A patient with a relatively minor surgical problem learns that the system is not design to offer value. She thought she was quoted an exact price for a surgical procedure.
“Because Qiu thought she was getting a deal on her usual 30% share of the bill, she decided to go ahead with the polyp removal on Nov. 5, 2019. As she sat in the waiting room filling out forms, staffers let her know she needed to pay in full before the surgery.”
Then came the actual bills
“Palomar Health billed Blue Shield $22,219.64 for the polyp removal, which the insurer negotiated down to $8,576.79. Blue Shield paid $5,769.72 and stated in an explanation of benefits document that Qiu was responsible for a $334.32 deductible and $2,472.75 coinsurance.”
“Because Qiu had already paid $1,873.20 on the day of surgery, the hospital billed her an additional $933.87, which meant Qiu was on the hook for the remainder of her 30% coinsurance.”
“These figures don’t include the fees Qiu paid for anesthesia or her doctor’s services.”
Medicynical note: What’s pathetic about our system of revenue production, sometimes known as healthcare in the United States is that it’s designed to maximize costs…….not quality of care.
“The simple fact that a hospital staffer misinformed a patient isn’t a legal reason to force a hospital to lower a bill, Brousse said.”
“Initial estimated bills can be full of asterisks and “weasel words,” said Akshay Gupta, co-founder of CoPatient, a medical bill review and patient advocacy company.”
“”Even though she tried to be diligent, obviously she still didn’t know that she would need to get something that was legally enforceable,” said Gupta.”
So at one of the most vulnerable times in a person’s life the U.S. medical system of revenue production kicks in with a price that isn’t a price, excessive billing, and obfuscation that would embarrass a used car salesman (with apologies).