Seeing the price range you pay is interesting, but I'm not sure what we are supposed to do with it.
My wife had her prenatal anatomy scan a few months ago at Stanford medical, $11000 for a 1 hour ultrasound. I personally was on the hook for around $500 and insurance paid $10500.
End of the day, what say do we have as consumers? How did the insurance company negotiate a rate of $11,000? Does the insurance company really care when every year they can just increase premiums and shrug and go "costs are going up! sorry!"
It feels a lot like a pyramid scheme, at some point the gravy train has to stop
healthcare insurance is the best example of a state-sponsored scam I've ever seen.. and it just continues unabated. I can guarantee that almost no one involved in that transaction actually knows what the per-unit cost for a 1 hour ultrasound actually is.. and when I say 'cost', I mean how it costs the hospital. Health insurers, hospitals, doctors are so awash in money they probably can't believe they're still getting away with it after all this time. Just look at all of the new hospitals and care facilities that are getting built. You don't do that if you're 'squeaking by'.. Hospital lobby is full of shit. You can probably trace all of this back to the HMO model where insurers began to add a lot of distance between the caregivers (i.e. doctors, hospitals, etc) and the patients. Like wall street did (with basically every financial instrument), they add layer upon layer to the cost chain, which adds an equivalent number of money-takers, to the value proposition. Insurance companies amortize the total cost across their subscriber base and 'poof', you've got our ever increasing health premiums. Just ridiculous and so obvious.. but since they're 'doctors' and 'care givers', we automatically just assume they're not motivated by profit and therefore beyond reproach...um, wrong.
The insurance most definitely did not pay $11,000 USD. They paid a percentage of an adjusted figure, and the balance was passed on to you. Billing and payment amounts usually differ by an order of magnitude.
Oh yea they paid it. Negotiation for rates happens before you pay coinsurance. I’ve called them and discussed it all. They send a $10000 check.
Odd part was in this case, we had a follow up ultrasound for another $2500 for a second hour after they “saw something odd” and it turned out to be nothing. Second hour had billing codes that were 75% less for some reason.
Wow, that's an absurd disbursement, even if the procedure might have been done out-of-network. Glad everything turned out okay. The administrator should have taken you out to celebrate. :)
Here in the UK we paid for a prenatal scan and NIPT a few years ago (this was in addition to free NHS scans at our local hospital), and IIRC it was £200!
My wife had her prenatal anatomy scan a few months ago at Stanford medical, $11000 for a 1 hour ultrasound. I personally was on the hook for around $500 and insurance paid $10500.
End of the day, what say do we have as consumers? How did the insurance company negotiate a rate of $11,000? Does the insurance company really care when every year they can just increase premiums and shrug and go "costs are going up! sorry!"
It feels a lot like a pyramid scheme, at some point the gravy train has to stop