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mrmpa

(4,033 posts)
Tue Aug 28, 2012, 01:12 AM Aug 2012

I am pissed at healthcare and billing practices...........

I recently had a brain MRI with and without contrast. The office where I had it done billed my insurance company over $2000. With contracted prices, etc. the insurance company will pay $489 and my responsibility is $951.

I checked the Healthcare Blue Book pricing for this procedure in my zip code and find that it is $771. This is for the procedure and interpretation.

The Blue Book shows that the pricing for an MRI without contrast is $536 and if I had one with contrast it would be $581.

I was charged three times the Blue Book fair price and which according to Blue Book Price includes the total amount for both physician (interpretation) and technical (imaging) fees. Sometimes the test will be billed in two parts but they should add up to the listed price.

I've already started my letter to the office requesting that they either resubmit the bill at the lower price, or subtract the $489 paid by insurance from the $771 leaving me with a payment due of $282. Wish me luck on that.

9 replies = new reply since forum marked as read
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I am pissed at healthcare and billing practices........... (Original Post) mrmpa Aug 2012 OP
I do wish you luck. yellerpup Aug 2012 #1
I will...........eom mrmpa Aug 2012 #2
Have you asked your health care insurance provider to intervene on your behalf? Lasher Aug 2012 #3
Yes, it seems they would want to reduce the bill, right? freshwest Aug 2012 #4
Yes. From my experience hospitals routinely overcharge. Lasher Aug 2012 #8
I will give that a try........... mrmpa Aug 2012 #7
Just call the number on the back of your insurance card. Lasher Aug 2012 #9
The only thing besides healthcare customerserviceguy Aug 2012 #5
$1000 out of pocket is common for an MRI (I know, I've had a shitload of them). HopeHoops Aug 2012 #6

Lasher

(27,641 posts)
3. Have you asked your health care insurance provider to intervene on your behalf?
Tue Aug 28, 2012, 01:41 AM
Aug 2012

I have found that to be an effective tactic.

Lasher

(27,641 posts)
8. Yes. From my experience hospitals routinely overcharge.
Tue Aug 28, 2012, 11:20 AM
Aug 2012

And they charge more than once for the same procedure. Health care providers are obligated by contracts with insurance companies to charge only the contract price.

mrmpa

(4,033 posts)
7. I will give that a try...........
Tue Aug 28, 2012, 11:06 AM
Aug 2012

we have a family friend that is a VP for this company. I may call him for advice.

customerserviceguy

(25,183 posts)
5. The only thing besides healthcare
Tue Aug 28, 2012, 07:26 AM
Aug 2012

that is sold with so much disparity in pricing for the same damned thing is airline seats.

 

HopeHoops

(47,675 posts)
6. $1000 out of pocket is common for an MRI (I know, I've had a shitload of them).
Tue Aug 28, 2012, 09:20 AM
Aug 2012

Whether there's contrast or not doesn't change it much, but Technetium-99m is more expensive than gadolinium. Either way, I still end up with a $1000 hit every time whether it's in the hospital or an outpatient center. All I get back from it is a "meh".

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