You are grossly misinformsed. I receive a bill for my consumables related to an insullin pump that is also submitted to the insurance company. Within 2 weeks, I receive an explanation of benefits that shows how much Aetna has agreed to pay and that is much lower than the initial bill. I am not charged anything from that company due to the reductions made by the insurance comapny. Insurance companies, being the source of the major cash flow into these companies dictate discounts based upon the amount of business they give that company. The insurance can demand that you change suppliers to save them money. If I did not have insurance, I would have to pay the initial bill prices.
That is what she told me. I know what you are saying but what she is saying is that instead of overcharging to begin with.....like providers do when they know full well the insurance carrier only will accept so much.....she negotiates down to the quick to begin with and gets the best price available for the service. On the other hand Tom I have seen more and more instances with my coverage that show the high charge like they used to along with the amount allowed by the insurance company but then....and this is the document I am getting from the insurance company......it shows what my portion is for the overage. Maybe this is just how Florida does it but it seems like more and more the provider wants more than the insurance company allows and I get stuck with the remainder.
You are truly, truly misinformed if you think that insurers are overpaying doctors. Like any other bureaucracy it gets muddled and some procedures get overpaid...but the vast majority of the insurance codes pay little compared to provider's costs. Sometimes the services are very expensive...and that isn't all profit. The overhead is incredible, for many of the reasons we have discussed. She (and you) look at it as "paying more because she has insurance." Her doctor is probably trying to cut folks a break who have no insurance and he himself is taking a loss. Don't think so? I did it all the time. Fair? Maybe not because those with insurance end up paying more of the freight. And it gets harder and harder to do because insurance companies are (wisely) saying they are no longer going to allow "cost shifting" from the poor and welfare patients onto their insureds...but still we do it and take the loss.
Read my post above. More and more the providers in this area are not accepting what the insurance company allows for the service and they are passing the overage along to the insured.... me.
Why not go to the ones that do? Change providers.....your friends coverage is very expensive.....I pay $850 a month forva family of 4
I have my wife's coverage which costs a more reasonable $500 or so per month but she is an RN. Trouble is she wants to change jobs again as she works for a loser of an organization and she is stressed to the max. In any event the premium is lower but the coverage isn't necessarily that great when you consider the co-pays. If I took my company's healthcare the premium is 1100.00 per month with even higher co-pays so I am stuck riding her insurance coattails.