Medical charges
Ever since I've carried an individual policy, perhaps even before, I paid attention to the charges and to what insurance paid and, personally, felt bad for the providers.
And now after spouse had a knee replaced, stayed three days in the hospital, I reviewed insurance payments to several physicians and anesthesiologist. The physicians submitted a total of $13,000 for which the insurance reimbursed them $3,100. Nothing owed by us.
And then the hospital submitted an invoice for $41,000! Medicare paid $13,000 and there was a comment of "Medicare Sequestration Adjustment" of $260 (I thought that the sequester was long gone). Our insurance paid $1,100 and our share was $200.
And I have to wonder: either the service is worth $41,000 or $14,000. How can there be such a gap?
My spouse wry comment is that if the hospital would have to accept $14,000 for $41,000 otherwise it would go bankrupt.
Thus, why charge $41,000 if all you are going to get about a third? And I have seen it with other submissions.
Even with the physicians - they were paid one fourth of what they charged.
And I am not even talking about people with no insurance. I just don't understand such a gap. I think that medical providers who, after all, save life after long study, should be paid what they think they are worth. On the other hand, why charge so much more than what you think you will be paid?
And thinking of the tens of millions that CEOs of insurance companies make really makes me sick.
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