Re: Negotiated fee rate


"Steve P" <perilmung@xxxxxxxxxxxxxx> wrote in message
news:SZkQe.2830$Wd7.1736@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
>>>Blue Cross won't give me a list of NFRates, and the hospital says they
>>>don't
>>>have it. Are they hiding the relatively low rates from the uninsured?
>>>Do I
>>>have to pay a bill without the evidence of the calculations used?
>>>
>>>I assume it should be my right to see this list.
>>
>>
>> Why would this be a "right"?
>>
>> You agreed to pay a portion based upon the current reimbursement
>> formulas. The reimbursement formulas are typically proprietary info
>> held close to the vest by the insurer. Since there's usually very
>> little difference between insurers and hospitals, reimbursement is the
>> key to gaining (or losing) business.
>>
>> It's not uncommon for the hospital billing dept not to know the exact
>> fee paid for a specific procedure until they receive the number from
>> the insurer. It's often not based upon a list or menu, but a
>> (sometimes) elaborate calculation agreed upon by both parties. You
>> are a beneficiary of this lower rate, but not necessarily privvy to
>> the details.
>
> I understand their motivation for keeping me in the dark, but it makes me
> uncomfortable. There is no way for me to check up on their adherence to
> the agreed upon contract. The information being withheld from me leaves
> me powerless.
>

That is the definition of being a patient. You are physically and
financially powerless and this is on purpose.


.

Relevant Pages

  • Re: OT: Greet your congress-critters
    ... Gee the insurer charges $50 for two tylenol pills? ... the government and insurance plans to they can get actually get some ... negotiating with the hospitals. ... The current bill specifically says that the government program ...
    (alt.home.repair)
  • Re: NDC, Carl Bernstein on the Colbert Report last night ...political content
    ... Because of the way hospitals are reimbursed they ... diagnosis, for everything that pops up in your stay there will be a new ... off finanacially if it had a new pt in that ICU bed each day for 30days than ... reimbursement will be the same. ...
    (rec.music.gdead)