Should Food Stamp Recipients have to work? - Page 7
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Thread: Should Food Stamp Recipients have to work?

  1. #61
    Posting Addict ClairesMommy's Avatar
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    Quote Originally Posted by Jessica80 View Post
    Not true. Insurance contracts a much lower rate and if not on insurance the hospital can bill you their normal charges not their contracted rate.

    For example...I had a claim today. 5 day stay. Total charge (not including docs, anesthesia etc.) was 48, 000. We paid them 8000.00. Big difference.
    I cannot even comprehend that. It blows my mind.

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    Community Host wlillie's Avatar
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    Quote Originally Posted by Jessica80 View Post
    Not true. Insurance contracts a much lower rate and if not on insurance the hospital can bill you their normal charges not their contracted rate.

    For example...I had a claim today. 5 day stay. Total charge (not including docs, anesthesia etc.) was 48, 000. We paid them 8000.00. Big difference.
    It is true. Since Insurance usually pays people to work for them, by the time they've made a profit, paid the costs of their employees and other expenses, and hospitals have paid the cost of their employees that deal with insurance, it adds to everyone's bottom line (at least those who actually pay!). It's just common sense that insurance would drive up the cost of healthcare and that's without the fact that they aren't nearly as careful about checking charges as people who are paying out of pocket to make sure there aren't any errors. AND it's a fact that people with insurance are much much more likely to go to the doctor for stupid **** they don't need to go to the doctor for that those wihtout insurance (or with catastrophe insurance) would just put a bandaid on and take some tylenol.

    eta-For example. We have a family doctor in my hometown who refuses to handle ANY insurance. He charged (when I was a teenager) $25 for a school physical or a yearly checkup, $50 for a pap smear, and another $50 for the labs to do with the pap smear. That same pap smear was billed/paid for over $200 with the lab work with my parents insurance the year after and my school physical was paid out at $50.

    Then they (insurance) paid the doctor in their network over 200 to find out what was wrong with me and it turns out I had low blood iron. It was a 10 min office visit and his assistant took like 3 vials of blood. I have no clue what the lab costs were.
    Last edited by wlillie; 10-01-2012 at 05:56 PM.

  3. #63
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    I work for health insurance. We are not for profit. We pay 90-92 cents of every insurance premium dollar to paying claims. The other is administrative costs. That will be the federal guideline. Each private insurer must ensure that they are paying a minimum amount of premium dollars to claims. So for profits can no longer pocket 60%+ of their premium dollars.

    And actually, when people have insurance that involves deductible especially HSA compliant high deductible plans they are much more aware of waste than people with master medical plans or plans that cover everything with 1 copay. They are the mainstream now and become more popular each year. Insurance plans can detect double billing on same dates of service as well as billing for higher cost visits when they have been paid those previously. Of course, we cannot determine right away if a service billed is not fraudulent but we do periodic audits and that can weed out those issues.

    This is my life for 37.5 hours a week for the past 4 years. I know of what I speak of.

  4. #64
    Posting Addict GloriaInTX's Avatar
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    I think things would be so much simpler if they just took insurance out of the picture. If everyone just paid the actual cost of the Dr visit and took out the middleman. Insurance should be for what its intended for, if something terrible happens. Most people don't get bumper to bumber coverage on a car for every little thing that goes wrong, they get insurance for if something unusual happens like an accident. It should be the same for heath insurance. Insurance should cover something catastrophic not a runny nose. One of the local urgent care clinics here charge $12 for school physicals if you pay for it without going through insurance. It must be cost effective or they wouldn't do it. A lot of the expense a Doctor has to pay is to hire someone just to file the reams of paperwork insurance requires, and then they get paid less and less for each procedure.
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  5. #65
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    Actually it typically costs more for someone who hasn't had primary care and waits until a problem arises. It's much cheaper to pay for a generic blood pressure med than to pay for treating the heart attack, ambulance to bring them to the ER, the ER triage to inpatient and the subsequent visits to cardiac rehab and specialist visits. A pcp can monitor the beginning stages of high blood pressure. MUCH cheaper. Most major insurance companies now file electronically and a typical office visit would require 5-10 minutes of billing entry (something else I've done before).

    A doctor with a non participating status with insurance will charge more than a participating doctor does because they know they can. That's why I had to review a 10000 surgery center claim (who didn't take insurance) on something we normally pay 1000.00 for.

    If a school physical cost 12.00 I would be shocked and would stay far away from the center to be brutally honest. There is no way a doctor that is worth their stuff would charge that much. A physical should be your most in depth visit with your pcp for the year. A school physical means they are just filling out the paperwork and not really delving into your questions.

  6. #66
    Posting Addict GloriaInTX's Avatar
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    Quote Originally Posted by Jessica80 View Post
    If a school physical cost 12.00 I would be shocked and would stay far away from the center to be brutally honest. There is no way a doctor that is worth their stuff would charge that much. A physical should be your most in depth visit with your pcp for the year. A school physical means they are just filling out the paperwork and not really delving into your questions.
    I bet a lot more people would go to the doctor if they could go pay $12 for a simple checkup, and that would probably catch most of the stuff that they go to the ER for.
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  7. #67
    Community Host wlillie's Avatar
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    Quote Originally Posted by Jessica80 View Post
    I work for health insurance. We are not for profit. We pay 90-92 cents of every insurance premium dollar to paying claims. The other is administrative costs. That will be the federal guideline. Each private insurer must ensure that they are paying a minimum amount of premium dollars to claims. So for profits can no longer pocket 60%+ of their premium dollars.

    And actually, when people have insurance that involves deductible especially HSA compliant high deductible plans they are much more aware of waste than people with master medical plans or plans that cover everything with 1 copay. They are the mainstream now and become more popular each year. Insurance plans can detect double billing on same dates of service as well as billing for higher cost visits when they have been paid those previously. Of course, we cannot determine right away if a service billed is not fraudulent but we do periodic audits and that can weed out those issues.

    This is my life for 37.5 hours a week for the past 4 years. I know of what I speak of.
    Well then you should know that 8-10 cents on every dollar is spent on something other than healthcare. ADDING to healthcare costs. People can do all those same things you just said you guys pay people to do on their own if they didn't have insurance.

  8. #68
    Prolific Poster Danifo's Avatar
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    I am thankful for my insurance. My hospital stay for a week and dd2s NICU stay was billed at over $300,000.

    I wouldn't want to be without it.
    DD1 July 2008 (41w3d)
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    Posting Addict Spacers's Avatar
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    Quote Originally Posted by GloriaInTX View Post
    One of the local urgent care clinics here charge $12 for school physicals if you pay for it without going through insurance. It must be cost effective or they wouldn't do it.
    It's called a loss leader; it's the same concept as the $0.29 box of mac & cheese at the grocery store. You go there for the cheap thing, and either get more stuff while you're there, that covers the loss on the mac & cheese, or in the case of the urgent care center, you remember them & go there when you need a doctor but not the ER but can't really wait for an appointment on Monday. And that's when they'll make up the money they lost on the school physical.
    70% of the U.S. population now lives in a state where same-sex marriage is legal. At 36 and counting!

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    Quote Originally Posted by Sapphire Sunsets View Post
    Yes, with emphasis on help. I know that. We were in that situation. We paided out over $800.00 a month and they helped by paying a little over $400.00 a month. I'm not complaining, that health insurance was amazing, but when you go from 2 fulltime incomes to 1 fulltime income where all the money is going towards health insurance it kinda sucks.


    $1000.00 is alot of money to people who are trying to budget or are counting on some sort of refund.
    I'm a little confused by this. If you are paying $800/month for insurance, that's $9600/year. The penalty is $1000/year?

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