Thursday, February 03, 2022

Well That Cleared A Year's Worth Of Deductibles In A Month.

Got the bill in the mail for the surgery, which I have now paid.

Reading the top line I almost passed out.  Bottom line was quite a bit better by comparison, which is likely why they do it.

Our medical system is kinda crazy in terms of billing, but the level of care is rather great. 

A $60k top line, but then there's an insurance reduction of $47k.  Then followed by the  insurance company  payment of $10,842.82 and our deductible of $1,577.18.  So for a $60k charge, they actually got paid $12,420.00.  This is probably what they actually wanted to make from the outset in order to get a decent profit for a few rather intensive and high quality hours of care, so they had to raise the stated price to be able to get to where they wanted to be.

If anybody can make sense of this kind of system where the insurance company's contractual reduction is the majority of the stated charge, good luck with that.

Note that was just the surgery center and didn't include the separate bill from the surgeon, who, just like the surgery center, definitely deserved the money. So, understand that I'm not complaining at all, just remarking on the inanity of how the system works and how the top line price just has nothing to do with the actual final price paid.

Between the two invoices from them alone, we cleared our insurance company's annual High Deductible Health Care Plan out-of-pocket deductible for the entire year and all in the month of January! Ouch. 

We've only cleared that deductible in a year once before - last year when some other serious family health care problems occured and had to be dealt with, but then we hit the max in September, not January. 

Of course, some things aren't covered by insurance at all, such as the ice/compression machine so we paid that out of pocket, but the rental fee  for the 3 weeks for it was really, really worth it. Highly, highly recommended if you get offered it, do it.

Well, the rest of the year now has services without out of pocket deductibles so we've got that going for us, and that's nice.

3 comments:

Lucy and Tigers Mom said...

A relative, who works in medical billing, told me there’s another reason. Apparently, they get to claim the difference between charged and allowed costs as a loss for tax purposes.

Old NFO said...

Lucy is correct... Cuts their 'profit' so they can pay shareholders more $$$... sigh

Aaron said...

Lucy and Tigers Mom and Old NFO: Now that's a very interesting move on their part.