What brought this on was one common blood draw and test, and one extremity x-ray.
My insurance normally pays $19 for the draw and $19 for the read (which isn't a read at all, since they just forward a print-out to my Doc).
The pay for the x-ray is normally $24 + $67 for "hospital services".
So, once I reach my deductible the total for this bill would normally be $129 to my insurance company and nothing to me. (Not bad, huh?)
Because I have not reached my deductible, Fairfield Medical Center bills my insurance company $465, of which the allowable is $363.
Here is the breakdown:
x-Ray = $268
Basic Metabolic panel = $68
Ast/Sgot = $19
Ast/Sgpt = $19
Lipid Profile = $63
Cbc with Diff = $20
Venipuncture fee = $8
Total = $465
Allowable = $363
The 15% discount for paying early (the outrageous overbilling is not why I am bitching - yet) is $54.
Someone without insurance is going to be billed at least $465 -- if they pay it early, they pay $398. I have heard that the bills to persons with no insurance can reach the quadrupled total of the amount billed insurance companies. I am told that this is to "fluff" certain statistics, and to make a higher profit off of the discounted percentage from the sale of bad debt to outside collectors (Incredibly evil, if true). I have heard of hospitals even operating their own debt collection agencies as separate entities, in effect selling debt to themselves. (Now that would make even Dr. Evil squirm.)
Someone who cannot afford to pay in full is going to be paying at least $468 for a service that will cost my insurance company $129 and me nothing once I reach my deductible.
For those of you who say that the deduct of 15% is just to cover costs, I have this:
The "interest" or AR cost is covered in this notice: "If you choose to send a partial payment your account will be subject to a onetime 12% late payment fee or $100, which ever is less, with the obligation that all accounts will be paid in one year."
Lessee, that's 27% on any bill under $835, if you have to make payments, if my math is correct?
Amazing they didn't go out of business when we did in payday lenders.
An automatic 15% discount for paying a bill is not a good thing. It means the initial charge is too high... It also puts an undue burden on those who are less fortunate but still determined to pay their bill.
The full price should be a fair price, with no special deals that only apply for the more fortunate of us, especially if they are a "not-for-profit", as FMC is structured to be (they are technically a 501c 3, but they outsource most work to money-making corporations, doctors, labs, and the like).
This is patently unfair. And I'm the guy taking advantage of the "discount", which in reality isn't -- a discount.
Them that's got, get... Which is usually fine, but not when there is no alternative except drawn out sickness and/or eventual death.
There it is.
And here's another tidbit:
It takes some wading through, but this sheds some light on the scam that is most "not-for-profit" hospitals.
It's basically a way for them to expand; making the debt they accrue less risky by selling bonds, even while exempt from tax, profiting from their tax exempt status, while in reality remaining for-profit corporations.
Check it out: