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Valued Social Butterfly
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Re: Health Insurer Sending Large checks to Patients

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   What if the patient doesn't pay the bill?    

    Second, there is an assumption here that the patient chose to go out of network which is not always the case.  

 

   It is amusing to read stories about healthcare and all of its problems and then watch those same individuals turn and go ballistic when they reject the easiest and least costly model.   

PRO-LIFE is Affordable Healthcare for ALL .
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Valued Social Butterfly
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Re: Health Insurer Sending Large checks to Patients

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Message 2 of 8

This sort of nonsense will vanish with Single Payer. The Insurance Company will have only one payment schedule, the provider will have only one set of prices, and both will agree.

 

No more "formularies" no more "Charge Master", and no more sticking the patient for any disputed amounts.

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Treasured Social Butterfly
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Re: Health Insurer Sending Large checks to Patients

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@GailL1 wrote:

@Richva wrote:

@GailL1 wrote:

@Richva 

 

I find your comparison unrelated.

The only thing this has to do with the patient is because, in this case, the patient is the "middle man".  

 

In fact, if the patient is willing to go thru the horrors of collections by the provider , they could even deposit the money in an interest bearing account and make a few bucks - well, maybe enough to pay their share of the out of network cost.

 

i just find it amusing that this is happening between the out of network provider and the insurance company - with the patient as the middle man - the money holder.

 

Guess, we will have to wait to see how this law case goes 

 

 

 


Any time you are dealing with a private insurance company you are going to be screwed. 


How so in these situations ?  The insurers have paid their part of the bill - they just paid it to the patient rather than the provider since the providers are out of network.  The insurer has no allegiance to these providers - the patient picked them, they are out of network - now, it seems to me that it is between the patient and the out of network provider to work it all out between them.

 

Since the patient is holding the majority of the money, seems to me this has put them in an EXCELLENT bargaining position for whatever cost they are to pay out of pocket.

 

Time for these patients to start thinking on their feet and taking full advantage of the situation.


Provided they have the insurance in the first place.  

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Valued Social Butterfly
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Re: Health Insurer Sending Large checks to Patients

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Message 4 of 8

@Richva wrote:

@GailL1 wrote:

@Richva 

 

I find your comparison unrelated.

The only thing this has to do with the patient is because, in this case, the patient is the "middle man".  

 

In fact, if the patient is willing to go thru the horrors of collections by the provider , they could even deposit the money in an interest bearing account and make a few bucks - well, maybe enough to pay their share of the out of network cost.

 

i just find it amusing that this is happening between the out of network provider and the insurance company - with the patient as the middle man - the money holder.

 

Guess, we will have to wait to see how this law case goes 

 

 

 


Any time you are dealing with a private insurance company you are going to be screwed. 


How so in these situations ?  The insurers have paid their part of the bill - they just paid it to the patient rather than the provider since the providers are out of network.  The insurer has no allegiance to these providers - the patient picked them, they are out of network - now, it seems to me that it is between the patient and the out of network provider to work it all out between them.

 

Since the patient is holding the majority of the money, seems to me this has put them in an EXCELLENT bargaining position for whatever cost they are to pay out of pocket.

 

Time for these patients to start thinking on their feet and taking full advantage of the situation.

* * * * It's Always Something . . . Roseanne Roseannadanna
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Re: Health Insurer Sending Large checks to Patients

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Message 5 of 8

@GailL1 wrote:

@Richva 

 

I find your comparison unrelated.

The only thing this has to do with the patient is because, in this case, the patient is the "middle man".  

 

In fact, if the patient is willing to go thru the horrors of collections by the provider , they could even deposit the money in an interest bearing account and make a few bucks - well, maybe enough to pay their share of the out of network cost.

 

i just find it amusing that this is happening between the out of network provider and the insurance company - with the patient as the middle man - the money holder.

 

Guess, we will have to wait to see how this law case goes 

 

 

 


Any time you are dealing with a private insurance company you are going to be screwed. 

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Valued Social Butterfly
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Re: Health Insurer Sending Large checks to Patients

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Message 6 of 8

@Richva 

 

I find your comparison unrelated.

The only thing this has to do with the patient is because, in this case, the patient is the "middle man".  

 

In fact, if the patient is willing to go thru the horrors of collections by the provider , they could even deposit the money in an interest bearing account and make a few bucks - well, maybe enough to pay their share of the out of network cost.

 

i just find it amusing that this is happening between the out of network provider and the insurance company - with the patient as the middle man - the money holder.

 

Guess, we will have to wait to see how this law case goes 

 

 

 

* * * * It's Always Something . . . Roseanne Roseannadanna
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Re: Health Insurer Sending Large checks to Patients

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Message 7 of 8

Well, let us remember the health insurers are the ones who refused to pay for heart surgery because the patient had the pre existing condition of acne.   They cancel policies when people are too sick and some companies have cancellation goals for their  employees. 

 

You can say all you want to about not trusting the government with health care but no other nation on earth has these problems with health insurance companies. 

 

https://www.justice.org/sites/default/files/file-uploads/InsuranceTactics.pdf

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Health Insurer Sending Large checks to Patients

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Message 8 of 8

Boy, this is really one for the books -

It is now at lawsuit stage - Happens like this:

A patient who is insured by Insurer A goes to see an out of network provider.

Their policy and insurer does cover some of of their out of network cost - but instead of sending it to the out of network provider, the insurer is paying the patient which in turn is suppose to be paying the out of network provider - sometimes they do and well, sometimes they don't.

 

According to the lawsuit brought by the out of network providers - they say this is a way that the insurers are using this heavy handiness to force the providers into their network (and accept a lower payment) 

Sounds good to me -

============================

https://www.cnn.com/2019/03/01/health/anthem-insurance-payments-patients-eprise/index.html

Critics say it's a revenge tactic against doctors, hospitals, treatment facilities and other medical providers that don't agree to insurance companies' demands to be "in-network," by making them chase down money. The insurance industry disputes any such characterization.

 

Regardless of who and what is to blame, Arthur Caplan, the director of medical ethics for New York University's School of Medicine, called the idea of insurers sending money to patients "insane."

( So What ! )

============================

The out of network provider provided them with the care - they could have refused and told them to see an IN-Network provider.

 

Can you image how some folks will see and take care of these BIG checks - the article mentioned one for $ 375,000, another for $ 240,000 and another for $ 130,000.  Because the patients receive these funds, they do become financially liable.  Some of them are really confused.

 

Are we just growing people more and more stupid ?  Can they even take care of themselves and their finances without either the government or somebody else doing it for them. 

Can't wait for the Courts decision here - what Big Brother are we gonna assign to clean up this mess ?

 

 

* * * * It's Always Something . . . Roseanne Roseannadanna
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