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View Diary: New government data shows how messed up health care pricing is (62 comments)

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  •  Insurance companies "negotiate" with physicians, (4+ / 0-)
    Recommended by:
    JerryNA, DSPS owl, susanala, eps62

    too, if that's what you want to call it. For expensive procedures that require pre-authorizations, the insurance company will call and "offer" to pay less. The implication is that the pre-authorization depends on the price. What's a physician supposed to do in a situation like that. (Nice patient you've got there. It'd be a shame if anything bad happened to him.)

    Several years ago, a disabled friend of ours who lives on SSI and  Medicaid was referred to a pain specialist for back pain. The pain specialist required a spinal MRI to treat. The hospital where the MRI was to be preformed obtained a pre-authorization from Medicaid and notified our friend in writing, but when the bill came, Medicaid had refused to pay any of it. The charge for the MRI was 2.5 times his total monthly income. There was no way he could pay it. He was so upset about, he asked me to call the hospital about it. I made several phone calls over a couple of months trying to get the hospital to discount the price and accept really low monthly payments, when suddenly they informed me that they had a "fund" for situations like his and had decided to absorb the full cost. I was pleasantly surprised, but also aggravated that our friend had to go through so much anxiety over it.

    The whole situation is Kafkaesque.

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