Many hospitals, doctors offer cash discount for medical bills

The lowest price is usually available only if patients don't use their health insurance. In one case, blood tests that cost an insured patient $415 would have been $95 in cash.

A Long Beach hospital charged Jo Ann Snyder $6,707 for a CT scan of her abdomen and pelvis after colon surgery. But because she had health insurance with Blue Shield of California, her share was much less: $2,336.

Then Snyder tripped across one of the little-known secrets of healthcare: If she hadn't used her insurance, her bill would have been even lower, just $1,054.

"I couldn't believe it," said Snyder, a 57-year-old hair salon manager. "I was really upset that I got charged so much and Blue Shield allowed that. You expect them to work harder for you and negotiate a better deal."

Unknown to most consumers, many hospitals and physicians offer steep discounts for cash-paying patients regardless of income. But there's a catch: Typically you can get the lowest price only if you don't use your health insurance.

That disparity in pricing is coming under fire from people like Snyder, who say it's unfair for patients who pay hefty insurance premiums and deductibles to be penalized with higher rates for treatment.

The difference in price can be stunning. Los Alamitos Medical Center, for instance, lists a CT scan of the abdomen on a state website for $4,423. Blue Shield says its negotiated rate at the hospital is about $2,400.

When The Times called for a cash price, the hospital said it was $250.

I was a contractor in Germany, and it was a known fact that German doctors liked having us as patients because we’d just flash the credit card and they got immediate cash that day. The German patient with German health care? Well...it’d be six to eight weeks down the road before he got that cash, and there could always be a disagreement about what was allowed. So a guy with the credit card got an immediate discount via their system (figure 30 percent minimum).

I personally think we have three problems with our current system.

First, there’s the lawsuit issue....where if you elected to sue someone and lose....you ought to pay all court and legal cost for the other party, and this would eliminate fifty percent of the medical legal cases we currently have.

Second, both Wal-Mart and Walgreens should offer a simple out-patient policy for $100 a month for a family, and $30 a visit. I think that would carve off half the stupid health insurance companies in America within two years who offer bloated policies that cost twice what they should.

Third, visits to the emergency room ought to immediately require a credit card...or cash....or no entry. These guys who walk in and have no credit and no cash....are forcing the rest of us to cover their lousy health care situations at the emergency room.

These three simple changes could be written up in eight pages and could have been passed by congress in two weeks. We didn’t need two thousand pages.

A few years ago I needed a throat culture, and paid $75.00 cash for it, which also included the dr. visit. On the same day, a teacher friend of mine took her daughter to the same doctor for a throat culture. She had insurance and she was charged $350

She too said something about the payment schedule and how it wasn’t right for her insurance to be billed that much when a cash payer was charged so little.

I don’t know what to say about it except that it happens.

Several years ago I had to take a family member to an eye doctor for a rare eye condition. For a while, we had to go daily. I paid the initial $45 fee, cash and they put it through the insurance company for me so that I received the payment directly. At the next visit, I took that $45 and paid the visit, for which I was reimbursed by the ins. company. I never had to worry where the money for the dr visit was going to come from and the only thing paid out of pocket was that one initial visit.

I guess it just depends on how the Dr. offices work things out. Sometimes things can work out quite well. I don’t think I ever did pay a co-pay on that deal.

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