One thing that upsets me is my insurance EOB (explanation of benefits) that you get in the mail when you go through insurance company.
They read: Charges $2000 Negotiated Discount $1900 We paid $100.
Most of the time it’s not that huge a difference but I did have one with almost that much! And I think “How about I go to the doctor and say, ya know, you’re charging too much for that procedure, I’m only going to $200 - not the $800 you billed”. How would that work for the rest of us? The whole insurance system is screwy.
My wife is a controller/accountant in a rural hospital and TennCare nearly destroyed them. Getting paid .50 cents on the dollar. She told me they had figured for example how much it cost the hospital to xray for a broken arm and these figures are by no means correct. With the xray machine, techs, radiologist, maintenance etc... $100 and they recoup their overhead and make a respectable profit.
In comes Medicare and they say you will accept $35 for this xray period. So right off the bat any profit is gone and they are not even meeting overhead. Medicaid pays even worse! So they have to charge the patients with insurance and paying out of pocket even more to try and recoup losses from the government Medicare/Medicaid.