Who Says You Can’t Get Something for Nothing?
So much of our current healthcare system is confounding. One major area that defies reasonable explanations is discounts offered by hospitals to major insurance carriers.
Recently I had a little lab work done in preparation for my annual physical. All in-network services were deeply discounted by the hospital/lab. A number of tests carried discounts of 84%; some were discounted 90%. But the one that amazed me was discounted 100%.
Now, how does that work? The lab performed the test and billed the carrier, the carrier recognized the covered service but, presumably, the lab has agreed to discount the service 100%. The lab has agreed to receive absolutely nothing for this particular test.
I can make no sense of this. Carriers who insure millions of patients can get discounts of 85% or more while individuals who are uninsured or “underinsured” get no discount at all and must pay full charge. What’s the point of having a charge if you’re going to offer an 85% discount?
All of us have a tremendous stake in this system. No one here is looking out for you. The best advice is to stay out of it to the greatest extent possible.
We can help you with that. OMCA can help with plan design, network selection, utilization review, medical management, wellness, centers of excellence and all other aspects of negotiating the medical system. We can make the dollars you spend on healthcare produce results for your employees and increase the return you get on this major investment.
Posted in Medical Cost Containment, OMCA