4 ms·

I had a procedure done recently. I was given a bill, I opted for a more expensive treatment, it was a ~$1500 total, my insurance wouldn't cover an extra $300, I

I had a procedure done recently. I was given a bill, I opted for a more expensive treatment, it was a ~$1500 total, my insurance wouldn't cover an extra $300, I paid it since it seemed worth the extra money. I received another bill in the mail for $300 a month later that my insurance had additionally decided not to cover. What is this world you live in where American health insurance means you don't have to comparison shop? Healthcare is a huge expense and not only are the prices high, they change after the fact at the whims of the people I'm theoretically paying to handle the negotiations.

timr 1y ago
You're describing a scenario where you bought the product without knowing the price, and were shocked by the additional bill(s) you got after the fact. At what point in your story were you able to comparison shop for a cheaper option? I know you said you chose a more expensive option, which is always your prerogative, but how many other providers did you evaluate before you made that decision?
- etchalon 1y ago
  He explicitly said he did know the price. The price changed.
  - timr 1y ago
    He said he was presented a price. That price was not correct, so...it wasn't the price.
- lukeschlather 1y ago
  I received a bill for the price and the price became more expensive after the fact. In my experience it's a fact of American healthcare that you always pay more than the price you are quoted. But you are usually quoted a price. I was quoted a price, I paid it, and then it increased. This is how paying for healthcare works in America.
  - timr 1y ago
    OK. So...you were presented a number, but you can't depend on the number, and therefore my question stands: how do you shop for a cheaper option?
    - lukeschlather 1y ago
      Any sort of repair is inherently unpredictable, and healthcare especially so. Whenever I pay for something like this it's natural that the costs may prove more than what I expect. The risk that there is some irregularity with my insurance is similar, it's a risk that I take when I pay for a procedure. You can't depend that money spent on healthcare will help you in any way, it's a fact of life. I mean, in this case I actually was able to depend on the numbers, it's just I can't depend on my insurance but then that's also a fact of insurance markets. Take away the insurance, I doubt my total cost would've been lower, even accounting for my insurance premiums and whatever my employer pays as part of that. There's a market here, I would prefer it were more regulated, not less. A less regulated market would not help me. A less regulated market would make it easier for prices to change at random.
      - timr 1y ago
        > Any sort of repair is inherently unpredictable, and healthcare especially so. There are certainly acute situations that are unpredictable -- go to the ER with a gunshot wound, and nobody can tell you what it's going to cost. That's fine. But most of the time, you're wrong. Health care moves slowly, and there's lots of time to think and plan. The costs of pretty much any procedure is pre-negotiated by the insurer and the provider, so they actually do know what it's going to cost. They just don't tell you. There's no fundamental reason you couldn't have been quoted an accurate price in the scenario you described.
        lukeschlather 1y ago
        > But most of the time, you're wrong. Health care moves slowly, and there's lots of time to think and plan. The costs of pretty much any procedure is pre-negotiated by the insurer and the provider, so they actually do know what it's going to cost. They just don't tell you. I received an itemized bill with the exact cost and what would be covered listed, then it changed after the fact. It is certainly the case that for some procedures you can't get this, but for procedures where you know the cost will be hundreds you can easily obtain such a bill. Such bills always involve guesswork though. Even absent insurance this would be true, complications happen.
yepitwas 1y ago
For our kids births, it was typical to still have bills trickling in six months later from some company or another, having no idea which part they were really involved in unless we felt like spending three hours on hold to figure it out. And always they're like YOU MUST PAY THIS IMMEDIATELY or be sent to collections even though they take their sweet fucking time getting them to you, and also make it a pain in the ass to question any of it (and some of them are serious, in two cases we had trivial-amount ones slip through the cracks of the 50+ billing and EOB and blah blah blah letters we received, and go to collections right at 30 days, not even a follow-up "hey you may have missed this, you're overdue" letter) I wouldn't be surprised if there are a bunch of scam artists out there sending fraudulent small bills to patients with recent major procedures (guaranteed to have a mountain of confusing bills coming in for months) whose info they got from our massive privatized spy network, and having almost all of them get paid. Like, compared to some other stuff that goes on, that seems like a no-brainer of a scam to run, with likely a very high success rate (am I going to burn potentially half of a day per bill to figure out if one of these fifteen $10-$200 invoices is fraudulent? No, no I am not)

timr 1y ago

You're describing a scenario where you bought the product without knowing the price, and were shocked by the additional bill(s) you got after the fact. At what point in your story were you able to comparison shop for a cheaper option? I know you said you chose a more expensive option, which is always your prerogative, but how many other providers did you evaluate before you made that decision?

etchalon 1y ago
He explicitly said he did know the price. The price changed.
- timr 1y ago
  He said he was presented a price. That price was not correct, so...it wasn't the price.
lukeschlather 1y ago
I received a bill for the price and the price became more expensive after the fact. In my experience it's a fact of American healthcare that you always pay more than the price you are quoted. But you are usually quoted a price. I was quoted a price, I paid it, and then it increased. This is how paying for healthcare works in America.
- timr 1y ago
  OK. So...you were presented a number, but you can't depend on the number, and therefore my question stands: how do you shop for a cheaper option?
  - lukeschlather 1y ago
    Any sort of repair is inherently unpredictable, and healthcare especially so. Whenever I pay for something like this it's natural that the costs may prove more than what I expect. The risk that there is some irregularity with my insurance is similar, it's a risk that I take when I pay for a procedure. You can't depend that money spent on healthcare will help you in any way, it's a fact of life. I mean, in this case I actually was able to depend on the numbers, it's just I can't depend on my insurance but then that's also a fact of insurance markets. Take away the insurance, I doubt my total cost would've been lower, even accounting for my insurance premiums and whatever my employer pays as part of that. There's a market here, I would prefer it were more regulated, not less. A less regulated market would not help me. A less regulated market would make it easier for prices to change at random.
    - timr 1y ago
      > Any sort of repair is inherently unpredictable, and healthcare especially so. There are certainly acute situations that are unpredictable -- go to the ER with a gunshot wound, and nobody can tell you what it's going to cost. That's fine. But most of the time, you're wrong. Health care moves slowly, and there's lots of time to think and plan. The costs of pretty much any procedure is pre-negotiated by the insurer and the provider, so they actually do know what it's going to cost. They just don't tell you. There's no fundamental reason you couldn't have been quoted an accurate price in the scenario you described.
      - lukeschlather 1y ago
        > But most of the time, you're wrong. Health care moves slowly, and there's lots of time to think and plan. The costs of pretty much any procedure is pre-negotiated by the insurer and the provider, so they actually do know what it's going to cost. They just don't tell you. I received an itemized bill with the exact cost and what would be covered listed, then it changed after the fact. It is certainly the case that for some procedures you can't get this, but for procedures where you know the cost will be hundreds you can easily obtain such a bill. Such bills always involve guesswork though. Even absent insurance this would be true, complications happen.

yepitwas 1y ago

For our kids births, it was typical to still have bills trickling in six months later from some company or another, having no idea which part they were really involved in unless we felt like spending three hours on hold to figure it out. And always they're like YOU MUST PAY THIS IMMEDIATELY or be sent to collections even though they take their sweet fucking time getting them to you, and also make it a pain in the ass to question any of it (and some of them are serious, in two cases we had trivial-amount ones slip through the cracks of the 50+ billing and EOB and blah blah blah letters we received, and go to collections right at 30 days, not even a follow-up "hey you may have missed this, you're overdue" letter) I wouldn't be surprised if there are a bunch of scam artists out there sending fraudulent small bills to patients with recent major procedures (guaranteed to have a mountain of confusing bills coming in for months) whose info they got from our massive privatized spy network, and having almost all of them get paid. Like, compared to some other stuff that goes on, that seems like a no-brainer of a scam to run, with likely a very high success rate (am I going to burn potentially half of a day per bill to figure out if one of these fifteen $10-$200 invoices is fraudulent? No, no I am not)