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from the meanwhile-don't-get-sick-or-hurt dept.
The bipartisan plan to end surprise ER bills, explained:
The policy proposal, which you can read here, essentially bars out-of-network doctors from billing patients directly for their care. Instead, they would have to seek payment from the insurance plan. This would mean that in the cases above, the out-of-network doctors couldn't send those big bills to the patients, who'd be all set after paying their emergency room copays.
The doctors would instead have to work with patients' insurance, which would pay the greater of the following two amounts:
- The median in-network rate negotiated by health plans
- 125 percent of the average amount paid to similar providers in the same geographic area
The Senate proposal would also require out-of-network doctors and hospitals to tell patients that they are out of network once their condition has stabilized, and give them the opportunity to transfer to an in-network facility.
[...] it's pretty good policy too! That's the general feedback I got from Zack Cooper, an associate professor at Yale University, who, along with his colleague Fiona Scott Morton, has done a lot of pioneering research to uncover how frequently and where these surprise bills happen.
"It is fantastic that they're doing something, and that it's bipartisan," he says. "It's one of those areas where we can agree what is happening now is not good, and this gets us 80 percent of the way to fixing it."
[...] "My concern here is that in-network rates are already quite high, so we're cementing that into the system," he says. "The current world gives emergency physicians tremendous power in negotiating higher in-network rates."
See also: Emergency room visit costs: what's the price of care?
(Score: 2) by PartTimeZombie on Tuesday October 09 2018, @12:00AM (2 children)
If it's emergency healthcare how is anyone even talking about shopping around? How would you even do that?
Last year when Mrs. PartTimeZombie fell down the stairs and broke her ankle, do you think I phoned several hospitals for a quote?
What I did was phone an ambulance which took her to the hospital where she was treated. At no point did I worry about the stupid concept of "in network" or "co-pay".
After several months of care, including two operations I had paid about $100 for some extra physiotherapy and whatever parking at the hospital cost because I had already paid for everything else when I paid my taxes.
(Score: 0) by Anonymous Coward on Tuesday October 09 2018, @12:10AM
You would first do it to go in for a non-emergency. Eg, the optometrist, dentist, dermatologist, or whatever. Then realize that you should be figuring out what you want to happen in an emergency beforehand. Here is an example:
http://selfpaypatient.com/2014/01/03/insured-patients-can-save-money-by-pretending-to-be-uninsured/ [selfpaypatient.com]
And if you still want that feeling of insured safety, just get a really cheap, high deductible plan for true emergencies and/or a health savings account.
(Score: 0) by Anonymous Coward on Tuesday October 09 2018, @09:21PM
The way you could do that is to compare prices in aggregate before the emergency, and then use the ER that worked best for you in terms of price/location.
However, since no one will give prices, you are left with picking the closest one because they like to not give you actual choices.