This is absolutely true. A hospital tried to charge me $6800,00 for an outpatient procedure that my insurance had already paid for. I sent the hospital a registered letter demanding a completely itemzed invoice down the last pill and gauze pad and threatened to sue them if they continued to pursue payment. I never heard back from them. Total scam.
This reminds me of the time I launched into an epic rant in a crowded elevator full of state employees about the word "system."
_______
I found this interview to be not only true but very interesting personally because much of my employment over thirty years in some way related to medical and hospital care and bills.
I could see early on that the billing of hospital charges was generally a big mess and a big joke. I sort of adopted a consoling phrase that I would use to counsel patients who were very upset and worried about their hospital bills. I would say "Don't worry. These things can be worked out."
Most of my own health care and medical bills were sort of just taken care of by Divine Providence. However one time I had to have spine surgery and I had good regular health insurance coverage, no medicare or medicaid involved. My bill for my hospital stay was extremely high and the amount I was said to owe after my insurance paid was still very high.
I called the medical records department of the hospital and told them I wanted to come in and look through my medical record chart and compare it line by line with every charge on my hospital bill. The response of the employee at the hospital seemed to be sort of mild apoplexy.
They gave me an appointment date and time to come in and do what I requested but like within two or three days I received another bill from the hospital that showed all charges were paid in full and that I owed no money at all for anything connected with that hospital stay.
Just thought I would share that because doing what I did may work for you who are in a similar situation.
_______
I am running on faith now and that is a firm foundation for everyone.
________
Saint Paul's letter to the Ephesians
Ephesians 6:13-15
"Therefore take unto you the armour of God, that you may be able to resist in the evil day, and to stand in all things perfect. Stand therefore, having your loins girt about with truth, and having on the breastplate of justice, And your feet shod with the preparation of the gospel of peace:
Wow! Thank you so much. Health Industry debt is the largest cause of bankruptcy in the USA. The fear and anxiety around "healthcare" probably kills more people than 3rd largest killer which is medical errors. This is life saving information. - Roger
Thank you so much for the great discussion. Thank you for sharing your experience to help other people. What you both are saying is so important to tell people the truth so they can understand what is going on. I am a retired RN & USAF veteran. I have discovered a better way to stay healthy called alternative medicine which has been around a lot longer than the pharmaceutical industry and our hospital monopoly. Keep up the good work and God bless you!
If you translate 'Health Insurance' directly into German, it will be called 'Gesundheitsversicherung'. But, if you say to a German ' I have good Gesundheitsversicherung' he will have no clue what you are talking about, because in German the american 'Health Insurance' there is called 'Disease insurance'... Also all MD down there prefer private patients, they treat, get the cash directly into their hands and only pay taxes on that income, all WITHOUT Health/Disease-Insurances... The American doctors are richer than German ones, that's why there are almost no German MD's down there, all foreigners, thus welcome immigrants... Example: a dental treatment. A tooth removal (always a great pity) there costs ~50 euro, here, depending on where you do it, for example by a biological dentist, it can cost ~2500$.. Thus. in need, buy a ticket, get nice trip and then a quick and painless treatment at the dental office...
I expected that most hospital bills contain major fraud...looking at the size of them. Luckily, neither my wife nor I have had major hospital bills and the insurance coverage along with Medicare has been mostly adequate for hospital charges.
This is incredible info. Something to definitely keep on the back burner should the need arise to question outrageous hospital bills. Is there anything in this entire country that isn't corrupt, fraudulent and a big fat lie?
This is exactly why authority can never be trusted. There is never anyone watching what they do.
What about people who cannot afford insurance? We lost insurance when Obama care caused premiums to rise so far above what we our small budiness could afford we lost it. Yet we made just enough to not be eligible for any subsidies. Last year my diabetic husband ended up in the hospital FOR 8 MONTHS. We are now a million dollars in medical debt. He sobs daily over the worry of it. Do any of these secret agreements apply to us? Ironically, I could have paid off his bills in a few years if they were billed at Medicare rates, but instead were are billed at the maximum for every little thing.
This is not exactly accurate. When your insurance company is billed for a medical service, an Explanation of Benefits (EOB) for the claim is generated by the insurance company, showing the billed amount, the covered amount, and the amount the patient owes. So the insurance company calculates the amount you can expect to receive an invoice for, from the provider, in the mail. It's one big scam and we ain't in on it!
What the entire article is saying, is that the provider and insurance have agreed on the fees. They are always less than what you see on the bill - but the point is you don't owe a red cent. They are only to bill for what the insurance has arranged - if they fool patients into paying - the rest is gravy.
One thing about these medical bills is that there is never any amount listed for what Medicare paid. If I have a bill that is charging $500 for a service, it might say the insurance paid to the provider $225 and I owe $75. Who paid for the other $200? It never fully explains the charges.
No one. Providers always overcharge so they don't leave any money on the table. They know they won't be paid what they bill.
However, many yrs ago I read that there is some reason for this that involves one of the parties being able to clawback money at end of year from some federal account and/or use it for huge write off... unfortunately the computer I bookmarked it on has long since died. It was appalling!
Dr yoho, thank you very much. This is a mind bogling theme but not at all surprised. Again much appreciated from your insight. To conclude, with respect,, F;;;K them in their play. Be safe.
This seems to be for HMOs, PPNs, etc.; with traditional Medicare, I don’t have a network, so I don’t see that there would be such a provider agreement. I find that most of my doctors take Medicare assignment, and I can remember only 1 bill from an emergency room for <$30 in years. Fortunately, I am pretty healthy; like all of us, I fear serious illness in part because of the financial consequences, but definitely do not want any part of the private, overpaid Medicare (dis)Advantage plans, and encourage all folks turning 65 to stick with Original/Traditional Medicare if they possibly can.
I am unable to find a doctor to see that I have any faith in after being diagnosed with Hashimotos 6 years ago. Trying to figure things out on my own is a crapshoot at best. If you could provide any guidance I am a paying customer with Medicare which to date I have never used
Regular MDs are notoriously ill-informed about thyroid issues. They look at TSH and maybe prescribe T4 (Synthroid), which may get your numbers more normal but not alleviate symptoms. I can't completely vouch for this doctor, but there is some interesting (and perhaps helpful) information on his Web site. One caution: he sells nutritional supplements that support thyroid health, so be careful with your $. That said, what he says makes some sense, and I continue to read his articles: https://www.restartmed.com/hashimotos-thyroiditis/
I look forward to checking out the link; thanks! I started taking 12.5mg Iodorol along with my Synthroid about 6 months ago. Ironically, I'm about to leave to get a complete metabolic panel done, hopefully including iodine. Recent concerns regarding lung cancer have kind of swept the thyroid issues aside, but they're too important to forget about completely!
Yes I'm aware of all stated. I was fortunate to find a neurologist/psychiatrist who was able to get me diagnosed and knew more about thyroid issues than most. I was never offered meds since my "numbers" were off but nonetheless in balance. After having to spend $10k out of pocket for help getting back on track, since insurance wouldn't cover anything for an unaffiliated MD, I need to find someone locally to help me manage things going forward. I appreciate the link and I'll check it out. Everyone in functional medicine have to sell something so I'll proceed with questions as always. 👍
The occupational prestige once afforded the medical industry has been eviscerated. It turns out for many the prestige was never deserved. Like sanitation workers and auto mechanics and plumbers there are good and bad. Medicine is no different however we were led to believe the medical school education and the hippo oath were gold standards. Such a ruse when considering the med school system is severely influenced by the pharma industry and upon graduation the diagnostic skills of many is very
Limited. What is evident is the favoritism towards pill prescribing and medical device surgery. The behavior of many health industry
Professionals during the recent plague (IFR of .015-.025) was the big reveal. There is widespread corruption from med school to research to public health agencies. It’s a high prestige sewer.
I sell health insurance and I find that some physicians are asking for money up front for a surgery that involves "cosmetic surgery." the patient is told that the procedure will require longer than what they are paid for and that part of it will be what is deemed by Medicare or Insurance as cosmetic. In these cases the person pays for the surgery. I can see the reasoning behind this and I think it is a good solution. Health insurance since Obama Care is so expensive. Many people are paying more for monthly health insurance than for their mortgage payment. Paying more for less is insane, but we are prohibited in CA to sell non ACA compliant policies, there are none available.
This is absolutely true. A hospital tried to charge me $6800,00 for an outpatient procedure that my insurance had already paid for. I sent the hospital a registered letter demanding a completely itemzed invoice down the last pill and gauze pad and threatened to sue them if they continued to pursue payment. I never heard back from them. Total scam.
Thanks Robert for this discussion!
oh, what kind of 'health-insurance' do the homeless have? any actually? is it needed at all?
If covid times learned us anything, then it would be that one: never enter a hospital..
This reminds me of the time I launched into an epic rant in a crowded elevator full of state employees about the word "system."
_______
I found this interview to be not only true but very interesting personally because much of my employment over thirty years in some way related to medical and hospital care and bills.
I could see early on that the billing of hospital charges was generally a big mess and a big joke. I sort of adopted a consoling phrase that I would use to counsel patients who were very upset and worried about their hospital bills. I would say "Don't worry. These things can be worked out."
Most of my own health care and medical bills were sort of just taken care of by Divine Providence. However one time I had to have spine surgery and I had good regular health insurance coverage, no medicare or medicaid involved. My bill for my hospital stay was extremely high and the amount I was said to owe after my insurance paid was still very high.
I called the medical records department of the hospital and told them I wanted to come in and look through my medical record chart and compare it line by line with every charge on my hospital bill. The response of the employee at the hospital seemed to be sort of mild apoplexy.
They gave me an appointment date and time to come in and do what I requested but like within two or three days I received another bill from the hospital that showed all charges were paid in full and that I owed no money at all for anything connected with that hospital stay.
Just thought I would share that because doing what I did may work for you who are in a similar situation.
_______
I am running on faith now and that is a firm foundation for everyone.
________
Saint Paul's letter to the Ephesians
Ephesians 6:13-15
"Therefore take unto you the armour of God, that you may be able to resist in the evil day, and to stand in all things perfect. Stand therefore, having your loins girt about with truth, and having on the breastplate of justice, And your feet shod with the preparation of the gospel of peace:
https://drbo.org/chapter/56006.htm
good job and exactly right
Amen
Wow! Thank you so much. Health Industry debt is the largest cause of bankruptcy in the USA. The fear and anxiety around "healthcare" probably kills more people than 3rd largest killer which is medical errors. This is life saving information. - Roger
Thank you so much for the great discussion. Thank you for sharing your experience to help other people. What you both are saying is so important to tell people the truth so they can understand what is going on. I am a retired RN & USAF veteran. I have discovered a better way to stay healthy called alternative medicine which has been around a lot longer than the pharmaceutical industry and our hospital monopoly. Keep up the good work and God bless you!
If you translate 'Health Insurance' directly into German, it will be called 'Gesundheitsversicherung'. But, if you say to a German ' I have good Gesundheitsversicherung' he will have no clue what you are talking about, because in German the american 'Health Insurance' there is called 'Disease insurance'... Also all MD down there prefer private patients, they treat, get the cash directly into their hands and only pay taxes on that income, all WITHOUT Health/Disease-Insurances... The American doctors are richer than German ones, that's why there are almost no German MD's down there, all foreigners, thus welcome immigrants... Example: a dental treatment. A tooth removal (always a great pity) there costs ~50 euro, here, depending on where you do it, for example by a biological dentist, it can cost ~2500$.. Thus. in need, buy a ticket, get nice trip and then a quick and painless treatment at the dental office...
Where is "down there"?
well, in Germany is 'down there', here is US... There is apparently a shortage of MD's, according to many I talked to...
I expected that most hospital bills contain major fraud...looking at the size of them. Luckily, neither my wife nor I have had major hospital bills and the insurance coverage along with Medicare has been mostly adequate for hospital charges.
This is incredible info. Something to definitely keep on the back burner should the need arise to question outrageous hospital bills. Is there anything in this entire country that isn't corrupt, fraudulent and a big fat lie?
This is exactly why authority can never be trusted. There is never anyone watching what they do.
things are a mess aren't they
What about people who cannot afford insurance? We lost insurance when Obama care caused premiums to rise so far above what we our small budiness could afford we lost it. Yet we made just enough to not be eligible for any subsidies. Last year my diabetic husband ended up in the hospital FOR 8 MONTHS. We are now a million dollars in medical debt. He sobs daily over the worry of it. Do any of these secret agreements apply to us? Ironically, I could have paid off his bills in a few years if they were billed at Medicare rates, but instead were are billed at the maximum for every little thing.
"For the love of money is the root of all evil" - 1 Timothy 6:10.
Thank you for this good article.
This is not exactly accurate. When your insurance company is billed for a medical service, an Explanation of Benefits (EOB) for the claim is generated by the insurance company, showing the billed amount, the covered amount, and the amount the patient owes. So the insurance company calculates the amount you can expect to receive an invoice for, from the provider, in the mail. It's one big scam and we ain't in on it!
What the entire article is saying, is that the provider and insurance have agreed on the fees. They are always less than what you see on the bill - but the point is you don't owe a red cent. They are only to bill for what the insurance has arranged - if they fool patients into paying - the rest is gravy.
One thing about these medical bills is that there is never any amount listed for what Medicare paid. If I have a bill that is charging $500 for a service, it might say the insurance paid to the provider $225 and I owe $75. Who paid for the other $200? It never fully explains the charges.
No one. Providers always overcharge so they don't leave any money on the table. They know they won't be paid what they bill.
However, many yrs ago I read that there is some reason for this that involves one of the parties being able to clawback money at end of year from some federal account and/or use it for huge write off... unfortunately the computer I bookmarked it on has long since died. It was appalling!
Very interesting. I wonder if the same is true in Canada or other countries?
Dr yoho, thank you very much. This is a mind bogling theme but not at all surprised. Again much appreciated from your insight. To conclude, with respect,, F;;;K them in their play. Be safe.
Good information and another reason to embrace good health practices in order to avoid hospitalization.
This seems to be for HMOs, PPNs, etc.; with traditional Medicare, I don’t have a network, so I don’t see that there would be such a provider agreement. I find that most of my doctors take Medicare assignment, and I can remember only 1 bill from an emergency room for <$30 in years. Fortunately, I am pretty healthy; like all of us, I fear serious illness in part because of the financial consequences, but definitely do not want any part of the private, overpaid Medicare (dis)Advantage plans, and encourage all folks turning 65 to stick with Original/Traditional Medicare if they possibly can.
Extremely interesting....hard to believe, but very interesting. I'll be checking out the book.
I am unable to find a doctor to see that I have any faith in after being diagnosed with Hashimotos 6 years ago. Trying to figure things out on my own is a crapshoot at best. If you could provide any guidance I am a paying customer with Medicare which to date I have never used
Bob in NC
shop doctors
be polite
don't complain
just ask for help
go to Mayo if you cannot figure it out
Regular MDs are notoriously ill-informed about thyroid issues. They look at TSH and maybe prescribe T4 (Synthroid), which may get your numbers more normal but not alleviate symptoms. I can't completely vouch for this doctor, but there is some interesting (and perhaps helpful) information on his Web site. One caution: he sells nutritional supplements that support thyroid health, so be careful with your $. That said, what he says makes some sense, and I continue to read his articles: https://www.restartmed.com/hashimotos-thyroiditis/
Best of luck, and I hope you find some answers!
iodine is important; look at my iodine post
also read the chapter in Hormone Secrets
stopthethyroidinsanity.com is a great resource
I look forward to checking out the link; thanks! I started taking 12.5mg Iodorol along with my Synthroid about 6 months ago. Ironically, I'm about to leave to get a complete metabolic panel done, hopefully including iodine. Recent concerns regarding lung cancer have kind of swept the thyroid issues aside, but they're too important to forget about completely!
Could you have meant "stopthethyroidmadness.com"? None of my browsers could connect to "insanity".
Yes I'm aware of all stated. I was fortunate to find a neurologist/psychiatrist who was able to get me diagnosed and knew more about thyroid issues than most. I was never offered meds since my "numbers" were off but nonetheless in balance. After having to spend $10k out of pocket for help getting back on track, since insurance wouldn't cover anything for an unaffiliated MD, I need to find someone locally to help me manage things going forward. I appreciate the link and I'll check it out. Everyone in functional medicine have to sell something so I'll proceed with questions as always. 👍
Check out Moosa’s Substack. They are also writing a book. Also check out Dr. David Brownstein MD books.
they are people, too, and if you are courteous, they will try to help
Iodine has a lot to do with thyroid health, and most of us are deficient. See my iodine post.
The occupational prestige once afforded the medical industry has been eviscerated. It turns out for many the prestige was never deserved. Like sanitation workers and auto mechanics and plumbers there are good and bad. Medicine is no different however we were led to believe the medical school education and the hippo oath were gold standards. Such a ruse when considering the med school system is severely influenced by the pharma industry and upon graduation the diagnostic skills of many is very
Limited. What is evident is the favoritism towards pill prescribing and medical device surgery. The behavior of many health industry
Professionals during the recent plague (IFR of .015-.025) was the big reveal. There is widespread corruption from med school to research to public health agencies. It’s a high prestige sewer.
I sell health insurance and I find that some physicians are asking for money up front for a surgery that involves "cosmetic surgery." the patient is told that the procedure will require longer than what they are paid for and that part of it will be what is deemed by Medicare or Insurance as cosmetic. In these cases the person pays for the surgery. I can see the reasoning behind this and I think it is a good solution. Health insurance since Obama Care is so expensive. Many people are paying more for monthly health insurance than for their mortgage payment. Paying more for less is insane, but we are prohibited in CA to sell non ACA compliant policies, there are none available.
But it sounds like those physicians are duping their patients then and the patient is within their rights to refuse, based on the article. No?
yes