03-26-2017, 11:41 AM
(03-26-2017, 10:33 AM)oncemoreuntothejimbreech Wrote: The insurance company doesn't send you a bill. The insurance company sends you an explanation of benefits which says, "This is not a bill." It details what payments the insurance company made on your behalf IAW your policy. It also details what wasn't covered. Would you like to know why it says, "This is not a bill"? Because the provider is the one who rendered services, not the insurance company. Therefore, the provider sends you a bill charging you for the services they, not the insurance company, provided.
The bill the provider sends you details the charges, the insurance payment (which you can compare to the EOB sent from the insurance company), and the balance. The patient is responsible for the balance. Why? Because the patient must sign a statement of financial responsibility stating they are ultimately responsible for any charges the insurance company doesn't cover. If the patient refuses to sign the statement of financial responsibility then they aren't seen except in the case of an ER visit IAW EMTALA.
If the provider's charges are $20K, but a self pay patient is only responsible for $500 that equals a 97.5% discount. That's insurance fraud with any provider who participates with Medicare (which is virtually everybody) due to various anti inducement and kickback laws.
Your insults don't change any of that, either. But, they do make me laugh.
Rep.
A savings fund is a great idea to use for health care as long as you know for sure that you will not need any health care until you have a lot of money saved. But what happens if you get sick or injured before you get any money saved up?
