Service provider billed insurance 150% more than cash rate

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PostPosted: Tue Feb 25, 2014 10:11 pm   Post subject: Service provider billed insurance 150% more than cash rate  

1) Is this fraud that when a service provider encourage clients to use insurance because they (the client) will has no out of pocket cost? The service provider is in NJ



2) Their published rate is $1,800 per week, which come out to be $360 per day, that's before any multiple weeks discount. However, they billed insurance company $850 per day and received $595 or 70%.



$595 is over 65% market over cash rate.



Is both fraud?


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PostPosted: Wed Feb 26, 2014 12:48 am   Post subject:   

Nope. It's called every day... as this is how it works. One of the issued with health insurance is that their structured payment rate can be higher then a provider get's paid from those without insurance.



Many would argue that this is one issue with currently have with our medical insurance. I'd argue that law makers continue to ignore this issue so the system remains broken.



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PostPosted: Mon Mar 03, 2014 4:50 am   Post subject:   

If you have the insurance why would you not use it anyway? Unless paying cash would be cheaper, around here the amish folks have an agreement where they get health care cheaper because they pay cash out of pocket.

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PostPosted: Mon Mar 03, 2014 7:34 am   Post subject:   

Quote:
$1,800 per week, which come out to be $360 per day
Perhaps a lesson in math is needed. A week has 7 days . . . $1800 divided by 7 is $257.14. You don't get two days free with every five.

The billed cost could certainly include other charges not part of a daily hospital rate. $257 (or even $360) is unusually low for one day in the hospital, and I would think you are incorrect. Nurses alone earn more than that per shift, and there are two or three shifts per day. There are nursing attendants, secretaries, housekeepers, foodservice and maintenance personnel, laboratory staff, administrators, and all the overhead costs of utilities, taxes, maintenance, and other costs of doing business.

$850 sounds more reasonable, and HMOs and PPOs typically contract at about $400-$500 per day, so $595 does not seem unreasonable.

Again, if you were an insurance agent or broker, you might have a better understanding of this.


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PostPosted: Wed Mar 19, 2014 4:48 am   Post subject: Payment Protection  

It is very important to have an insurance to help you if something bad happens accidentally. An insurance will always be there to help you with your extra finances. It will always be a big help financially. Payment protection for charge cards seems like a good option, as it is insurance in case one can't pay their credit card bill.

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PostPosted: Wed Mar 19, 2014 6:31 am   Post subject:   

Quote:
An insurance will always be there to help you with your extra finances
. Insurance does not do this. Second, insurance lasts only as long as premiums are paid -- it will not "always" be there.



Quote:
It will always be a big help financially.
Insurance does nothing unless we experience a loss. And even then, it will only "help" if the loss is covered. Not all losses are covered by insurance, so this statement is inaccurate.



Quote:
Payment protection for charge cards seems like a good option, as it is insurance in case one can't pay their credit card bill.
This is absolutely FALSE. How does paying up to 1% of your credit card balance as a monthly premium seem like a good option? If you have a $5000 balance, you could be paying upwards of $45 - $50 per month for $5000 in protection. That same $45 - $50 per month could buy tens of thousands of dollars' worth of legitimate life insurance. Credit card insurance merely pays the balance if you die. It does nothing for your family. And if you "can't pay [your] credit card bill" because you spent all your money on cigarettes and soda pop this month, the insurance does not pay your credit card bill. But the unpaid insurance premium will be added to your balance, and you'll pay future insurance premiums on insurance premiums.



Such a deal.



Jenna . . . if you were a licensed insurance agent, you might understand this.


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