Health care inefficiencies (Fayette hospital)

mapleleaf's picture

In August, a friend of mine went to Piedmont Fayette Hospital for a routine mammogram. Because the doctor was not totally satisfied with the first picture, she returned about a week later.

As she is covered under a Medicare plan run by Blue Cross Blue Shield, she was not liable for the charges. But Piedmont Fayette Hospital sent her bills anyway, being careful to show that nothing was due right away but that the bill had been sent to the insurance company.

Each two-page bill came separately and was accompanied by a return envelope.

The insurance company recently paid each bill, each within three months of the date of service. The amount to which the hospital was entitled as full compensation under Medicare was about 25 percent of the amount shown on each bill, and that was the amount paid. That satisfied the bill in full.

How many bills did the hospital mail my friend? A total of ten. Five for each procedure, each separately.

Think of the wasted postage, paper and effort involved.

Should the insurance company have paid earlier? That depends on whether the hospital complied with the billing procedures applicable to these Medicare plans. The patient has no way of knowing what the hospital has or has not done, or whether it was done right.

Should the patient receive five bills within 13 weeks for a simple routine procedure where the hospital knows that under Medicare law the bill is not due by the patient? The answer is no. That was an utter waste of effort, time and money on the hospital’s part, and a gesture of harassment toward the patient (who is not in a position to influence the claims processing by the insurance company).

Unless the point of sending all these bills, which everyone knows are not the legal responsibility of the patient, is to cause the patient’s blood pressure to rise so as to produce more business for the hospital, there is no point to sending them. It is wasteful and counterproductive.

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maple leaf: many hospital statements (not bills they say)
Submitted by Bonkers on Mon, 11/17/2008 - 7:50pm.

You are precisely correct.
Since the total cost of a mailed fancy bill is estimated to be about a dollar, i would say I have received at least $500 dollars worth in the last several years.
They have all been paid eventually by my insurance.

Now, as my dentist once told me when I ask him if I cold pay him over a year for a 12,000 dental bill, he said, " no, I am not your banker. You can sign up for a credit thingy we have if you wish."

The hospitals feel the same way---they don't want to carry the bill for 3-4 months until insurance pays. Yet, they don't have the guts to say you owe it now, anyway part of it is usually medicare and they know better than to punish you instead of them!

What it really is though, in my opinion, is that it does keep the pressure on the insurance companies, through your complaints about the "bills." Otherwise they feel they won't get paid except yearly!

Since hospitals deal in scores of millions of billings, the postage thing, and the labor to do them, doesn't look like much to their total.

Much of it will be billed as a $8.30 Percocet anyway.

They do a good job for the volume in my opinion---they should, they are double staffed. However much changes are to come to try and avoid great layoffs in the medical industry as others are having to do.

Do you have any idea just how many $150,000 medical reps are on the road pushing prescription drugs! You might be amazed.

The national debt will eventually ruin our good system and also ruin a big employer.

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Maple and Bonkers
Submitted by boo boo on Mon, 11/17/2008 - 9:20pm.

I think there is a method to their madness. I think they want people to go ahead and pay even though they know insurance will pay it. If people do pay just to stop the repeat billing or calling as a friend told me happened to her, they, the Dr's, hospital's, etc. get to use your money if only a short time, looks good on their books. It is a game they have been playing for years and it needs to stop. The bills are deceiving on purpose the stinkers!
Dentist are way over priced in this area. I have been going to the same dentist for years 12 maybe more and I got a letter from the office saying I was going to be charged, close to $70.00 now for some kind of exam of the mouth that same dentist has been doing for nothing for all of the years I've been going there. I think I will forgo that part.

I was on a web site that says you can now go to other country's(Costa Rica was one) and get dentistry done very inexpensively as compared to here, including airfare and hotel. Same goes for surgery's. Is this in our future, health-care, dentistry so expensive even with insurance we are all forced to go to other country's. Or maybe only the very rich will be able to afford health-care, and of course our highly paid Politicians with their free or nearly free health-care. What do they care if the rest of us are left wanting. If Obama only accomplishes a remake of our health-care system, he will have accomplished a great deal. It is a mess!

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boo boo: dentists (and others)
Submitted by Nitpickers on Tue, 11/18/2008 - 5:33am.

I can layout for you why these pros charge so much:

First, they are a job creation function--there isn't much else to do in this country now except medical or finance.

Then what you figure is this: Two dentist who want 200- 250,000 dollars per year income, plus 3-4 dental assistants at 40-60,000 per year, plus 6-8 phone answerer's and clerks who average maybe 30-45,000 per year--all these plus health and 401-k benefits and a bunch of holidays and vacations!

Now throw in the rent (maybe $100,000 per year for the developer).

Of course depreciation of equipment is maybe $100,000 per year and then they triple their cost for bridges, caps, etc.

Pretty soon you are talking about real money!
Do you know any poor dentists, doctors, or helpers?
A $200 dollar teeth cleaning and doping does sound high doesn't it?

Ever notice the dentist come in for a sit down five minute discussion as to your tooth future? Well, that just added $75 to your visit!

Of course Gen Pract. Doctors and others charge from 120-300 dollars for a 10-15 minute visit--but don't get me started on the visits they get from the drug companies!

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