Hospitals jacking up prices is kind of a function of the insurance industry. Insurance says “We’re only going to pay you ten percent of what you’ve actually billed,” so health care providers take the amount that they’re willing to receive for the services and add a zero to the end. This becomes the “retail price,” and you don’t get access to the insurance price. Only the insurance companies do, and you have to pay them a monthly “protection fee,” whether you require healthcare that month or not.
Do insurances only pay a set % of charged? Because in that case hospitals would just charge whatever arbitrary amount they wanted.
I think insurances set hard limits on paying individual types of tasks and procedures. Hospitals and doctors bill whatever they want, insurance pays X that’s allowed, tells the insured what they owe, and the rest is written off by the doctor because no one is obligated to pay it.
Hospitals jacking up prices is kind of a function of the insurance industry. Insurance says “We’re only going to pay you ten percent of what you’ve actually billed,” so health care providers take the amount that they’re willing to receive for the services and add a zero to the end. This becomes the “retail price,” and you don’t get access to the insurance price. Only the insurance companies do, and you have to pay them a monthly “protection fee,” whether you require healthcare that month or not.
Do insurances only pay a set % of charged? Because in that case hospitals would just charge whatever arbitrary amount they wanted.
I think insurances set hard limits on paying individual types of tasks and procedures. Hospitals and doctors bill whatever they want, insurance pays X that’s allowed, tells the insured what they owe, and the rest is written off by the doctor because no one is obligated to pay it.