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WHY Hospital Sleep Studies So Much More Expensive

'Facility Fees' Are Surprise Cost For Many Patients.

Called "provider-based billing," it allows hospitals that own physician practices and outpatient clinics that meet certain federal requirements to bill separately for the facility as well as for physician services. Because hospitals that bill Medicare beneficiaries this way must do so for all other patients, facility fees affect patients of all ages. Doctors' offices owned by physicians and freestanding clinics are not permitted to charge them.

NOW I know WHY our local hospitals are building outpatient clinics all over town and the area! NOW I know WHY my husband's family doctor's office calls went from $35 to $85 over night!

http://blog.cleveland.com/metro/2009/06/patients_fume_over_clevelan..." target="_blank">

http://www.kaiserhealthnews.org/Stories/2009/October/06/fees.aspx" target="_blank">

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Thanks for that info Judy.

Our local hospital is goobling up many private practices. They are also building satellite clinics in all the small towns around. Of course it is "suppose" to mean better care of the patient (us).

Years ago a wealthy lawyer (early 1900's) funded several projects in our town. One being our local hospital. In order for the town to get the hospital he wanted to see if the town would help support it through our local tax base. The issue was put before the voters and accepted. He wanted ALL residents to be able to receive care, regardless of the ability to pay. Guess what, our tax dollars still support the hospital. But in the name of "progress" of course, they only "stablize" one if they do not have the ability to pay their outlandish fees. Their costs are in-line with other for "profit" facilities. This I do not understand, since they are suppose to be non-profit. Yes, I understand they need to be self-supporting through their fees, that they need to "break even", but in my opinion when their charges are comparable to the "for profit" hospitals something is wrong. Oh by the way, there is no such thing as "free or reduced" medical care for those unable to pay -- you don't pay you are taken to court and sued.
Oh-oh, Judy, I feel a major rant coming on....

I am so tired of the government intervention that is designed to help certain members of society, but ends up hurting many others.

This insurance is a perfect example. The goverment says "Let's help the people on Medicare get more access to clinics, and keep them out of emergency rooms. In order to encourage providers, let's allow them to charge for their facility. BUT! We won't allow them to charge us only because we're willing pay. We'll only allow them to charge us if it's legitimate. How do we know it's legitimate? If it's a charge that EVERYONE has to pay, then it must be legitimate!"

Great idea, so far. However, what does that mean to everyone BUT Medicare patients? We now have another charge to pay, which we wouldn't have if the government hadn't stepped in to "help."

I used to do medical billing for doctors. How did they handle it when the insurance company said they'd only pay 80% of a particular service? They raised the cost by 25%! Now the procedure that used to cost $80.00 is priced at $100.00, so when the insurance company discounts it to 80%, the doctor still gets his $80.00. No problem. Except for the people that self-pay. Now THEY have to pay the $100.00!

There are tons of examples of this, where the government "helps" some, and the rest of us lose. Every wonder why the price of baby formula is so high? It's because the government is the largest purchaser of baby formula, through its many programs to help those that can't afford it. The formula companies know this, so they price it as high as the govnerment is willing to pay, and the rest of us-- those not on any government aid-- get to pay outrageous prices.

I have a whole list of other examples, but I'll stop now, before I start looking like someone whose CPAP is set to a pressure of 327...

Besides, I have to go supervise the harvest of my government-subsidised tobacco plants by underpaid and untaxed itinerant farm workers, and take a tour of the 3,000 acres of empty land that the government is paying me not to farm...

;)
Andy, Carol are you two self pay?
And here I thought the change from a flat $35 office call fee to billing office calls in "time increments" was a nasty trick the insurance companies taught the doctors. Ah, we are so naive about the graft and corruption and greed in this country.

Or at least we WERE until the house of cards fell last year.

If our government hadn't allowed all these takeovers and mergers and leveraged buyouts, etc. there wouldn't have been any companiies or banks "too large to let fail".
Were we not the ones that voted those people into office? I agree with everything that everyone is saying. I do not think that we can pass blame without accepting a part of it. We as Americans have set back and "Allowed these things to happen".
Yes, we vote these people into office -- but when was the last time that a "common" man ran for President and was able to get on the ticket? I mean a middle class citizen that has had to scrape by at some point and understand the day to day struggle of the middle class? Even at the local level, we have to have so many signatures and pay a fee to get your name on the ticket. I think the signatures is fine, but the fees can be pretty high and so excludes those that can't afford them. Our town is non-partisan in the name of progress.

No, I have insurance. BUT have brothers and children that do not have health care coverage. Their lack of health care is that premium costs can not be met and still allow them to pay their day to day living expenses. My son-in-law needs meds -- they are over $200.00 a month. They have 2 kids and unable to afford the medicine. He doesn't have insurance available through work. He has a pre-existing condition so insurance cost are higher.

I don't think Obama's plan is the "fix" this country needs. Health care costs do need to be contained though.
Well, at least we have an administration that is focused on doing something to help the health care situation in this country. I don't know enough about the current proposal that is being worked on to know whether or not I agree with some or all of it-- but I am happy that there is a national debate going on about this. It is way to big an issue not to be at the forefront of the domestic issues that we need to deal with.

Jan
I haven't seen ONE SINGLE offering or suggestion made by our government that actually has any real bearing on REDUCING health care costs. Not one single thing.

I begain seeing health care costs skyrocket w/the advent of HMOs. At that time we all had to pay our own doctor office calls regardless how good our insurance. So we went to the doctor WHEN WE NEEDED to an not before. If we developed a cold we just lived w/it, aspirin, fluids, rest, maybe OTC cough medicine, etc. We didn't go running to the doctor for it. Then came HMOs to our area. Wow! Neat, so many jumped onto the HMO band wagon so that they wouldn't have to pay the office calls. It didn't matter to them that they couldn't stay w/their own doctor. Heck, they didn't see him that often anyway. But those "free office calls" were so ... nice ... so they began going to the doctor for things they used to just work thru at home.

Then came Dental coverage. In just six months after the advent of dental coverage the price of a teeth cleaning tripled.

And, you know what? I had a large kennel of dogs at the time. I was our veterinarian more often than I saw our family doctor. All out of pocket, of course. W/in a year of the advent of HMOs in our area, the cost of a culture and sensitivity went went up from $17 to $51 for just the culture and no sensitivity. Now, if you've got a dog that is dying, who gives a rat's rear WHAT is killing it?? You want to know what will kill what is killing it and hopefully save their life!!!!

It seemed like the cost of drugs started skyrocketing very shortly after Congress passed that "orphan drug act" to encourage the pharmaceutical companies to develop drugs for rare diseases. Turot's Syndrome, I think, is the rare disease that was the spur for that legislation if I remember correctly.

Our secondary insurance has never paid for our office calls. Then we were put on Medicare. Now, the doctors, hospital, etc. KNOW that our secondary doesn't cover office calls - but - Medicare REQUIRES them to bill our secondary insurance, our secondary insurance then must notify the doctor's office AND us, denying payment as office calls are not a covered benefit and they are not paying. Where is THAT SAVING on health care costs?

All insurance payments, hospital and doctors charges, etc. are billed by ICD 9 and HCPCS codes, etc. so WHY isn't there just one form for every insurance and Medicare plan, instead of a different form for every different insurance?
So what is the fix? I have heard quite a few people lash out against Obama's Plan. What I have not heard are very many, if any, other solututions. It is tough to get a "common man' into office. Even tougher to get that same man to not sell off his morals one by one once in office. I believe that it can be done. A man that can sell himself to the people due to his morals, virtues, and community activities can and will be sold by the people. Finding that man, or woman, seems to be the toughest part of this conundrum. I am willing to back anyone that can prove themselves to me with my time and money.

sleepycarol said:
Yes, we vote these people into office -- but when was the last time that a "common" man ran for President and was able to get on the ticket? I mean a middle class citizen that has had to scrape by at some point and understand the day to day struggle of the middle class? Even at the local level, we have to have so many signatures and pay a fee to get your name on the ticket. I think the signatures is fine, but the fees can be pretty high and so excludes those that can't afford them. Our town is non-partisan in the name of progress.

No, I have insurance. BUT have brothers and children that do not have health care coverage. Their lack of health care is that premium costs can not be met and still allow them to pay their day to day living expenses. My son-in-law needs meds -- they are over $200.00 a month. They have 2 kids and unable to afford the medicine. He doesn't have insurance available through work. He has a pre-existing condition so insurance cost are higher.

I don't think Obama's plan is the "fix" this country needs. Health care costs do need to be contained though.
I too have a brother caught without insurance. He will be entering the Ironworkers Local #22 in January. Right now though he has a severe case of mono. We had to take him to the county hospital to get diagnosed. Now he is trying to figure out how to pay and they are giving him the run around. All he wants to do is set up a payment plan.

My father was forced to take a disability retirement due to an illness. He has spent the last 5 years fighting for his life. During this time because he had to pay for all of his insurance he was forced to work a part time job. Interferion and a job is not a good combination. Due to his retirement he is limited to making under $20k a year. Now that he is better he has to go back to work and finish out his time so that he may reap the full benefits of his retirement. Osha just offered him a $75k desk job and he had to turn it down to save his pension. Now that's BS! By the way he has been turned down for disability over 20 times.
Yep, its a screwed up world out there. Nothing is allowed to be simple and straight forward for long. What sane, honest, moral person has ANY desire to enter the world of politics?

I can't claim credit for the following: author unknown

Let me get this straight.

We're going to pass a health care plan
*written by a committee whose head says he doesn't understand it,
*passed by a Congress that hasn't read it, but exempts themselves from it,
*signed by a president that also hasn't read it, and who smokes,
*with funding administered by a treasury chief who didn't pay his taxes,
*overseen by a Surgeon General who is obese, and
*financed by a country that's already broke.

What could possibly go wrong?

Look on the bright side. We can expect really long delays before they euthanize us.
LMAO

Judy said:
Yep, its a screwed up world out there. Nothing is allowed to be simple and straight forward for long. What sane, honest, moral person has ANY desire to enter the world of politics?

I can't claim credit for the following: author unknown

Let me get this straight.

We're going to pass a health care plan
*written by a committee whose head says he doesn't understand it,
*passed by a Congress that hasn't read it, but exempts themselves from it,
*signed by a president that also hasn't read it, and who smokes,
*with funding administered by a treasury chief who didn't pay his taxes,
*overseen by a Surgeon General who is obese, and
*financed by a country that's already broke.

What could possibly go wrong?

Look on the bright side. We can expect really long delays before they euthanize us.

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