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That sounds like it might be the staff just being uninformed because nobody has ever wanted to do that before. But a likely practical problem with that plan is

by wrs 2y ago

That sounds like it might be the staff just being uninformed because nobody has ever wanted to do that before. But a likely practical problem with that plan is that the cash price is unrelated to the price the insurance company has negotiated with the facility, and the negotiated price is a secret, so if you pay the cash price you won’t be reimbursed for the amount you paid. You’d need to get them to agree to refund the difference if insurance approved later. For imaging in particular, there are some facilities that can handle direct payment rather than expecting everything to be paid by insurance. Maybe look for one of those if this comes up again. Yes, this is very messed up. Welcome to the USA!

gizmo686 2y ago
Are the negotiated prices secret? I've never had a major hospital visit. But every time insurance has covered something for me, I could look on my account claims and see both the official price, and the negotiated price. I also had an "amusing" experience with my dental insurance, where my provider went out of network, and I didn't know until I was in the chair (at which point I was at least asked before they proceeded). When I went to pay, they gave me a bill that listed only something to the effect of "anticipated insurance payment", which is what I was charged. They also filed an insurance claim on my behalf, which was eventually reimbursed fully. However, when I got the reimbursement notice from my insurer, it list a cash price about 50% higher than what I paid, which my insurance company was able to negotiate down for me.
- wrs 2y ago
  Yes, they are secret (otherwise it wouldn’t be a very good negotiation!). You will eventually see some form of the negotiated price for your insurance on the bill, but you won’t see the rebates and so forth that are in the broader contract, so that isn’t equivalent to a cash price. Also, you will probably not be able to see what the price is until it is actually submitted and covered.

by wrs 2y ago

gizmo686 2y ago

Are the negotiated prices secret? I've never had a major hospital visit. But every time insurance has covered something for me, I could look on my account claims and see both the official price, and the negotiated price. I also had an "amusing" experience with my dental insurance, where my provider went out of network, and I didn't know until I was in the chair (at which point I was at least asked before they proceeded). When I went to pay, they gave me a bill that listed only something to the effect of "anticipated insurance payment", which is what I was charged. They also filed an insurance claim on my behalf, which was eventually reimbursed fully. However, when I got the reimbursement notice from my insurer, it list a cash price about 50% higher than what I paid, which my insurance company was able to negotiate down for me.

wrs 2y ago
Yes, they are secret (otherwise it wouldn’t be a very good negotiation!). You will eventually see some form of the negotiated price for your insurance on the bill, but you won’t see the rebates and so forth that are in the broader contract, so that isn’t equivalent to a cash price. Also, you will probably not be able to see what the price is until it is actually submitted and covered.