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-   -   have you negotiated w/hospital b4 surgery? (https://www.talkofthevillages.com/forums/medical-health-discussion-94/have-you-negotiated-w-hospital-b4-surgery-92648/)

jebartle 10-25-2013 04:32 PM

have you negotiated w/hospital b4 surgery?
 
The ole boy was playing golf with a retired insurance agent, who does NOT have supplemental insurance BECAUSE prior to hospital care (obviously NOT an emergency) he negotiates with hospital and doctor that they will accept Medicare for full payment of bill, if NOT he will take his business to another hospital and he reports that he has NEVER been turned down....Hmmmm!
Sounds scary to me! ...and wonder how you negotiate with a hospital when it is an emergency!

mulligan 10-25-2013 05:54 PM

Quote:

Originally Posted by jebartle (Post 768534)
The ole boy was playing golf with a retired insurance agent, who does NOT have supplemental insurance BECAUSE prior to hospital care (obviously NOT an emergency) he negotiates with hospital and doctor that they will accept Medicare for full payment of bill, if NOT he will take his business to another hospital and he reports that he has NEVER been turned down....Hmmmm!
Sounds scary to me! ...and wonder how you negotiate with a hospital when it is an emergency!

Quickly

Bizdoc 10-25-2013 07:19 PM

When it is an emergency surgery, most folks take negotiations straight to God. <smile>

justjim 10-25-2013 09:01 PM

A retired insurance agent should know better not to carry insurance. Hmmm!

Indydealmaker 10-25-2013 10:32 PM

Quote:

Originally Posted by jebartle (Post 768534)
The ole boy was playing golf with a retired insurance agent, who does NOT have supplemental insurance BECAUSE prior to hospital care (obviously NOT an emergency) he negotiates with hospital and doctor that they will accept Medicare for full payment of bill, if NOT he will take his business to another hospital and he reports that he has NEVER been turned down....Hmmmm!
Sounds scary to me! ...and wonder how you negotiate with a hospital when it is an emergency!

I have always worried about depending upon the "low bidder"! Just think about Zip Lines, Bungie Jumping, SkyDiving. Walmart Cardiac Care. :pray:Makes you think.

trichard 10-27-2013 09:32 AM

You may be better off negotiating following you hospital visit once you receive the bill. If you pay cash you can get up to 50 percent deduction on the bill.

blueash 10-27-2013 08:19 PM

I find this story to be very suspicious. All medicare eligible providers are required to decide whether they choose to accept assignment (participate in the medicare program) or not. If they are not in the medicare program they can negotiate whatever agreement they like with a patient. However if you are in the program you are required to follow their rules which include attempting to collect for any copays and coinsurance in the medicare program. As Medicare only pays 80% of the allowable charge (generally) if a doctor or hospital waived that 20% due from the patient or a secondary insurance then Medicare could and should adjust their payment to 80% of the amount they accepted as payment in full. Violating the Medicare billing rules is a major infraction. In a situation where the provider made a legitimate attempt to collect the 20% and then wrote it off, there would be no legal concern. I may be wrong but this is my understanding of the rule

http://oig.hhs.gov/fraud/docs/alerts...ns/121994.html

Long discussion of this issue including this:

Why Is it Illegal for ``Charged-Based'' Providers, Practitioners and
Suppliers to Routinely Waive Medicare Copayment and Deductibles?

Routine waiver of deductibles and copayments by charge-based
providers, practitioners or suppliers is unlawful because it results in
(1) false claims, (2) violations of the anti-kickback statute, and (3)
excessive utilization of items and services paid for by Medicare.


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