Talk of The Villages Florida - View Single Post - Has anyone ever looked at their Claims on Medicare site?
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Old 05-14-2023, 04:22 AM
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djplong djplong is offline
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Quote:
Originally Posted by jayerose View Post
How can hospitals stay in business?
It's pretty simple. Ridiculous overcharging. Rates set that have aren't tethered to reality. This is something I learned when I was working in healthcare (back office IT development).

The best example that I can give is a personal one to demonstrate. Ignoring the other issues I had to go through to get an MRI, suffice to say that, after enough pain and wasted effort with useless therapies that an insurance bureaucrat thought were appropriate, I got an MRI that immediately showed what was going on.

Initial price on the statement: Over $6000
"Adjustment" for insurance company: Reduced to over $4000
Remaining co-pay for me: $685
Keep in mind, I couldn't "shop around" for the best price as nobody would tell me what an MRI costs (I live in Southern NH).

Just for the heck of it, I looked to see if there were walk-in clinics in Montreal, Canada (just under a 4 hour drive away). And there were. MRIs are not always covered by their Medicare system so it's easy to find several clinics - AND THE PRICE THEY CHARGE (I think it's a law that they have to divulge that).

Retail price for a walk-in MRI, after the exchange rate: $475

My insurance company paid several thousand dollars, plus what I paid, for the same machine and diagnostic ability as I could get for under $500 in Canada.

THAT is how hospitals stay in business. Charging 10x what something actually costs and keeping their books obscure.
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