What is a "self pay bill"? (I'm guessing I know what it is from context, but I'd like to be sure.)

Check every and I do mean every billing code. Most of my insurance rejected claims were somebody else sent in the wrong code.

It’s ridiculous that this excellent information also feels like tips for dealing in the black market. They are also reminiscent of this scene from the Incredibles: https://youtu.be/_R8GtrKtrZ4. Thanks for posting OP.

This country's health system is a circus.

Source: living in the US after Singapore for 6 years and the rest of my life in Australia.

I had a spinal fusion in Singapore. 3 nights in a high dependency unit, an internationally renowned Neurosurgeon and a state of the art hospital (both selected by me) and all necessary diagnostics.

The bill was USD32k. The insurer covered 100%. I paid no premiums in addition to what my employer did.

A colleague here in the US had identical surgery. Same employer, so same level of cover. Premium is still $250 per month Leaving aside issues of network etc, he was discharged on the day of his surgery, and the total bill was USD170k. He had to cover $17k.

im in canada, but i upvoted anyways so that hopefully my american neighbours can see this

[deleted]

So, what you're saying is that medical costs are 40% higher than they need to be because of insurance companies.

OK. Gotcha.

As a non-American this post made me sad

Wow.

As someone who has worked for health insurance for nearly 30 years, almost everything this user posted is wrong.

1. If your claim is denied 100% your responsibility do not call to pay. Call the insurance company to find out why it was denied and work from there. 85% of denied claims are ultimately paid upon review or appeal

2. Same as above

3. False and dangerous advice. From my experience, especially recently, they often send you to Collections as soon as 2-4 months. Because it's a lost cheaper to sell your bill forn30% of its value to a collection agency than have it sit around fighting with you 4: WHAT?! many injection and infusions costs tens of thousands of dollars. Even a bag of simple saline cost $30-$50

4. Is this guy trying to wreck your credit?? Never ignore a medical bill. Negotiate and make A payment plan because if it goes to collection, your credit is destroyed

This post should be reported and removed immediately. It is patently false and very very financially damaging

[deleted]

I wish I had real physical gold to give you. You're an angel.

I have a much better idea.

Ban private insurance and pay for it like we pay for our military.

Vote Bernie

Good god, can we just fix this obviously broken medical system ffs?

Best strategy is to vote for candidates who want Medicare For All and just get rid of all this shit

This is what the post said.

I’m an analyst in the healthcare sector and I hope this helps. I know every single cost associated with seeing you as a patient.

If your claim was denied by insurance as 100% patient responsibility contact the billing department and request a self pay bill. It will be roughly 30-40% of the original invoice received.

If you get labs that are denied do the same thing but contact the lab service that billed you rather than the doctors office. Self pay pay rates are about 20% of what the original invoice was.

A vast majority of medical providers will not send you to collections If you stay in contact with them. Most organizations write off all unpaid claims at 12-18 months so they will accept anything you give them.

Almost every single injection or drug administered through needle or IV will get reimbursed less than $1 by insurance unless it’s a vaccine. Fight those the hardest. Insurance pays about 2% of what was billed.

The best thing you can do is delay the payment as long as possible if you can’t afford it. This way bad debt and adjustments have been factored in and they will thank you for your payment rather than demanding it.

Supplies used on you cost roughly $6. This includes all disposables and swab tests.

Average single doctor rates are $105-$120 for an MD and $50 for an NP/PA per hour. If you get a mid level you can fight the cost more as most insurance groups already charge a discount of 15-25% for mid levels.
Front desk averages $10-$15
Clinical averages $13-$19

Factor that into your required assistance.

Please note that some providers will be different, the main point is work with them and have any denied claims billed again through self pay to drastically reduce costs. Hope this helps some people.

I know Healthcare in the US is fucked but this will help in the meantime.

Send me a direct message if you have questions on an invoice. I can help you fight it. I know every single price point out there and can give you an idea of what the things you got done were actually worth. In the end the provider only cares about EBITDA which can be offset by those covered by insurance. Please don’t feel stuck, all medical bills are 100% negotiable.

Edit: if you’ve already been to that location before you are considered an established patient and insurance will pay roughly 75% of what is normally paid. Use this to your advantage.

r/humansbeingbros

This post was removed because everything shared was wrong and horrible advice....

As someone who has worked for health insurance for nearly 30 years, almost everything this user posted is wrong.

1. If your claim is denied 100% your responsibility do not call to pay. Call the insurance company to find out why it was denied and work from there. 85% of denied claims are ultimately paid upon review or appeal

   1. Same as above
   2. False and dangerous advice. From my experience, especially recently, they often send you to Collections as soon as 2-4 months. Because it's a lost cheaper to sell your bill forn30% of its value to a collection agency than have it sit around fighting with you 4: WHAT?! many injection and infusions costs tens of thousands of dollars. Even a bag of simple saline cost $30-$50
   3. Is this guy trying to wreck your credit?? Never ignore a medical bill. Negotiate and make A payment plan because if it goes to collection, your credit is destroyed

Point zero - start voting for people who want to introduce public healthcare. Don’t worry, it won’t turn you into communist.

Medicare for All.

Look at all this. It's insane that this is needed because we're at the whim of insurance companies. I'm done.

Vote Bernie if you want anything done to improve this.

10) change the system.

I'm a physician and I agree with most of it. BUT beware, if you want to save a little money upfront seeing a midlevel (NP or PA) over a physician, you are going to get what you pay for. PAs and particularly NPs have a tiny fraction the training of a doctor. They're great for very straightforward simple cases. The problem is that it's tiny differences that often distinguish the proper workup, diagnosis, and treatment. They don't have adequate pathophysiology or pharmacology to make this distinction. Sorry you cannot cram that amount of education into a 2 year NP program that requires 500 clinical training hours (vs 4 years of medical school and 15-25000 hours training for a doctor). So again, great for straightforward stuff but hopefully it's actually straightforward. Also because they lack that training they tend to order unnecessary tests and place unnecessary consults to specialists much much more commonly than a doctor. This often defeats the purpose of trying to save money using them. There are bad doctors out there but the average doctor is way ahead of the average midlevel.

So just be aware of that possibility that you aren't getting an equivalent of a doctor for cheaper, you're paying less for a reason. There are also states that unfortunately let them practice independently without a doctor and in many situations they dont have a doctor to fall back on or won't ask for help due to being overly confident.

I work with some great midlevels but I also have serious reservations about them as someone who has gone through extensive medical education with a spouse in nursing.

This is a post I'll save and hope to never need to look at

I only use my insurance for emergencies. Screw the deductible. Literally my bill is the same if they bill my insurance or not.

So now I tell docs I am self pay, give them a story how I am working hard on my own business, but I am not rich, but can pay my bills.

The rates I get are 10X less than the insurance.

I keep my insurance in case I have to go into the hospital on a big charge and only use it this way. I even ask "what is this going to cost if I pay now".

I use medical insurance like car insurance, only if I get into something big.

The best way to pay for health insurance is to vote for Bernie Sanders so we can get the Medicare for All act passed.

for 1 and 2, then that won't come off your insurance deductible. Depending on your future bills, you are better off not doing self-pay.

I had to pay for a ER visit, and it was a large bill but entirely deductible, so I paid it all out of pocket. The hospital refused any reduction, and refused any payment plan, because "I had insurance".

Medicare for all

Or move to Europe and start enjoying being treated like a human being.

Does this apply to emergency ambulance?

Right when i clicked on it disappeared

Also, most hospitals provide financial assistance. Always apply if you are having a hard time paying or know you qualify. The qualifying income levels are typically on their website. Some are very generous even if you have insurance. I know someone with nearly a million dollars in medical debt erased because he had a limited income. I have gotten 50% discounts.

Should I just call and say “ hey I was wondering if I can get a self pay bill instead, as my insurance didn’t cover it?”

I have a LOT of bills my insurance didn’t cover from my pregnancy. I seriously think they make insurance so complicated on purpose!

This is utter bullshit. Fuck this broken America.

YSK that we can should have free health care, like the rest of the civilised world, if we elect non-shills.

I am not sure why op deleted this entire post (apparently while I was reading it), but here is copy/paste:

I’m an analyst in the healthcare sector and I hope this helps. I know every single cost associated with seeing you as a patient.

1. If your claim was denied by insurance as 100% patient responsibility contact the billing department and request a self pay bill. It will be roughly 30-40% of the original invoice received.
2. If you get labs that are denied do the same thing but contact the lab service that billed you rather than the doctors office. Self pay pay rates are about 20% of what the original invoice was.
3. A vast majority of medical providers will not send you to collections If you stay in contact with them. Most organizations write off all unpaid claims at 12-18 months so they will accept anything you give them.
4. Almost every single injection or drug administered through needle or IV will get reimbursed less than $1 by insurance unless it’s a vaccine. Fight those the hardest. Insurance pays about 2% of what was billed.
5. The best thing you can do is delay the payment as long as possible if you can’t afford it. This way bad debt and adjustments have been factored in and they will thank you for your payment rather than demanding it.
6. Supplies used on you cost roughly $6. This includes all disposables and swab tests.
7. Average single doctor rates are $105-$120 for an MD and $50 for an NP/PA per hour. If you get a mid level you can fight the cost more as most insurance groups already charge a discount of 15-25% for mid levels.
8. Front desk averages $10-$15
9. Clinical averages $13-$19

Factor that into your required assistance.

Please note that some providers will be different, the main point is work with them and have any denied claims billed again through self pay to drastically reduce costs. Hope this helps some people.

I know Healthcare in the US is fucked but this will help in the meantime.

Send me a direct message if you have questions on an invoice. I can help you fight it. I know every single price point out there and can give you an idea of what the things you got done were actually worth. In the end the provider only cares about EBITDA which can be offset by those covered by insurance. Please don’t feel stuck, all medical bills are 100% negotiable.

Edit: if you’ve already been to that location before you are considered an established patient and insurance will pay roughly 75% of what is normally paid. Use this to your advantage.

I suck at formatting but that's what they wrote. I also screenshotted it but haven't put it up anywhere.

10.) vote for Bernie Sanders and fight for a single payer universal healthcare system.

if you’ve already been to that location before you are considered an established patient and insurance will pay roughly 75% of what is normally paid. Use this to your advantage.

Sorry, can you expand on this? So they pay less than if you're a new patient? Also thank you for this write-up. Our healthcare is fucked, but ensuring more people understand it is an important step in unfucking it and protecting themselves.

or we could vote Bernie in as president....

Having to find loopholes to minimize your already inflated medical bills in the US sounds like r/aboringdystopia to me

All I took from this is that health insurance companies in the US are marking everything up by between 20-40% because... they can? Apparently that's perfectly ok?

Fight your ass off for Medicare For All.

Aaaand it’s gone

What did it say? I was reading it when it got deleted.

Why has this been deleted? It was very helpful. Does anyone know where I can find a back up of it?

The correct answer is by voting

Or vote for Bernie and catch up with the rest of the worldaa

A lot of this is incredibly generalized and very misleading.

I’d encourage readers to do some additional research before accepting this as gospel.

Source: Also in the healthcare sector.

Step 1. Vote Bernie

Does this apply to a dental office?

Wish I would’ve known some of this a couple of years ago. Have an hsa, needed surgery, cost me my 10k deductible and totally drained my hsa account. So are you saying I maybe could’ve negotiated that 10k down? Haven’t even been able to fund my hsa since. Oh and my premium is going up..again. Since I started my plan in 2009 my premium has gone up over 350%. But it’s still cheaper than what most people pay and I can’t find anything cheaper. I’ve tried. What really sucks is that beyond that one surgery, we never use our insurance. Family of four, all healthy, do one well visit a year and in ten years we’ve had one hospital visit for me and my surgery. It’s just insanity.

Jeez, US seems like a good place to live until you get injured or sick.

Vote for Bernie Sanders!

MEDICARE FOR ALL. Let's end the middleman madness.

also vote Bernie Sanders

Or we could just have M4A like a normal developed country.

The USA fucking sucks.

fuck that bullshit people need a fucking uprising. fuck college and healthcare costs

Thanks for all of these tips, but honestly fuck the American medical system and all of the insurance companies.

holy shit, what a broken medical system

1) Vote Bernie Sanders

Number 10: vote for Bernie Sanders

The US health care system is a total clusterfuck. So glad I don’t have to deal with it

Is this some kind of American joke that i'm too european to understand?

What if I'm broke (but had insurance thru my job) and had to go to the ER for a broken bone and still got billed $2,600? I can't afford $200 let alone $2,600.

This will probably get buried but I wanted to note that if you are uninsured and a victim of a crime, you can apply for the federal victims of crime program (in the USA). The main requirement being that you have to have a case # from filing a police report. It can help get medical bills and sometimes other things covered.

https://www.ovc.gov/about/victimsfund.html

I’m so glad I don’t live in the US, medical bills sound scary as fuck. I live in the UK, keep your hands off the NHS please!

It's hilarious that there needs to be an explanation about how to pay for what is basically a necessity of life.. and people still defend the system in the US like it's working fine.

1. Move to Canada

The fact the bill magically gets smaller when it's self pay just goes to show you how fucked up there system is.

[Laughs in new Zealandish]

Good advice sad it needs to be given

Does any of this apply to dental implants and other work? I have so much dental work that needs done and I'm afraid it's going to kill me before I can even think about getting it handled.

The reason I ask is because I have heard that dental implants are considered "cosmetic" and I have 3 teeth that are broken off at the gumline - I'm terrified that the roots are infected.

I have to disagree with #4. Injectables are extremely expensive. I'm in the healthcare industry as well and have a child on hemophiliac medication enrolled under a 340b pricing plan, and it's still costing the insurance plan $1.2 million annually.

Good tips, I worked in ER and hospital billing for 7 years and I'm glad to see this knowledge being spread. This will get buried because this post has been up for so long but also keep in mind ER rates are insane and your insurance can deny emergency claims! Don't get stuck with an ER bill for something that was not an emergency! Do not go to the ER for something minor like a cold, mild injuries, etc. Make an appointment to see a doctor or go to a walk in clinic. Just because your condition was minor does not mean the bill will be. At my ER in a low income area it was $499 just to walk in the door for the lowest ESI.

Why is this deleted?

Why was this deleted?

Why was this deleted

Whoa. Literally tapped the post (on mobile) to read and saw the post and user gets thanos snapped

YSK how to decrease medical bills in the US significantly:

Step 1: Vote for Bernie Sanders

There is no step 2.

Who deleted the content of this post?

love u for this

This is extraordinary helpful!

I gotta ask, where did you get all of the knowledge?

NOOOOO no no no don’t do most of these if you have private insurance. DONT DO THIS

EDIT: i cannot stress this enough but this information is so completely flawed. it may be true in certain scenarios in a small region but DO NOT follow this advice without further research. this could not be more untrue in CA, for example.

Even after our insurance pays we negotiate down bills for patient responsibility. Often up to 50%.

This is really relevant to me right now, so i DM'd you.

Good on ya man, for sharing this info.

You are a saint! Thank you for this.

If you get care at a nonprofit hospital, they’re required to provide some charity care every year. Ask for documentation on their charity program.

Don't forget to ask for detailed billing. I know of somebody who was charged for doses of insulin that was enough to kill three people and when they asked for a detailed billing they got it reduced severely.

A couple years ago I came home with pain in my groin area after hanging out with my then gf at the time and felt this sort of deep throbbing pain that wouldn't go away even after lying down for a few minutes. I panicked and googled it and thought I had testicular torsion. So in a panic I wake my parents up and have my mom drive me to the emergency room and I waited there for about 15 minutes until a nurse came out and guided me to the room. Long story short they ultrasounded my ball sack and did not find symptoms of testicular torsion. My dumb ass just had a bad case of blue balls. Anyways the question I wanted to ask was for some reason I only had to pay the doctor visit bill and they wrote off all the other expenses with some latin phrase that I forget what it was called. Is it common for this to occur for "false positives" like in this case? Also what is that called? I can only assume they took pity for my dumbass and just wrote it off.

edit: I did not have health insurance at the time.

Does this apply to therapy and psychiatric care as well? Insurance picks up most of my bill but it is still $50 out of pocket ever session

Question for you. I got a surgery in 2016 by Cleveland Clinic. Theyve been fighting with me/my insurance over the bill since then... going on 4 years. My EOB from my insurance says I only owe $682 + $48. Cleveland Clinic says I owe the $682 + $2,260 for something or other. They did a code review and found no problems on that front. Come to find out the insurance must have denied that $2,260 bit as "cosmetic" though ABSOLUTELY NO part of that operation was cosmetic, IN THE SLIGHTEST. Beyond that, the operation fucked my situation up worse and it had to be redone with another operation a few months ago at a new surgeon. So my question is... what the fuck are they charging me a random extra 2,260 for? This surgery was preauthorized by insurance and CC Went and did something extra that the insurance NOR I consented to? What insurance and hospitals do is have contracts meaning they CANT charge me for extra shit beyond what my insurance says they can, which is called a contractual write off that I'm not responsible for. It's a mess and I dont know what my options would be aside from just never fucking paying it til they sue me because I 100% think they're being fraudulent or something. It's also been 4 years almost now and they've not yet reported the bill to the credit bureaus.

Will any of this work if the hospital sent your bill to a 3rd party? I was told by the hospital that the only way to lower my monthly payments was to go through a 3rd party billing place that they use, so my bill was sent to that place and that's who I pay every month.. I only started hearing about all the ways you can negotiate your hospital bill after I set up these payments. But I dont want to call and sound like an idiot if there is nothing this billing place can do

I fucking hate our healthcare system. I had pulmonary embolisms 2 years ago that included a 4 day hospital stay. Last year I got a respiratory virus that made me feel like I was having the same symptoms as my PE (shortness of breath, chest pains) and I got so scared and went to the ER. It thankfully ended up being just symptoms of the illness irritating my not quite 100% healed lungs.. I completely regret going in because of the bills. And even though I know how serious PE's can be, I'm seriously going to question whether I really need to go to the ER if I ever start to feel that way again because I can't freaking afford it.

I work for a revenue cycle services firm, and a big push in the industry now is helping patients understand these options. This was a really great post

Wow, thank you. You have a clear succinct way of explaining this complicated information. If you have the bandwidth, I would suggest you do an IAMA. I imagine lots of folks would have questions.

Can I ask two questions?

• I’ve been told that company’s health insurance premiums skyrocket if they have too many people over the age of 50. Hence, a lot of people are let go at that age. Is this possibly correct? (As I approach 50, I am concerned about this)

• is there any sort of information we, as citizens, could compile or anything else we can do to effectively reduce the cost of insurance? My thought was to create a spreadsheet with others documenting how much each of us pay on various items. This would Demonstrate that it’s less about the actual cost and more about the organization’s ability/willingness to negotiate. But am I correct in my perspective? I’d welcome your thoughts.

The best way to reduce your medical bills is to vote for someone who wants to pass medicare for all.

Many states also have an Ombudsman for Medical Care. They help consumers getting railroaded or ignored by hospitals and billing departments. Make sure you request your entire medical chart related to the date of service and ensure they have your signed personal guarantee and consent forms. I had an $8,000 bill completely wiped by the Ombudsman in my state because the hospital failed to bill my insurance in a timely manner and didn't have my Consents or Personal Guarantee on file.

Almost every single injection or drug administered through needle or IV will get reimbursed less than $1 by insurance unless it’s a vaccine. Fight those the hardest. Insurance pays about 2% of what was billed.

Ooh, nice, the single most effective way of delivering a drug isn't covered, and you have to fight it. /r/aboringdystopia indeed.

For a moment I thought this was /r/ABoringDystopia

Ok so there is a 30-40% markup that exists for no good reason? What am I missing?

What a fucking joke. You people would rather jump through these hoops, and call it a win - rather than universal health care?

Weird.

I'm a practice manager in Alaska and I can say that your price points might be accurate in some areas, but nowhere close in this part of the country. Some of this is good advice, but slot of it should be listed under r/ULPT.

Self pay gets a 20% discount unless you are going to a designated community health clinic where you can pay on a sliding scale based on your income. But if you already went to a regular clinic and got denied, it is too late for that.

Before calling and asking for a self-pay bill, CALL YOUR INSURANCE COMPANY! Ask why it was denied. Many times it is a matter of coding or they need the notes to say something specifically. Same for lab tests. Most labs for "screening" will be denied, but labs for "diagnosis" will be paid.

All accounts will be sent to collections. We don't write it off after 12 months, so delaying in hopes that we write it off does no good. We will gladly set up a payment system. Your account will stay in good standing even if you are only paying $10-20 a month. Your average mechanic won't do that for you, and nobody complains that they aren't fixing your car for free.

The bill is your responsibility, but many people don't want to deal with it, so they just delay and get mad that we don't provide services for free. I am personally an advocate for socialized medicine, but that is not reality right now. Trying to protest the system by not paying will just cause further headaches for you. My nurses make $40/hr and many times they spend 2-3 hours on the phone with an insurance company trying to work something out for a patient, because the patient won't complain to their insurance company, they complain to us. This is one of the reasons healthcare is so expensive - highly trained, well-paid professionals doing non-medical tasks to help a patient who refuses to help themselves.

The OP also fails to account for the room full of business professionals we have in place to work with the insurance companies trying to get your bill paid. There is more to it than just the front desk, office staff and doc, unless you are going to a mom-n-pop one-man show. Go to the small guys and pull these delays and refuse to pay, and you will put them out of business.

Finally, I don't know where he gets supplies for $6, but please send me a link. I buy the supplies, and I can hardly get a roll of kerlix for $6. OP also fails to account for the $7,000 vital sign machine, the $20,000 A1C machine, the $25,000 EKG machine, the $6,000 urinalysis machine (so I can save you money by not sending that to the lab), etc.

Bottom line - do your best to pay your bills. We depend on money to keep the doors open. None of my workers, including the docs, are independently wealthy. If you can't pay your bills, TALK TO SOMEONE. Call your insurance company. Call the business office. We will all work with you. Contrary to popular belief, most medical professionals are not trying to bankrupt people just so we can line our pockets with cash. We are trying to provide a service which costs a lot of money to provide, while keeping the doors open.

Little known fact - most larger primary care doctor offices are budgeted to lose money. We are considered feeders to the systems that make money - mostly surgical specialties, lab, and radiology. So your primary care doc is not just charging you a crazy bill because he is greedy.

I’m genuinely surprised that there’s a self-pay rate and an insurance-paid rate. It sounds pretty scammy.

1. Stop voting against your best interests to stick with party lines

Do you have any advise on ambulance charges? Particularly privately owned companies from a life threatening injury back in 2012 that is now on my credit report? I know the easiest, most effective answer is pay it off in small amounts, but I haven’t been able to bring myself to do that. Idk why, it’s just like dude...I literally almost died, had a hemorrhagic stroke, and I don’t owe those doctors anything....why is my credit shit because I didn’t pay you out if pocket to drive me to the hospital?

I do not have insurance but have pretty damn good healthcare.

For minor things and regular checkups, I subscribe to a Direct Primary Care provider. This is a doctor who does not accept insurance, and doesn't charge insurance prices. For a family of 3 we're paying 145 a month, and we can text our doctor if there's anything going on. We just recently had a kid, we're also getting vaccines with this and regular monthly checkups for the tot, and if one of the grown-ups has something they need looked at, it's covered by the monthly cost.

For major medical, we are part of a health sharing network. These prices can be a bit higher, we're paying 530 bucks a month. This provides 1,000,000 dollars worth of coverage beyond the "annual unshared amount", which is iirc 1500 (basically they don't cover the first 1500 bucks of our medical bills, this is for all bills, not each individual bill, so if you meet the AUA for the year you basically are covered for everything the rest of the year). My monthly "premiums" go to other members of the health share, to pay their medical bills.

This means that my total cost of healthcare for all three of us is about 600 bucks a month, which is lower than the insurance offered by my company, of a way way higher quality, doesn't have in-network/out-of-network doctor BS, and I can just text my doctor if there's a question.

I think this setup is going to be more common going into the future since regular insurance is such crap with all the regulations and "government fixes" to healthcare that continuously make healthcare more difficult to navigate. I opted for this instead of insurance. I feel like I'm definitely getting more bang for the buck, but get a better product at the end. It's sort of like skipping the Toyota Carolla and going for the Ferrari, except you got the Ferrari for a steal.

or just dont get sick, dont know know that americans are fit and strong and never are sick?

for shame.

How about just giving them fake info at the Emergency Room? Will that work?

This is the most American thread in history. What a shit show. You poor suckers.

And also, SLPT, just give all fake information in a case of an emergency hospital stay and you'll never hear back from them about those pesky bills.

So how does healthcare actually work here? If you’re really sick do they just let you die if you have no insurance?

Buddy, I don't think I'll use this info soon but you are doing a very good service to people in this country. I hope you get all that you desire and deserve.

any idea on what a rheumatologist will cost without insurance or what to do to reduce the cost? I'm dreading my appointment in January but I need to see my rheumatologist in order to keep getting the medication that keeps my spine from fusing into a single bone.

A few years back my wife had a rest do e that the doctor said "would be about $100...". We said okay and then the bill was $9850. We called up the lab and said we were self pay and they volunteered $65 as a fair price for them.

It was a real WTF moment for us.

America, what the fuck, bro? Why is this so complicated? Damn.

Join a health share instead of insurance.

My insurance rates were 1200 a month for my wife and I. We had 5k in deductibles and an 80/20 policy.

Health share is 400/ mo. 1700 deductible

Health share uses Medicare pay differential schedule to reprice all bills to the same level that is ok’d through Medicare.

Example. 1500.00 anesthesiologists Bill was reduced to 292.00

This was part of my deductible. I sent a payment for 292 to the anesthesiologist along with a repriced detail of services sheet ( provided by the health share)

Payment was approved.

We hit our deductible cap in April. I haven’t paid anything more than my premiums since.

Because of this I was able to take care of many health issues that I have been avoiding for decades because of the simple fact I couldn’t afford the steep deductible let alone worry about if the procedure was going to get rejected by the insurance company.

Health care is broken as fuck. Insurance companies do not have your best interests in mind EVER. Health care providers have to rig the system to get paid. What is left is the average person being stuck in the war zone between these two factions.

OPs post really bums me out. To have to play chicken with a medical provider over a payment vs collection shouldn’t be a way of health care cost management.

Health share has solved this for me. I have removed at least one faction from the war.

step 0 - eradicate medicine-for-profit in the first place

What do you think the UK chances are of avoiding this kinda shit after Briexit?

Or government policy change

What a fucked up system

As a 17 year old i really thank you for this. I'm not entirely prepared for the mental implications of financial troubles due to medical bills so this helps a lot.

This post makes me thankful I was born and bred in Ireland.

Or just get universal healthcare like the rest of the sane developed world.

Healthcare in America is a sick joke.

This should be required reading for every American.

Wow I'm from the UK, this is some dystopian shit. Soon to hit our shores too thanks to the fuckwit we have in power and Brexit.

Mr. Incredible got fired for this sort of thing.

Elect officials who seek to make this less confusing, not more convoluted. This is asinine.

Universal healthcare is a better option lol

As a Canadian, I salute the bravery of Americans who have to nitpick and argue for the medical attention to stay alive.

This doesn't work in many places. Self pay bills violate many contracts with insurance companies as they require they be charged the same rate as patients would be charged.

Number 3, used to be true. Not anymore. I got a scope last year at a local hospital. I set up a payment plan, but after the second payment I sent, they sent me to collections. I WAS MAKING PAYMENTS MONTHLY. And I still got sent to collections. Our city has two major providers, the next stuff got done wasn’t much better. I was sending payments and even portions of my bills got sent to collections.

I had to stop payments that I had set up as the hospital didn’t know how to send my payments to them to the collection agency. So I’d not be getting credit for those payments. Total crap.

I'll file this, as a non-American, under cool-stuff-to-be-aware-of-but-at-the-time-appalled-to-find-out-this-is-necessary-for-some.

Wait, people are insured and then have to pay things them self anyway. And on top of that, people have to pay more because the bill they receive is higher if they have an insurance, so if the insurance doesn't pay, you pay too much?

What is that for insane system? How are people in the USA not going on the streets revolting over stuff like this?

Jesus Christ, this is insane.

I remember I had a friend in the States who got sick with the common cold, used to play video games with him. He sounded like ass, and honestly I just wanted to hear him clearly, so I told him to go to the doctor. He replied with "but that costs money".

Bless Canada, I can visit any doctor any number of times I need for anything at anytime.

Do a fuckton of reading through everything you sign, every bill you receive, and fight everyone...as you're recovering from illness, surgery, or an extended hospital stay.

You know. Just do that.

Deleted wtf

I know a girl who is actually an MD and was saying that she grew up in a family business and never had insurance. They would always pay in cash. Her family must be doing this, but this seems like such a headache to do every time.

RIP OP's career.

Wait a minute, where did OP go?

Why was this deleted?

Oh no, they deleted the info. Anyone got a copy of it?

fuck, this is disgusting. so fucking glad I live in europe

1. Just move out of the US to almost any other western nation.
2. Have free healthcare.

A vote for Bernie Sanders can end this inhumane madness once and for all.

Jesus fuck, I am really starting to loathe this country. Land of the free...loading corporations, and fuck individual Native Americans.

Or vote for Bernie and have all your medical debt paid off

Or vote for someone who will rid us of this ridiculous system and bring forth a new one.

LPT : vote for the only candidate disgusted by this, Bernard Sanders

Thank you so much. I broke down at the procedure center this morning because I owed my insurance company money and they weren't going to cover my surgery.

I thought I was going to have to cancel my surgery. I had a 7 mm kidney stone that had actually adhered to my ureter and was causing a kidney infection, so obviously that wasn't a good idea. It was extra frustrating because I called Ambetter yesterday to make sure my coverage was up to date.

Luckily my aunt was with me and covered the fee until I can get back to work. The registration nurse told me that self-pay would be an option, but I had no idea how much it would cost. I didn't realize it was lower than the insurance cost.

I had a full-time blown panic attack in recovery, and I'm still freaking out about how I'm going to pay for this at the same time taxes are due. This just brought me so much comfort. Thank you.

I still have anesthésia in my system, so sorry if this is jumbled or oversharing.

Please vote for healthcare coverage in 2020, y'all. We can't keep doing this. I work. I pay taxes. I'm genetically predisposed to kidney stones and it has destroyed me financially.

Thank you for sharing this knowledge

This is great. Thank you! I imagine a lot of redditors will save your post,

Can you explain #4 a little more? Does that mean that if your insurance covers say an emergency visit to the hospital, it won't cover necessary IV drugs?

I’ve been dealing with that and just getting bills and bills, all of them above 1k! I’m seriously going to call them all tomorrow. I’m not trying to get away with not paying .. just a fighting chance!!

Seriously, thank you!

How would one use 6 - 9 to their advantage?

A true hero doesn’t need a cape. Well done, OP, well done.

Sorry but I have to push back on you here. Providers cannot just give you a self pay or "uninsured" rate. Unless the insurance denial is specifically based on medical necessity or a billing error (not following medical policy by billing without a required diagnosis or timely filing, for example), this is called discounting and can lose you your contract and status as a credentialed provider with the healthplan. Adjusting patient responsibility is in direct violation of all contracts. You must make and document a reasonable attempt to bill patients for all copays, deductibles and coinsurance due at the time services are rendered (most ehr platforms track this for you). Insureds (patients) should also be aware that they are expected to understand and do their part (take responsibility for) things like referrals and choosing preferred providers. It's a slippery slope for those not in the biz so careful there cuz

Great advice! We have insurance, but I'm terrified to see the bill after my wife's 5 day stay to give birth (c section) to our first child. Any specific advice for this situation?

Seeing the cost breakdown from you makes me realize that the US doesn't have an unreasonable cost when it comes to the actual healthcare, just that the problem is the suppliers and insurance companies. In fact, these prices seem pretty usual (a bit higher though) for what I pay in my country.

I mean, the doctor rate, front desk and clinical are pretty reasonable.

Yankees really need to get their shit together and fix the healthcare system, cause the basics for a good one are seemingly in place. But then y'all stack a shit ton of extra costs on top of it.

Probably because people keep voting Republican.

Sucks to be a sick American 🤣

Vote in someone who wants to reform health care!

Wow! What a simple idea.

r/latestagecapitolism in a modern society, our sickest people shouldn't have to work harder just to pay their medical bills. Change the system!That said, thanks for advising on the system that exists...

Why was this deleted?

YSK if you debt is sold to a debt collector, which it will be if you don't pay it. Do not talk to them, do not answer their calls and do not pay them a dime. They are parasites. And remember apart from those to the government, debts are only collectable for 7 years.

RIP Does anyone have a copy of the LPT?

The actual best way to reduce medical bills is Medicare for All. Find out more over at /r/SandersForPresident

10: Bernie Sanders

These are great tips. To add to that:

• Universal Healthcare.

Thanks for posting you a real 1

It was! :) thank you! Hopefully we both can do something with that debt, it doesn’t hurt to try right? Maybe we’ll get someone in the holiday spirit!

Does this include dental/specialist bills as well? (Root canal, crown, etc?)

I'm going in for revisionary surgery next year, 100% self pay. Pre-op is next week. May I message you after we get the preliminary bill?

They will knock off 10-20% on damn near anything if you are will to pay it now.

Source: had the cancer$

Will this work for dental? My dentist literally called me today saying my pre authorization was denied. I need to have a skin graft done for my receding gums. It's about 3k for the procedure.

UPMC’s self-pay discount is 20% They will not however change your bill to include that after an insurance denial unless the denial reason is for patient not being their insured. Definitely worth a try for other providers though!

Hi, thanks so much for your post! I have a question- I had to see an out of network plastic surgeon in the ER of an in network hospital. He was the only dr on call to treat my injury. This is the bill I am receiving from his office : http://imgur.com/a/ndWWSAb . My insurance is telling me it should be covered and I believe they are negotiating with him, but his office so far has been unreasonable about adjusting any rates. Do you have any advice based on the situation and billing codes? This was in NJ and my insurance is blue cross/ blue shield of Illinois. Thank you!

Any luck in reducing an emergency room copay. My regular doctor sent me for a test because it was late in the afternoon. I didn’t realize it would cost me 300$.

You are the hero that this country needs right now.

Sad thing is, some of us might refer to this comment in the future. Thanks for the info.

If we go to single payer do you lose your job OP?

I’m a cancer patient with thousands of dollars of medical debt. My doctor’s office assigned me a financial navigator - can I call her and ask for the bills to be decreased?

I’m also paying more than $400 per month for ACA insurance, so any advice there is greatly appreciated too.

I don't understand #4... My insurance covers annual physicals, which for me include basic blood tests. This involves injecting a needle obviously... but was covered.

I was also administered fentanyl via IV (before surgery). This was also covered.

I am sharing this in every venue I have access to. Future MD hoping to save some people from overpaying the industry.

Are #1 and #2 still applicable in the same way if you are on Medicare?

So what if I overestimated my income so I’m overpaying my premiums and copays and starting to drown? Meeting with my CPA Friday so I have an exact number this year. And yes this means my taxes are essentially done. Pleased.

What if it’s already been sent to collections? Am I fucked?

And I thought this would be a "don't vote X" joke.