<p>Hard? Its impossible to wade through literally hundreds and hundreds of pages of documents that are impossible to decipher, go in a circular loop and never explain what is wanted/needed in any way that is understandable, and thats when the website is working and one is able to get on. Lots of threats of fines if providers dont file some new forms that Medicare wants, but no clear explanation of where or how to file whatever it is they want.</p>
<p>I didnt see your specific post, Blossom, and healthcare is, in the normal, ideal world, supposed to be reimbursed for medically necessary procedures. Usually thats on a living person. But in my experience there can be errors on codes, descriptions of the code as written on the EOB/HCFA, date of service, provider, you name it. Yes, its a broken system. If the claim was processed in error, you should probably call the provider (the podiatrist) to get it addressed before trying to work through the medicare system. JMO.</p>
<p>Well…it took me several months to get my bills corrected thru BLue Cross and it was just to get the health insurance premium paid correctly. I kept getting letters threatening to cancel my insurance even though I was paid up. </p>
<p>On the plus side, when I received that 35,000 bill mentioned earlier, Blue Cross had it reduced to 5,000. Then the hospital reduced it 20 percent more for paying quickly over the phone. I heard that many medical organizations will reduce bills if paid quickly. True in what
I see.</p>
<p>The $35,000 is probably the provider’s list price which is mainly used as a starting point in negotiation with the insurance companies. Then it is discounted to the negotiated rate with whatever insurance company you have, then the insurance company pays some, leaving you the deductible to pay. There is plenty of negotiation room for a self-pay patient or for the deductible if large, but it means that pricing is very opaque if a self-pay patient attempts to find out the pricing up front for non-emergency non-urgent care. In other words, “shopping around” can be hard to do, which means that there is little pricing pressure from the users (even those few who care about costs) to keep medical costs reasonable.</p>
<p>At private colleges less rarefied than HYPSM (who can make their list prices stick for students from affluent families), the list price serves a similar function.</p>
<p>Not medical provider net cost calculator, however does give Usual and customary and medicare rates. Much easier if you have your CPT codes which you can get off your EOB however that is after the fact. CPT codes can be looked up on line. </p>
<p>This fair health site is the result of the IGENIX lawsuit</p>
<p>^^ dstark mentioned 3 nights at the hospital - so the bill would be based on the DRG and CPTs wouldn’t apply assuming it was an inpatient stay (and not an observation patient). ie., whether you had 3 xrays or no xrays, the payment will be the same, even though the bill would be different.</p>