IT'S TIME FOR UNIVERSAL HEALTH CARE

You said that your father's stuff was 10 years ago... That was well before the proliferation of computers into most medical facilities. Clerical errors were common.

See, this is my point... You'll criticize a system, having NO idea how it actually works or some of the actual problems in it... but then when someone tells you about them you refuse to believe them.

You're not interested in the truth. You're interested in blaming someone else.

maporsche wrote:

So, say my doctor says that I need a surgery and I get it. My insurance company then decides not to pay for it and I'm stuck with a 50,000 bill. What you're saying that I should do to solve this problem is find another insurance company who doesn't screw over their customers......but what do I do about this $50,000 bill? Hire a $10,000 lawyer to go up against the $500,000 lawyers that the insurance company has? Spend 10 years in court after losing my house, car, etc?

You have several options. (1) You could elect to forego the surgery, and opt for another treatment the insurer will cover. (2) You could pay the $50,000.

You would be in precisely the same situation if we had a government managed "universal" system and the operation in question wasn't covered by that.

$50,000 is the price of 1 1/2 Honda Accords (including taxes); or an Infinity M; or one year's tuition at a major University. If my health was at stake I would value it over these alternatives.

USAFHokie80 wrote:

So you think they just add extraneous things to a bill, that aren't on the patient's chart ?

I see evidence of it each and every day when I review U.S. hospital invoices. When we prepare the requests to OHIP for reimbursement, claimants often tell us they didn't receive the service they were billed for. Sometimes it's frighteningly obvious - when it's treatment for an uninvolved area of the body.

There's a reason some insurers in the U.S. hire specialized billing review services. You can almost always cut 20+% off a carefully reviewed invoice submitted by a U.S. hospital. Some of the billing review services have agreements with hospitals where upper limits to specific treatments/supplies/services have been set. It's worth the 2 - 3% review payment to those agencies for any U.S. hospital treatment that involves more than an emergency room visit (and sometimes those are worth investigating as well).

You said that your father's stuff was 10 years ago... That was well before the proliferation of computers into most medical facilities. Clerical errors were common.

See, this is my point... You'll criticize a system, having NO idea how it actually works or some of the actual problems in it... but then when someone tells you about them you refuse to believe them.

You're not interested in the truth. You're interested in blaming someone else.

when someone tells you about them you refuse to believe them. You're not interested in the truth.

USAFHokie80 wrote:

By the way, the insurance companies and hospitals and the way billing is done is HEAVILY regulated by the government through various agencies... So if you're complaining about all these things now, what do you think will happen when the govt takes full control?

Show us which government regulations regulate hospital billings?

USAFHokie80 wrote:

So you think they just add extraneous things to a bill, that aren't on the patient's chart ?

I see evidence of it each and every day when I review U.S. hospital invoices. When we prepare the requests to OHIP for reimbursement, claimants often tell us they didn't receive the service they were billed for. Sometimes it's frighteningly obvious - when it's treatment for an uninvolved area of the body.

There's a reason some insurers in the U.S. hire specialized billing review services. You can almost always cut 20+% off a carefully reviewed invoice submitted by a U.S. hospital. Some of the billing review services have agreements with hospitals where upper limits to specific treatments/supplies/services have been set. It's worth the 2 - 3% review payment to those agencies for any U.S. hospital treatment that involves more than an emergency room visit (and sometimes those are worth investigating as well).

USAFHokie80 wrote:

You said that your father's stuff was 10 years ago... That was well before the proliferation of computers into most medical facilities. Clerical errors were common.

See, this is my point... You'll criticize a system, having NO idea how it actually works or some of the actual problems in it... but then when someone tells you about them you refuse to believe them.

You're not interested in the truth. You're interested in blaming someone else.

It happened last week. It happened today.

I think

Quote:

when someone tells you about them you refuse to believe them. You're not interested in the truth.

is something that could be well said to you today, on this subject.

I think that the hospitals and insurance companies both bill for each and every piece of work they think they can actually get away with - whether it is legitimate or not.

All of which illustrates the enormous non-productive cost that is required to compensate for the adverse effects of disconnecting providers and consumers from the market and economic forces governing their transactions.

This clearly gives the lie to those who claim that government operated programs will be necessarily cheaper and more efficient.

cicerone imposter wrote:

USAFHokie80 wrote:

By the way, the insurance companies and hospitals and the way billing is done is HEAVILY regulated by the government through various agencies... So if you're complaining about all these things now, what do you think will happen when the govt takes full control?

Show us which government regulations regulate hospital billings?

You made the claim; now prove it. But it's understandable that you also fail to understand the basics of logic.

Cycloptichorn wrote:

I think that the hospitals and insurance companies both bill for each and every piece of work they think they can actually get away with - whether it is legitimate or not.

I'm curious what work the insurance company bills the patient for.

I've worked in and around different types of insurance for over 25 years now. Canadian companies, U.S. companies, European companies.

I've never seen an insurance company bill a patient for any work in those years.

USAFHokie80 wrote:

cicerone imposter wrote:

USAFHokie80 wrote:

By the way, the insurance companies and hospitals and the way billing is done is HEAVILY regulated by the government through various agencies... So if you're complaining about all these things now, what do you think will happen when the govt takes full control?

Show us which government regulations regulate hospital billings?

You made the claim; now prove it. But it's understandable that you also fail to understand the basics of logic.

You can try to piss me off all you want, I don't care. You made it clear earlier that you have no interest in the reality of these things. So I don't really care if you believe me or not. Go ask your wife.

Cycloptichorn wrote:

I think that the hospitals and insurance companies both bill for each and every piece of work they think they can actually get away with - whether it is legitimate or not.

I'm curious what work the insurance company bills the patient for.

I've worked in and around different types of insurance for over 25 years now. Canadian companies, U.S. companies, European companies.

I've never seen an insurance company bill a patient for any work in those years.

ehBeth wrote:

Cycloptichorn wrote:

I think that the hospitals and insurance companies both bill for each and every piece of work they think they can actually get away with - whether it is legitimate or not.

I'm curious what work the insurance company bills the patient for.

I've worked in and around different types of insurance for over 25 years now. Canadian companies, U.S. companies, European companies.

I've never seen an insurance company bill a patient for any work in those years.

See, that's my point. They don't understand how these things work. So they're making up their own ideas and then criticizing the industry for what they *think* happens.

USAFHokie80 wrote:

ehBeth wrote:

Cycloptichorn wrote:

I think that the hospitals and insurance companies both bill for each and every piece of work they think they can actually get away with - whether it is legitimate or not.

I'm curious what work the insurance company bills the patient for.

I've worked in and around different types of insurance for over 25 years now. Canadian companies, U.S. companies, European companies.

I've never seen an insurance company bill a patient for any work in those years.

See, that's my point. They don't understand how these things work. So they're making up their own ideas and then criticizing the industry for what they *think* happens.

You haven't given any actual evidence that you do, in fact, understand how these things work. So I would contend that your 'point' is not a valid one.

Cycloptichorn

icd-9 is the Classification of Diseases used to code and classify mortality data. What has this got to do with Cyclo's case?

There are two related classifications of diseases with similar titles, and a third classification on functioning and disability. The International Classification of Diseases (ICD) is the classification used to code and classify mortality data from death certificates. The International Classification of Diseases, Clinical Modification (ICD-9-CM) is used to code and classify morbidity data from the inpatient and outpatient records, physician offices, and most National Center for Health Statistics (NCHS) surveys.