Several weeks ago Ron had surgery on his nose. Not a big deal, about an hour's worth. He didn't have a room, didn't get a meal and he had to hold his own suction hose while the nurse was texting her boyfriend. Ok, that last part didn't happen, but I wasn't there - what if it DID?
Anyway, we got the bill for the hospital yesterday. Over ELEVEN THOUSAND dollars. Ok, so that's ridiculously insane, but it's not what made smoke start coming out my ears and nose. It's the fact that a "contractual adjustment" lowered the bill by almost EIGHT THOUSAND dollars. What the hell is that all about? I just don't get it. HeLLO-O. Maybe that's why the insurance industry and health care system is so jacked up. To the person who can explain this to me (to my satisfaction - that's the fine print) I will supply an apple pie every week for the rest of my life.
Seriously. What's that all about?
3 comments:
i really like the your chrysalis imaging part on the side.
very clever.
good post too. i'm scared for my healthcare, because all the money is going to you guys!
haha, just joking.
love you.
"contractual adjustment"
Well, as you know I am a licensed health insurance agent and well-informed on this issue. Essentially, the health insurance provider (ie. Blue Cross, Coventry, Humana, etc.) has contracts with different doctors and hospitals in your region or "network". They want you to go to a doctor within this "network" because the health insurance organization has a "contractual agreement" to be charged a certain price for each procedure by the doctor/hospital. However, if the doctor/hospital is outside the "network" a supposedly fair/reasonable charge is assessed. This is actually designed to "encourage" people to get health insurance so they do not have to pay the "fair/reasonable" charge for the procedure, but only have to pay the "contractually adjusted" price.
I actually prefer cheesecake, but I'll take apple pie as well. At least I live in Merriam and the cost in gas for the delivery every week won't be that bad.
Tom
Well, Tom, you gave it a good shot. And I actually understood the definition of a contractual adjustment. What I still don't understand is how they can afford to write off so much - who benefits from that? If they can do the procedure for three grand why put an eleven thousand dollar value on it? I have the same beef with retailers who can sell their wares for 75% off and still make money. Why not just charge a bunch less and know that we consumers will buy one in every color because they're so darn cheap?
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