldn’t that apply to people that are going to use insurance? The reason our healthcare costs are so high is because everyone with insurance past their deductible is price insensitive. People might at least care about their copay enough to make a difference. I know providers will balk because they negotiate with different insurers, but if they know how much they’re going to bill after the fact surely they can give you an estimate before.
flutas 3y ago
My favorite ones. "Payment is due at the time services are rendered" So you pay what they say it costs. Then months later you get a random bill from them for more.
- thmsths 3y ago
  How can they reasonably expect you to pay in these circumstances? They were clear about wanting payment upfront, you agreed to the price, (presumably) paid them, received the service/treatment. That should be the end of the story. What legal basis do they possibly have to send a bill months later? "We felt like we needed more money because we had a bad quarter" is not going to cut it.
  - nradov 3y ago
    In many cases the patient has insurance with set co-pays so providers collect only the co-pay at time of service based on a good faith assumption that the insurer will pay the rest of the claim at an agreed rate. But if the insurer doesn't pay by a certain deadline then the provider might bill the patient for the balance. Then the patient has to argue with their insurer over the claim. This is a screwed up system that leaves patients caught in the middle of commercial disputes. But providers do deserve be paid for services rendered and it would be unfair to just stiff them.
    - bb88 3y ago
      But also, the patient paid for health insurance for the explicit reason that insurance provides protection against surprise costs, often paying thousands of dollars per year for it. So fuck the patient? That's the current regime.
      - nradov 3y ago
        You may have a misunderstanding of medical insurance. Such policies are very specific and never promised blanket protection against surprise costs. Let's say you crash your car and take it to an auto body shop for repair. If for some reason your auto insurance doesn't pay for the repairs would you tell the mechanic to fuck off and eat the cost? I understand there are issues in healthcare with price transparency and estimates, but the basic principle is the same. Regardless of insurance or lack thereof, customers are obligated to pay for services they receive.
YeBanKo 3y ago
How can you do an upfront pricing for emergency situations?
- FireBeyond 3y ago
  Wait til you hear about how United Healthcare was sued for not covering Lifeflight flights from car accidents because "no preauthorization was obtained"...
  - YeBanKo 3y ago
    Can you link to a good source for this story?
- Danjoe4 3y ago
  You can't, but the vast majority of US healthcare expenses are routine/primary care. If we have price transparency, then price sensitive individuals seeking routine care will drive prices down to a reasonable cost. Many emergency treatments are used in non-emergency situations, and charging a wildly different rate would certainly violate some price gouging law. The debate around US healthcare often misses the point. We all agree it is too expensive. The next question we should ask is: how much does it cost? And the answer is we don't know. That is fundamentally an issue, because price discovery cannot occur if the price is unknown. Our current healthcare system is not a failure of capitalism; it is anti-capitalist. Collusion between big insurance, big pharma, and hospitals have captured the system. We need robust price transparency legislation.
  - YeBanKo 3y ago
    I support price transparency legislation, but I don't think that this is what is going to solve the healthcare affordability. This is a monopoly by design, price transparency is good for markets that are more open to shopping around.
- marcus0x62 3y ago
  Since 1986 in the United States, for all practical purposes, you don't. You provide stabilizing treatment before inquiring as to the patient's ability to pay[0]. Like most [1] significant [2] healthcare legislation in the US, this was passed via budget reconciliation. 0 - https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an... 1 - https://en.wikipedia.org/wiki/Consolidated_Omnibus_Budget_Reconciliation_Act_of_1985 https://en.wikipedia.org/wiki/Consolidated_Omnibus_Budget_Re... 2 - https://en.wikipedia.org/wiki/Health_Care_and_Education_Reconciliation_Act_of_2010 https://en.wikipedia.org/wiki/Health_Care_and_Education_Reco...
dheera 3y ago
Upfront pricing AND optional upfront payment for non-emergency services. If you choose to pay upfront you should receive no further bills, period.

toomuchtodo 3y ago

> Starting in 2022, there are new protections that prevent surprise medical bills. If you have private health insurance, these new protections ban the most common types of surprise bills. If you’re uninsured or you decide not to use your health insurance for a service, under these protections, you can often get a good faith estimate of the cost of your care up front, before your visit. If you disagree with your bill, you may be able to dispute the charges. Here’s what you need to know about your new rights. https://www.cms.gov/newsroom/fact-sheets/no-surprises-understand-your-rights-against-surprise-medical-bills https://www.cms.gov/newsroom/fact-sheets/no-surprises-unders... https://www.cms.gov/NOSURPRISES https://www.cms.gov/NOSURPRISES https://www.consumerfinance.gov/about-us/blog/no-surprises-act-how-we-are-protecting-people-from-side-effects-surprise-medical-bills/ https://www.consumerfinance.gov/about-us/blog/no-surprises-a...

darth_avocado 3y ago
The problem is that disputing claims is hard and puts an unnecessary burden on the patient at a time when they are struggling elsewhere. Companies operate in bad faith and more needs to be done to regulate companies (hospitals and insurers).
Auracle 3y ago
Why the hell shouldn’t that apply to people that are going to use insurance? The reason our healthcare costs are so high is because everyone with insurance past their deductible is price insensitive. People might at least care about their copay enough to make a difference. I know providers will balk because they negotiate with different insurers, but if they know how much they’re going to bill after the fact surely they can give you an estimate before.

flutas 3y ago

My favorite ones. "Payment is due at the time services are rendered" So you pay what they say it costs. Then months later you get a random bill from them for more.

thmsths 3y ago
How can they reasonably expect you to pay in these circumstances? They were clear about wanting payment upfront, you agreed to the price, (presumably) paid them, received the service/treatment. That should be the end of the story. What legal basis do they possibly have to send a bill months later? "We felt like we needed more money because we had a bad quarter" is not going to cut it.
- nradov 3y ago
  In many cases the patient has insurance with set co-pays so providers collect only the co-pay at time of service based on a good faith assumption that the insurer will pay the rest of the claim at an agreed rate. But if the insurer doesn't pay by a certain deadline then the provider might bill the patient for the balance. Then the patient has to argue with their insurer over the claim. This is a screwed up system that leaves patients caught in the middle of commercial disputes. But providers do deserve be paid for services rendered and it would be unfair to just stiff them.
  - bb88 3y ago
    But also, the patient paid for health insurance for the explicit reason that insurance provides protection against surprise costs, often paying thousands of dollars per year for it. So fuck the patient? That's the current regime.
    - nradov 3y ago
      You may have a misunderstanding of medical insurance. Such policies are very specific and never promised blanket protection against surprise costs. Let's say you crash your car and take it to an auto body shop for repair. If for some reason your auto insurance doesn't pay for the repairs would you tell the mechanic to fuck off and eat the cost? I understand there are issues in healthcare with price transparency and estimates, but the basic principle is the same. Regardless of insurance or lack thereof, customers are obligated to pay for services they receive.

YeBanKo 3y ago

How can you do an upfront pricing for emergency situations?

FireBeyond 3y ago
Wait til you hear about how United Healthcare was sued for not covering Lifeflight flights from car accidents because "no preauthorization was obtained"...
- YeBanKo 3y ago
  Can you link to a good source for this story?
Danjoe4 3y ago
You can't, but the vast majority of US healthcare expenses are routine/primary care. If we have price transparency, then price sensitive individuals seeking routine care will drive prices down to a reasonable cost. Many emergency treatments are used in non-emergency situations, and charging a wildly different rate would certainly violate some price gouging law. The debate around US healthcare often misses the point. We all agree it is too expensive. The next question we should ask is: how much does it cost? And the answer is we don't know. That is fundamentally an issue, because price discovery cannot occur if the price is unknown. Our current healthcare system is not a failure of capitalism; it is anti-capitalist. Collusion between big insurance, big pharma, and hospitals have captured the system. We need robust price transparency legislation.
- YeBanKo 3y ago
  I support price transparency legislation, but I don't think that this is what is going to solve the healthcare affordability. This is a monopoly by design, price transparency is good for markets that are more open to shopping around.
marcus0x62 3y ago
Since 1986 in the United States, for all practical purposes, you don't. You provide stabilizing treatment before inquiring as to the patient's ability to pay[0]. Like most [1] significant [2] healthcare legislation in the US, this was passed via budget reconciliation. 0 - https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an... 1 - https://en.wikipedia.org/wiki/Consolidated_Omnibus_Budget_Reconciliation_Act_of_1985 https://en.wikipedia.org/wiki/Consolidated_Omnibus_Budget_Re... 2 - https://en.wikipedia.org/wiki/Health_Care_and_Education_Reconciliation_Act_of_2010 https://en.wikipedia.org/wiki/Health_Care_and_Education_Reco...

dheera 3y ago

Upfront pricing AND optional upfront payment for non-emergency services. If you choose to pay upfront you should receive no further bills, period.