Bitter Pill: Why Medical Bills are Killing Us

East of Here
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Re: Bitter Pill: Why Medical Bills are Killing Us

Post #21 by East of Here » April 18th, 2013, 9:16 pm

My brother was pull-starting a pressure washer years ago. When he pulled, the cord popped out of the engine and flew back and hit him in the eye, doing some damage. He went to the emergency room at Pitt Memorial Hospital (home of the Brody Medical School at ECU). He was seen by 2 separate E.R. doctors, who determined that a specialist was needed. So, an eye doctor was called in. The eye doctor examined him, treated him and told him that his injury would be a good example for purposes of teaching medical students about such injuries - as it was not a common injury to see. He asked my brother if he would mind if they allowed the resident/intern med students to come in and look at his eye, as it would help them in their education. My brother didn't care, and figured it would be a nice thing for him to help out these med students. So, he said it was okay, and the eye doctor called the resident/intern students in to take a look. About 10 minutes later, they showed up and the eye doctor had them look at my brother's eye, and explained the injury and treatment to them. Then, they released my brother.

Fast forward a week or two, and my brother gets the hospital bill. The hospital had all of its usual charges. Then, he got separate bills for both E.R. doctors, the eye doctor, and BOTH of the residents/interns who he allowed to look at his injury. Needless to say, he called the hospital and pretty much told them to cram several of those bills up their collective ass. They eventually dropped the bills for one of the E.R. doctors and both of the residents/interns. Basically, if the hospital can find any way (honest or not) to shoehorn in another charge, they are gonna do it. They also know that less than 1% of people can understand their bills, and therefore, 99% of the people will not know they are being robbed/defrauded.

John Thomas8
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Re: Bitter Pill: Why Medical Bills are Killing Us

Post #22 by John Thomas8 » April 18th, 2013, 11:28 pm

The press is unable to print/report a story using facts and logic. ANYTHING that may make one more sale is valid for release.

Which is on of the reasons we can't have nice things any more.

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7rob7
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Re: Bitter Pill: Why Medical Bills are Killing Us

Post #23 by 7rob7 » April 19th, 2013, 7:21 am

What do you mean by "profit-based medicine" or what you perceive the alternate to be?

When people die or suffer because they can't pay for medicine/care that would save them.

The alternative is to eliminate making a buck off of people's misery.
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Re: Bitter Pill: Why Medical Bills are Killing Us

Post #24 by John Thomas8 » April 19th, 2013, 3:50 pm

When shareholders demand high returns on their investments, for-profit companies are going to do the things that maintain/increase profit. If that means making drugs that vaguely control symptoms while leaving the underlying causes intact, well that's what they're going to do.

Most hospitals are not for profit, so do not have that pre-made lack of ethics in place in their normal function.

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7rob7
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Re: Bitter Pill: Why Medical Bills are Killing Us

Post #25 by 7rob7 » April 19th, 2013, 8:08 pm

I'm not talking about hospitals, profit or non-profit.

ANYONE who [s]exploits[/s] [s]charges[/s] blackmails suffering people into paying for relief is using profit to get rich from human suffering, and IMHO that's a pretty sucky idea.

Like these guys: After Making $2 Billion In Profits, Insurer Complains It Doesn’t Get Enough Government Money
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7rob7
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Re: Bitter Pill: Why Medical Bills are Killing Us

Post #26 by 7rob7 » April 20th, 2013, 6:28 am

[center]Boston bombing survivor needs donations to pay his medical bills[/center]
Jeff Bauman, Jr., who helped authorities in their search for the suspects connected to Monday’s bombing at the Boston Marathon, has taken to social media to enlist help in paying his medical bills.

Think Progress reported on Friday that a donation page has been set up to pay the $300,000 in medical bills for Jeff Bauman, Jr., who was photographed being taken away from the explosion site by wheelchair after losing his legs in the bombing, an image that was widely circulated online.

“As most of you know, Jeff was severely affected by the tragedy that had taken place at the Patriots Day Boston Marathon this year,” said Brooke Gibbs, who created the page on Tuesday. “Throughout this difficult time we want to help in every which way we possibly can to get Bauman back on track as soon as possible.”
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clando
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Re: Bitter Pill: Why Medical Bills are Killing Us

Post #27 by clando » April 20th, 2013, 10:09 am

I do know that Adidas was selling a shirt to support victims.

Adidas is selling a limited edition T-shirt to honor victims of the Boston Marathon attacks. All proceeds from the shirts will go to a fund for those affected by the tragedy.

The shirts are selling for the marathon-inspired price of $26.20. Both the men's and women's version have "Boston stands as one" written across the chest with a small Boston Athletic Association logo underneath.

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clando
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Re: Bitter Pill: Why Medical Bills are Killing Us

Post #28 by clando » April 20th, 2013, 10:11 am

With regards to the bombing victim Jeff Bauman, he should have every cost covered...

One of the Boston Marathon bombing victims is also a hero. 27-year-old Jeff Bauman was at the race to cheer on his girlfriend. He ended up being the first casualty brought to Boston Medical Center. He was standing so close to one of the bombs, he ended up losing both his legs. But when woke up in the hospital - he helped the FBI identify the suspects. His brother Chris was by his bedside and says, "He woke up under so much drugs, asked for a paper and pen and wrote, 'bag, saw the guy, looked right at me.'" Jeff then gave a description of the suspect to the FBI, telling them that he wore "a cap, sunglasses and a black jacket over a hooded sweatshirt." Despite all that had happened to him, Jeff was still able to accurately remember what he saw.

He was visited in the hospital yesterday by New England Patriots wide receiver Julian Edelman and actor Bradley Cooper.

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clando
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Re: Bitter Pill: Why Medical Bills are Killing Us

Post #29 by clando » May 8th, 2013, 8:41 am

Hospital billing stories continue. The NY Times had an article today...

NY Times wrote:Hospital Billing Varies Wildly, Government Data Shows

Data being released for the first time by the government on Wednesday shows that hospitals charge Medicare wildly differing amounts — sometimes 10 to 20 times what Medicare typically reimburses — for the same procedure, raising questions about how hospitals determine prices and why they differ so widely.

The data for 3,300 hospitals, released by the federal Center for Medicare and Medicaid Services, shows wide variations not only regionally but among hospitals in the same area or city.

Government officials said that some of the variation might reflect the fact that some patients were sicker or required longer hospitalization.

Nonetheless, the data is likely to intensify a long debate over the methods that hospitals use to determine their charges.

http://www.nytimes.com/2013/05/08/business/hospital-billing-varies-wildly-us-data-shows.html?hp&_r=0&pagewanted=all

Reading this article and the comments at the end of the article made me think about how we could better explain hospital billing as an industry. We've seen more articles like this, and it amazes me how poorly charges are explained. This leads to readers making wild assumptions and even crazier comments about what the system does or doesn't do.

The best analogy I can come up with to describe healthcare billing is probably new car prices. We all know the MSRP is not the "real" price and hardly anyone pays it. With all the rebates, dealer incentives, and variable interest rates its almost impossible to accurately determine the actual price.

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clando
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Re: Bitter Pill: Why Medical Bills are Killing Us

Post #30 by clando » May 8th, 2013, 8:54 am

Here is a better article on the Medicare release of billing data...http://www.washingtonpost.com/blogs/wonkblog/wp/2013/05/08/one-hospital-charges-8000-another-38000/?hpid=z1

This article provides more figures and comparisons of charges. Here is a great example of how ridiculous looking at charge master charges are...

Washington Post wrote:Las Colinas, the Texas hospital that billed more than $160,000 for a joint replacement, was reimbursed, on average, $12,643. Nearby Baylor Medical Center submitted significantly lower charges ($42,000) but received a larger reimbursement: $14,202.
So Las Colinas charges were 4x that of Baylor's but got reimbursed 11% lower. Yet these articles and people want to concentrate on the charge master charges as if they are real charges.

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Re: Bitter Pill: Why Medical Bills are Killing Us

Post #31 by John Thomas8 » May 8th, 2013, 10:19 am

That's got to make estimating cash inflow kinda hard, if you're randomly changing prices like that.

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clando
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Re: Bitter Pill: Why Medical Bills are Killing Us

Post #32 by clando » May 8th, 2013, 12:10 pm

John Thomas8 wrote:That's got to make estimating cash inflow kinda hard, if you're randomly changing prices like that.
You have no idea. When you add in delayed payment, denials, appeals and all the other stupid parts of billing it can be even worse than you imagine. Cash on hand is very important. A former CEO of a large physician practice told a story about how he almost had to declare bankruptcy and close the practice because an insurer with held payment over a disagreement. He learned then and there to always keep plenty of cash on hand.

With our system it can definitely be hard to estimate cash flow, but it doesn't really have that much to do with the charge master pricing and things talked about in this article. While the charge master is completely out of whack with regards to costs and what we actually get paid. We do know what our contracted reimbursement rates for each insurer are. So you if compare your payer mix volumes with your reimbursement rates, you can get a rough estimate of your expected cash flow. It can get a little complicated if you have lots of insurers with widely varying reimbursement rates.


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