Quote:
Originally Posted by CoachKandSportsguy
its a billing distinction, of pure doctor / medical and then rent, overhead, etc.
yes, it used to be all in one. . and i will check to see when and who, i suspect CMS, started demanding the two be split out, so that all medical services are identified separately from rent/ operational overhead. medical then should be billed per procedure to medicare. . facilities are dependent upon the local situation. .
the biggest problem is that there are two bills instead of one now.
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No, the biggest problem is not that there are two bills. The biggest problem is the surprise billing of a charge not mentioned ahead of time. Attached is a screenshot of the recent news segment I saw. The man went in for a routine shot of some kind in his doctor's office. He had this exact same visit in the past. Suddenly there is a facility fee of over $14,000 plus several other unexplained fees for a total of over $17,000 for a routine doctor's office visit. That's just f***ing ridiculous. The man's out-of-pocket cost on this visit was over $700. He later found an independent doctor (not affiliated with a hospital group) where the same service resulted in a $35 co-pay.
This fee / practice should be criminal without clear notice well before the office visit. If I get a notice like that, I drop that doctor like a hot potato. I'll bet an independent doctor somewhere would love my business.
The Epi-Pen story is a classic example that still persists. And there are generics of this product. The actual 0.3mg of epinephrine in each pen costs about 35 cents. But, a pair of these pens loaded with the generic form of this cheap chemical is still priced anywhere from $500 - $800. WTF!! The actual pen is a cheap disposable device that costs about $3.00 to manufacture. Research and development is BS. This device is less complicated than the mechanics of just the print head of an $80 inkjet printer.
Medical costs are high because there is very little market knowledge. People need to be able to see a price list and get a quote BEFORE scheduling service or choosing a pharmacy. Obviously, this is not the case for an emergency situation. But, the vast majority of medical purchases for service and pharmaceuticals are routine. I should be able to visit multiple websites to see both patient reviews of doctors' services as well as the cost of various services by same. Ditto with pharmacies and costs for drugs - a complete price list made public. And perhaps some kind of mechanism where the consumer is rewarded for making better economic choices with that information. For example, make the co-pay (there should always be a co-pay, never a no-cost transaction) a percentage of the price giving the consumer (insured or not) the proper incentive to make good choices. Competition works but not when prices are hidden and surprise billing exists.