3rd
Health Care Reform
I was just wondering if somewhere in that monstrosity of a bill there was anything about requiring care providers to bill patients in a timely manner?
Have you ever gotten a bill from a provider like six months after the date of service and then they have the stones to put “Upon receipt” as the Due Date? The hospital and clinic here do this all the time. You don’t get a bill for months and months and then they practically call you a deadbeat the first time you’re hearing anything about it.
I’ve learned to keep an eye online to claims submitted to my insurance. I usually get an Explanation of Benefits for services long before I get a bill from the provider. We’ve gotten burned in the past because of what I believe is an intentional lag on the part of the provider. By the time you get your bill, you’ve gone in a half dozen more times, only to find out that this particular provider is considered “out of network” or that you’ve reached the annual limit for that particular service. Silly you for not knowing that a “unit” of service was a pathetic 15 minutes, meaning that you already burned through the 40 units (10 hours) of physical therapy allowed per calendar year and you’re responsible for the half a dozen hours at over $250/hour that you’ve received before you finally got anything that would have given you a heads up that you were going to get hosed. Hospitals deal with these insurance companies all the time, and yet they’d have us believe that they don’t know damn well what’s going to end up in the patient’s lap. It’s like making a deal with the devil. We’ve gotten to the point of seeking pre-authorization for services that don’t even technically need it, but then you also need to make sure you cover all your bases; is this in-network?, is there a limit of number of visits per year?, etc. If you don’t ask, they won’t tell. They want to keep you as ignorant as possible so that you’ll slip up. The providers aren’t going to do anything to discourage you from racking up as many charges as possible, and the insurance company certainly doesn’t want you to understand your policy enough to fully utilize everything it has to offer.
That reminds me of another bullshit trend in insurance lately - separate deductibles for in network and out of network. It’s not enough anymore that they only pay 80% or so for out of network, but now I have another $3000 deductible to reach before they pay a nickel. This isn’t often an issue, but small practices providing more specialized services are much less likely to be in-network.
