Saturday, June 14, 2008

S-townMike as a Medical and Insurance Case Study for the Cavalcade of Capitalists

I was going through our medical bills this morning and I found $264 dollars that the Vanderbilt Medical Center charged me for a test that according to my doctor ended up being "not processed properly as ordered." No where on the bill is the $264 credited. There was also a $45 blood test that did yield results according to my MD. My insurance company credited the $309 bill $222.04 for "contractual discount," which friends in the medical profession tell me is a standard discount that insurance companies give to hospitals for supplies and service. And my MD tells me that I will need to do the test over again in the future.

Do you see the problem here? Not only is the hospital going to make a percentage of the $87.00 that they say I owe on a test that they screwed up, but the insurance company is going to count a percentage of the $222 they paid toward a total lump sum of expenses that they will use to calculate future costs to be passed along to consumers. Once I am charged a second time for the test, then both the medical and insurance entrepreneurs will be guilty of double-dipping for what will be only a single set of results. If the hospital labs screwed up the test, then the hospital should eat the loss and not pass them along to their consumers and the insurance company discount should not be paid on the charges.

But do you think that Vanderbilt Medical Center or the insurance company really care about questions of fairness when it comes to passing along future costs to consumers? I'm going to fight these overcharges for the sake of my own pocketbook, but what if this irresponsible billing occurs on a more widespread basis? Who's going to fight the societal costs of hospitals demanding payment for services not rendered?

1 comment:

  1. You have to fight this - not only for you and your pocketbook, but to work with the millions of others who are doing the same thing to try to clean it up. Most of the health insurance companies have a program for rewarding customers when they find things like this, so you might want to check your insurance co's website or give their customer service line a call. If your Doc didn't tell the ins co that the test was no good, due to faulty preparation, then they don't know and they don't know not to pay it. Now PLEASE don't think I'm sticking up for the Ins Co's - you'll never find me doing that - but I do the insurance billing for my hubby's chiropractic office, so I spend a lot of time with insurance companies both online and on the phone.

    Please do let them know what happened and talk to them about the charges.