Tales from Rohan

November 28, 2008

The wonderful world of Medical Billing

Filed under: rants — rohan @ 14:42

About once every three months I go through medical bills and figure out who did what wrong. Often the insurance company screws something up and even more often the provider does not dot an “i” or cross a “t” and the claim gets denied. Even more often, the provider forgets to adjust down their price to the insurance company negotiated price. So I decided to keep track of how much I was overbilled this cycle.

Since August, I accumulated bills for which I owed $483.26 after my insurance company paid, and I was over-billed by an additional $172.79. That’s a 36% overage. It took me about 2 hours with all the information in front of me to slog through these bills and write little notes to each provider. This is an enormous waste of time and money.

For a long time I thought that the insurance companies negotiating a lower price than private pay customers is exactly backwards. The insurance companies require the providers to spend a ridiculous amount of time doing things they don’t get paid for. AFAIK, a private pay person who pays as they leave should pay less than someone paying with insurance, because there is less overhead.

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