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Scenario

Posted on: September 25, 2024 at 08:36:04 CT

alwaysright MU

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52939

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Pick any service the doctor might provide and let’s just generically say the doctor needs $100 to be appropriately profitable.

The doctor bills $100 and the insurance company makes a couple of claims. One, doctors are greedy and that’s too much money. Two, we’re going to force them to participate in some quantity discounts and therefore we’re only gonna pay $75.

Doctor still needs $100, so next time he bills $125 trying to make up that $25 shortfall. Insurance company says it is established practice that we only pay 75% and so the doctor only gets $90.

Now the doctor is $35 behind and so the next time he bills $135, but insurance has already decided that said procedure is not worth $100 and so they only pay $92.

At this point, the doctor has had to hire an extra office employee to help keep track of all this BS and so his hundred dollars no longer cut it, he now needs $125 but he knows that billing $135 doesn’t even get him to his 100 so now he’s got a bill the $135 Plus the eight dollars shortfall plus the $25 needed for the new employee. So at this point, he’s now billing $168 for something he originally only wanted $100 to do. And he still chasing his tail with the insurance company.

Please explain why this message is being reported.

REPLY

MESSAGE THREAD

Early morning health insurance question. - sprintcar STL - 9/25 07:33:31

The rates for services are set by the government - XRob MU

- 9/25 10:42:36

We had a better one this summer. My daughter was in the ER - DHighlander NWMSU - 9/25 08:47:22

My wife has had some things denied too. You're correct..(nm) - sprintcar STL - 9/25 09:23:09

Insurance dudes know more than your doctor - JayHoaxH8r MU

- 9/25 09:46:17

this is misleading and naive. - phrejd KC - 9/25 11:15:14

they would charge you that much BUT - tigerinhogtown STL - 9/25 08:43:34

Scenario - alwaysright MU - 9/25 08:36:04

health insurance billing is an absolute nightmare - Joeboo MU

- 9/25 08:38:28

there is 1 insurance co in particular let's call them - tigerinhogtown STL - 9/25 08:58:32

its never a good sign when the government agency is the most - Joeboo MU

- 9/25 09:06:28

Part of the issue is that Medicare/acid set their rates and - alwaysright MU - 9/25 11:16:57

not sure i agree with every point, but i agree with the - phrejd KC - 9/25 11:18:45

decades of deregulation and billions in lobbying end up - colonel angus beef KC - 9/25 09:54:00

you hit the nail on the head...tax writeoff - Joeboo MU

- 9/25 08:30:24

there is no tax write off - your income is your income - tigerinhogtown STL - 9/25 08:50:23

Correct. There is no "write off" advantage to billing more - zaaguy MU - 9/25 09:45:30

Because healthcare isn't an open market so everyone - phrejd KC - 9/25 07:49:25

Weird how every other major country in the world - JayHoaxH8r MU

- 9/25 08:07:53

lmfao, UK waiting lists are 18 months (nm) - 90Tiger STL - 9/25 09:41:32

14 weeks is median wait time - JayHoaxH8r MU

- 9/25 09:45:22

lol oh well that's great then let's copy that (nm) - phrejd KC - 9/25 11:08:48

agree, hoax - Fire Marshall Bill MU - 9/25 08:24:56

even if you accept all that propoganda - colonel angus beef KC - 9/25 09:42:27

You try to get into a specialilst in the US lately? - JayHoaxH8r MU

- 9/25 08:36:21

lol i called an ortho specialist 2 weeks ago and got in the - phrejd KC - 9/25 11:22:46

yes, it took about 10 days(nm) - Fire Marshall Bill MU - 9/25 08:39:34

You've lied at least twice now in this thread - JayHoaxH8r MU

- 9/25 08:40:15

"MISINFORMATION"!!!!!!!!(nm) - Fire Marshall Bill MU - 9/25 08:42:29

Took me less than a couple of weeks (nm) - Bosalphus KC - 9/25 08:38:18

And lots of people are a so indoctrinated that they - StaleyTiger MU - 9/25 08:22:57

^^ good example of someone who doesn't understand (nm) - phrejd KC - 9/25 08:29:06

another thing not understood, insurance companies are not - tigerinhogtown STL - 9/25 09:05:19

we have elements of socialism here already - Fire Marshall Bill MU - 9/25 08:26:12

we have a watered down ****ty product. There are also long - SabertoothTiger MU - 9/25 08:29:17

Where do you live? It can be a pain to see your family Dr - DHighlander NWMSU - 9/25 08:51:33

my parents have Canadian friends that live in the states for - Fire Marshall Bill MU - 9/25 08:31:34

I don't know the solution. I just know ours is slowly - SabertoothTiger MU - 9/25 08:35:44

Of course the gov't is heavily involved (nm) - Bosalphus KC - 9/25 08:37:58

think what you want. Sure they make the laws but - SabertoothTiger MU - 9/25 08:39:47

I'm not taking any blame away from the insurance companies - Bosalphus KC - 9/25 08:41:06

Correct. It's not great. (nm) - phrejd KC - 9/25 08:30:26

Its not horrible...yet and I don't know the solution. I - SabertoothTiger MU - 9/25 08:33:36

lol yes the ones calling for the gov't to get out - Bosalphus KC - 9/25 08:25:43

People are flooding into our country and the government is - alstl MU - 9/25 08:19:31

I wish your ancestors wouldn't have flooded into - SabertoothTiger MU - 9/25 08:30:51

you're a weird dude(nm) - Fire Marshall Bill MU - 9/25 08:33:27

thanks. From the second weirdest person here I'll - SabertoothTiger MU - 9/25 08:37:07

You have a pretty limited understanding of the - phrejd KC - 9/25 08:13:39

ahem - JayHoaxH8r MU

- 9/25 08:39:48

you're proving his point (nm) - Bosalphus KC - 9/25 08:44:37

apparently i need to explain to him the links he provided (nm) - phrejd KC - 9/25 11:26:15

healthcare "rankings", LOL(nm) - Fire Marshall Bill MU - 9/25 08:52:58

run along - JayHoaxH8r MU

- 9/25 08:48:32

You could have just said "of everything" (nm) - Bosalphus KC - 9/25 08:14:42

It's always strange to me that people are so quick to - phrejd KC - 9/25 08:20:51

But they get great medical outcomes. - Newcatbirdseat MU - 9/25 08:26:04

Just b/c the gov't pays for it doesn't mean - Bosalphus KC - 9/25 08:12:02

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