"
. With Mysteries of health care
Posted Under: Mysteries of health care
Several months ago, I had to have some tests done at a hospital. (Don’t worry, this isn’t going to get distressingly personal.) I was billed $1,875.41. I have health insurance, which I pay for myself, as I am not on staff at The Times or anywhere else, Day Job notwithstanding. Because of some transition issues related to our move from New Jersey to Georgia, there was confusion about pre-existing conditions and all that, so there was a delay in determining whether I was on the hook for that amount, or for the amount that my insurance carrier “negotiated” with the hospital. The latter figure was $937.70.
So that’s not trivial. I would much rather write a check for $937.70, than for $1,875.41. Wouldn’t you?
I jumped through the various hoops. I ignored the bills and urgent letters from the hospital. Eventually, I got word from my insurance company that the lower rate they’d “negotiated” was now in effect. So I waited for the hospital to send me the new paperwork.
Today, I got a phone call. From the hospital. With a sense of dread, I returned the call. I explained the situation and asked the rep what I owed. She said $937.70. I was relieved, and said I was just waiting for the paperwork. According to her, it had been mailed weeks ago — but then she explained the reason the hospital was calling. The reason was this: If I would pay up right now, via phone, using a credit card, debit card, or (somehow) a check, then I would get a 30% discount.
I said: Okay. My cost at that point falls to $659.39. Done.
So. The hospital’s fee was $1,875.41. The insurer-negotiated rate was $937.70. But if I fork over $659.39 right now, we can all call it a day.
Is this hospital on the brink of bankruptcy? What is its business model? What is the true cost of my procedure? Is someone out there paying $1,875.41 for the same thing that cost me $659.39?
How dysfunctional is the health care business?
.
.
Kim Fellner's book 
.
A
Reader Comments
I get the sense that hospital bills are kind of like the sticker price on a car. They’re just a suggestion (one that can mess up your credit rating, though because the sticker is only shown to you after the procedures).
There seems to be a very long process of negotiation with insurance companies and it seems to leave the patient out of it until the very end and then it’s a “hurry up and pay now” sort of thing. However, I’ve had great success with offering cash right then while saying I could file with the insurance company to reevaluate the coverage. They seem to understand the labor involved in that process and will take a fraction of the bill in cash.
I’ve had better success with dental stuff by offering cash. I had a wisdom tooth taken out and negotiated with the dentist as he was numbing me. The opening bid from him was $700 … I got him down to $190 if I paid that day, which included the follow up appointment.
same thing pretty much happened to me after shoulder surgery a couple years ago – there were all these original billed prices for the hospital, the doctor, the radiologist, the anesthesiologist, etc… then the bills started arriving – eventually the ‘negotiated’ amount for just over half the original billed price. so then i started setting up monthly auto-pays to all the above-mentioned entities…
then a few days before the next quarter close (i note you posted this on 06/20, my call was in late september), the hospital called to tell me that, instead of making monthly payments, if i can get them 65% of the total outstanding, i’d be all done. so ‘done’, i said.
the hospital’s either trying to speed up revenues or generate more cash-on-hand for that quarter’s result… either that or the hospital’s A/R department is trying to prove it’s worth…
Thanks, both of you. I’m a little surprised about all this, but clearly I shouldn’t be.
Cybele, I must say, I am amazed at your negotiating skills! I don’t think I”d have the guts to start haggling with a guy who was about to take my wisdom tooth out! (Perhaps he knows you’re a candy blogger, and will be back?? Ha ! )