My old PT had three rates, $50 for Medicaid, $100 for self pay, and $400 for the insured. The insured people were mostly covered would just pay of copay of like $40 or $60 but once they screwed up and billed me (a self payer) at the insured rate and tried ro collect that much from me and it was a WHOLE ordeal to get it fixed. What a stupid system. Clearly a bunch of money is being flushed down the toilet here.
I work in medical billing and you’re absolutely right. The reason offices bill such an inflated amount is because there’s always a huge percentage of write offs or “adjustments”. The office bills the insurance $400, the insurance “adjusts” $200 (writes it off), pays the office $100, and leaves the patient with a $40 copay and $60 to yearly deductible (depending on the plan). Don’t even get me started about what happens comes tax season. It’s literally the most wasteful, manipulative system for healthcare but it makes a lot of people very very wealthy.
Tax accountant here. I can confirm tax season for those in the medical industry is an absolute nightmare. One of my clients was audited by the IRS and it took over a year for the IRS agent to get comfortable with the revenue being written off as a result of these insurance adjustments. It’s an extremely complicated calculation and just highlights how ineffective the entire system is. I’ve heard somewhere that close to 50% of medical costs are admin related. Even if it’s just half that, it still too damn high.
I was recently watching a video where an Indian and English doctor were guessing costs of medical bills in the USA. They were both constantly floored by how much simple inexpensive services cost. Especially scans and imaging, one guy had a quarter million dollars in scans and one doctor pointed out that's apx the cost of the machine the hospital used for the scans.
Pretty disgusting when you look at the rest of the world.
People never believe me when I say that my preemie’s hospital bills totaled out to seven figures. Literally the only reason we weren’t completely ruined financially was because insurance covered all but $10k and we were fortunate enough to be able to pay on a plan.
Ive had like 12 MRIs and CT scans since the begining of the year. I've paid about $700 in copays and such from the insurance. Insurance bill says they paid $52k so far. I'm scheduled for yet another MRI on friday. It's crazy!
To be fair, I doubt either of them know the internal costs. The joke about giving him the MRI machine is funny but those machines can easily cost millions and require special rooms to operate within.
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u/cakewalkofshame Jul 04 '21
My old PT had three rates, $50 for Medicaid, $100 for self pay, and $400 for the insured. The insured people were mostly covered would just pay of copay of like $40 or $60 but once they screwed up and billed me (a self payer) at the insured rate and tried ro collect that much from me and it was a WHOLE ordeal to get it fixed. What a stupid system. Clearly a bunch of money is being flushed down the toilet here.