Why more than half of hospital bills don’t get paid

[lovuian]

http://www.usatoday.com/story/news/nation-now/2016/03/08/unpaid-hospital-bills/81478658/

Working people are on the hook for an increasingly large portion of the cost of their care, as insurance policies pay for less. It’s a trend that is not reversing — and it’s causing financial distress for families and CEOs alike.

In health care, the billing process is called revenue cycle management. It’s a complex system of diagnostic codes, services, insurance benefit analysis, billing departments and software.

Hospitals and providers, historically, received 90% of the reimbursement from insurers, according to The Advisory Board. The patient portion was more of an afterthought.

That dynamic is shifting as more people come under high deductible health plans. The ratio could settle around 70-30 — with patients paying nearly a third of their bills, said Ken Kubisty, senior vice president at Advisory Board Consulting and Management.

For every patient dollar being billed, hospitals have historically failed to collect 65 cents.


with healthcare costs going up and up and wages going down down down

hospitals will go bankrupt ...and the healthcare system in America is in crisis

[alarimer]

1. It doesn't help that the bills are incredibly confusing

I recently had gall bladder surgery and probably paid around $1500 total for everything, including an emergency room visit. But the worst part about it was how confusing the billing process is. I had a couple of bills from the same provider that were nearly identical in amounts and codes. But apparently they were different and I wasn't just double-billed. There was no way to tell.

In addition, almost nothing I paid went towards the deductible. The way I always understood it was that insurance paid for everything after you met the deductible. But my guess is they make damned sure (through manipulating the billing codes) that nothing ever actua;ly applies to the deductible.

Insurance is a racket.

[StandingInLeftField]

2. Truer words were never spoken!

[angstlessk]

3. I went to the emergency room for a broken shoulder

They gave me besides an xray of my shoulder, a chest xray and a cat scan.

I never once complained about my head, but they insisted IF I fell on my shoulder, I could have hit my head!!!!!!!

The chest xray? In case I broke a rib...but to be sure a broken SCREAMS OUT

[Dont call me Shirley]

4. People are dying and going bankrupt because of medical bills and inability to pay. This system is

FUCKED UP!

The hospitals I have no sympathy for they got themselves into this mess by promoting such a fucked up system!

[ThoughtCriminal]

5. I'm fighting an insane battle right now

Had an ER visit last year with extreme abdominal pain and nausea. Five minutes after arrival the ER Dr. orders a CAT scan.

Insurance approves the hospital bill for the scan, but refuses to pay radiologist because they don't have the paperwork from the ER doctor (who also bills separately) justifying the scan.

Hours on the phone with insurance company, hospital, billing company for radiologist and I can't get this resolved. Meanwhile I get payment demands from the radiologist's billing company. I have NO control over the movement of paper, but making sure that the proper papers are in order and paying the bills if they are not, is totally my responsibility.

It is an insane and deliberately messed up system that adds billions and billions to the cost of providing medical care.