Is This Why Health Insurance Is So Expensive?

While going through my mom paperwork after her death, I noticed Blue Cross Blue Shield statements kept showing up. The finally stopped coming in the mail 18 months after her death. When you open them and look at the header, it proclaims it is not a bill. I started looking at the details. The tell about money paid to service providers. On about statement number 5, I noticed a charge for a certain date. I noticed the date because it was a friend’s bday. It was also a date my mother had been in the hospital. The statement told of a home visit for blood work. Another statement detailed blood work the same day at the hospital. The non-bills have a contact number on them. I started calling suspicious charges. Many went to an answering machine. If you found the provider on line, many had one number to request service. That was always answered by a person. They would refer you to the answering machine number for questions regarding past service. I got 4 return calls after leaving 15 messages.
I called BC/BS to complain. They had no process for reporting fraudulent claims. Then they dropped the bomb on me. I asked why I continued to get statements. I was told the providers have 18 months to submit the claims. This is where the problem lies. What business can wait 18 months before billing? What 85 YO remembers all of the dates of their care? They don’t care because they aren’t charged. 18 months is considered to be a reasonable amount of time (according to BC/BS). All of the unreturned calls came from statements after my mother’s death.
What will happen when the baby-boomers hit? 18 months is way too long. That needs to be changed.

I guess that’s part of why health insurance is so expensive. Originally Posted by waverunner234

When a provider "accepts" your insurance it is usually because the provider has already "contracted" with the carrier to accept what the carrier agrees to pay for the "coded" services billed by the provider. I have serious doubts that a carrier will increase payments for "rooms" because it has a flat screen TV.

On the other hand from an "overhead" point of view ... flat screen TV's take less room, are safter to mount, have a clearer image and sound qualty, have multiple purposes, and they rated for less energy consumption than "standard" TVs, particularly when one factors in standby (when not turned on).

Many providers will not "accept" many carriers, because the carriers notoriously pay less for various "coded" services and/or the carriers refuse to pay for some of the services provided at all.

When, AND IF, "Obamacare" kicks in, rates will go up because carriers will be required by Federal regulations to "cover" certain procedures that they currently will not cover AND providers will be required through Federal regulations to provide those services at the level contracted with the carriers. Two results: Some carriers will get out of the health care business and some providers will not accept the carriers with coverage that fails to pay a substantial amount of the charges for the services provided. The number of quality providers will decline and the services will necessarily be diminished.

As a consequence of the anticipation of "Obamacare" two health care systems are now developing. The beginning is the exceptions given to many "employers" to "grandfather" their health care programs and that includes the union shops being exempted from the Federal requirements.

Do you think any of the three branches of the government will "allow" their health care and insurance coverage to be dictated by the Secretary of Human Services?

[quote=hookem69horns;1728406]

exactly. no insurance, no medical care. greedy doctors.


Ok. When you are in the hospital fighting for your life, ask yourself if your attending surgeon is greedy, then ask him if he feels overpaid right before he saves your life ... Originally Posted by Af-Freakin

doctors around the world make much less than doctors in AmeriKKKa. theyll sue your azz & force u into bankruptcy. ruin your financial life 4ever

[QUOTE=Af-Freakin;1728878]

doctors around the world make much less than doctors in AmeriKKKa. theyll sue your azz & force u into bankruptcy. ruin your financial life 4ever Originally Posted by hookem69horns

BANNED, thank God, he was making you liberals look real bad

exactly. no insurance, no medical care. greedy doctors. Originally Posted by Af-Freakin

Obamacare doesn't cover mental health......

Thank god of both of us.

[quote=cptjohnstone;1730826]

BANNED, thank God, he was making you liberals look real bad Originally Posted by Af-Freakin

I say bring him back.

He was cracking me up!

[QUOTE=TheDaliLama;1731613]

I say bring him back.

He was cracking me up! Originally Posted by cptjohnstone

your right!!!

isn't the high cost of medicine largely the result of govt. interference?

I remember reading that the late Senator Ted Kennedy and his allies led the effort to pass a national healthcare law in the U.S. in the early 50's. That effort wasn't successful, but they did succeed in passing piecemeal some legislation that effected medicine.

Well my friends and enemies, I'm back home since Wednesday and everything is okay.
I couldn't write much here on ECCIE guess what, ECCIE was blocked in both the hospital and the therapy clinic. I used a few times my blackberry to feed my laptop with internet but that's kind of expensive (paying by the Gb). Especially when you watch porn video's LOL

And about how expensive it all is, I was completely knocked out when I read the completed charges from the providers to my insurance company on their website.
Incoming charges are still ongoing but the running total up till today is almost $80,000.
This includes an outrageous charge from the hospital were I was less than 3.5 days. (Friday morning 8am through Monday evening 5 pm) for $63,723. That is more than $18,000 per day. (And for that money you get a blocked ECCIE internet site)
This total will still run up with 9 days Physical Therapy facility and now ongoing care at home for blood tests and a Physical Therapist for weeks to come and more doctors visits and X rays.

Lol, suddenly the $610 per month I pay for health insurance sounds cheap, Right?

And too funny, the insurance company doesn't know yet but my other hip needs replacement too. I'm trying to schedule that in December so I won't have to pay deductibles and co-pays anymore.

If you do have a hot nurse just keep pressing that buzzer that is wired into the nurses station! Keep her on her tip toes. Originally Posted by CPT Savajo

NEVER FUCK WITH THOSE THAT WORK ON YOU, i.e. THOSE WITH THE NEEDLES AND SHARP OBJECTS.

I have to go for surgery Friday morning and a 4 day stay in the hospital + a week in a physical therapy center after that. I was just informed of everything that was going to happen and all about the hospital and therapy center and so on.

I must say I’m probably lucky to be in a brand new hospital that was completed just a year ago of so, but I was stunned to see all the luxury they provide on a personal level. From a private room for everyone till big flat screen TV with built in internet service and free “movie as you go” channels.
Not just meals in your room but a full “restaurant like” room service 24/7.
And an on-going list of other amenities.

And the hospital itself? It just breathes the whole atmosphere of being in the most luxurious hotel you’ve ever been.
I’m not totally sure but I think they will charge my health insurance for intensive care (first day) $25,000 per day and $5,000 per day after that.
What I mean to say is that after surgery and being sleepy I could just settle for much less. Just a TV, a book and I’ll get through those days. But there is really no choice other than living the expensive life.

I guess that’s part of why health insurance is so expensive.
You used to have a say in this yourself (a choice of private / non private room but I guess that’s history?)
What’s your experience? Originally Posted by waverunner234

I have had quite a few major surgeries over the past several years. What I can say is that during recuperation I had no desire to watch TV but only sleep and try and manage the pain from recovery. I had very little interest in eating as well, the meds messed with my stomach. So I don't understand why a hospital would spend so much on expensive TV's and expensive food/service etc. What is most important to me is the level of care I receive while in the hospital and the precautions taken to insure I don't get infections etc. I will do just fine in a basic hospital bed with basic amenities so long as I know I am getting the best medical care to help me recover and get well. I would think most people would feel the same, but maybe only the rich want to have their expensive lavish amenities in a hospital setting? Maybe the hospitals are catering to the well off with better medical insurance? This is no pock shot at you, I am just saying that I can see no reason for a hospital to justify making such expenditures on these type things. The money should be spent on other priorities in my opinion. But maybe these hospitals are making a profit and their catering to those with money and better insurance coverage.

I really don't know, but your post does make one wonder what the hell..

That's not an unusual bill for that sort of procedure. I often see back surgeries that run well over $80 - 90,000. Of course there is some cutting from the sticker price once the bill is paid, but it still ends up costing about $45- 65,000 after discounts. In most back fusion cases, as well as joint replacements, it is surprisingly (at least to most people) how much of the costs is for the actual implants, not to mention the associated bone allograft material. I saw simple pedicle screws and Herrington rods for a two level fusion run almost $10,000 the other day, and carbon fiber and PEEK (Polyetheretherketone) devices can be even higher.

Thanks, I'm already looking forward to continue to make your life miserable.
That was just the motivation I needed. Originally Posted by waverunner234

Don't get too cocky dipshit you haven't recovered fully yet.

There was one thing incredibly difficult to find out, or maybe I was just too chicken. In the Therapy Facility it was literally crowded with young beautiful nurse assistants and students from 3 nearby college's. For gods sake I couldn't find out which of them paid for their college partly as a provider. I'm sure there must have been a few.
Any ideas on how to find that out for the next time?

Now this lady that comes to my home for therapy, she's also young and a beauty. Maybe I should ask her next time when she's finished teaching me walking and stair climbing again, if she is also supposed to teach me how to have sex again? LOL that would be funny. She can't even slap me in my face because I might fall and dislocate something.

That's not an unusual bill for that sort of procedure. I often see back surgeries that run well over $80 - 90,000. Of course there is some cutting from the sticker price once the bill is paid, but it still ends up costing about $45- 65,000 after discounts. In most back fusion cases, as well as joint replacements, it is surprisingly (at least to most people) how much of the costs is for the actual implants, not to mention the associated bone allograft material. I saw simple pedicle screws and Herrington rods for a two level fusion run almost $10,000 the other day, and carbon fiber and PEEK (Polyetheretherketone) devices can be even higher. Originally Posted by TexTushHog

In a couple of days I will see the breakdown of the hospital amount and see what is included and what is billed separately.

Oh and another surprising thing ..... I am a smoker so I asked for nicotine patches. They gave me the choice to have disposable electronic cigarettes.
So that's what I'm smoking now at home too. Perfect.