HOSPITAL PRICING ROULETTE


Hospital charges appear on patients’ bills, but they often bear no relation to the discounted fees that an insurer will end up paying. Still, some patients do get stuck paying the retail price. They include the uninsured, those with bare-bones or high-deductible plans, and even some fully insured people.

Even if you have health insurance, if you don’t look under the covers you may be surprised that not only does your hospital of choice not participate as an “in network provider” but that the charges for your procedure can be all over the place.

That’s what RONI CARYN RABIN reported in her recent NYT article “The Confusion of Hospital Pricing“. The subject of her article is probably not unlike most people faced with hospitalization. His was an emergency and he sought care close to home.

For his appendectomy, he was charged over $59,000 while charges in his region of the country ranged from a low of $1,500 to as high (due to extenuating circumstances of almost $183,000. It turned out that the hospital he chose did not have a contract with his insurance carrier.

We assume too much perhaps and without adequate research, fall into situations like this. With more and more responsibility being placed upon the patient to be proactive in their care, the financial burden for not doing that can be mind boggling.

Understanding the system a little better is certainly helpful, and Ms. Rabin provides some tips as to what we should do and helpful links to resources. Keeping in mind that his was an emergency, may have made advance preparation a little difficult, however how better for others to learn from someone else’s experience.

 

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