Our office sends out bills sometimes to people whose insurance information we already have. It has to do with the software that sends out the bills; if it can't match up that the provider participates with the insurance (which is almost always true with a Medicare secondary, or smaller commercial insurances), the patient will get a bill. They call wondering why and we just say, oh, you can disregard that bill, we are submitting to your insurance. It's a wild system!

wow.

And, of course, that's not the only bill that will be submitted - you'll probably get doctor bills, too! When my grandfather was in the hospital, we got 4-5 different bills, at least!

Wow, that's genuinely shocking to me. The NHS has many faults but if I was in an accident all I'd have to pay for is any prescription meds that I needed after I left hospital, and those are only £7.85 per script.

The fun thing is that you get these bills and not only can't you tell if you have to pay it, if it's already been paid or will be paid but you don't even know who it's from. You get these bills from some random office that you never heard of and doesn't seem to have any connection to the hospital but somehow thinks you owe them money.

After six phone calls you finally figure out that it was the office name of the doctor's practice for the physician who filled in for ten minute while your doctor was in the john or something like that.

It's kind of a fiction, though. Insurance companies never pay that amount, and anyone who knows better doesn't either. You call the providers and negotiate a compromise of the amount.

Oh, yeah. No one actually pays those prices.

Except the people who don't know better (which is a lot of people). They do pay those prices, or, more realistically, they can't and it dings their credit, big time.

I should be used to seeing these costs by now, but they still give me a little jolt. Like Senyar, this would have cost me only any meds needed for after care. Even ambulance services here are free. Well, free in the same way that health care is - the money comes from levies). But what raised my eyebrows the most was the intensive care item - what happens to someone that they end up in intensive care but are discharged the same day?

Except the people who don't know better (which is a lot of people). They do pay those prices, or, more realistically, they can't and it dings their credit, big time.

^^^ this

Yeah, you're right TPS. I wish everyone knew they could call and get the amount lowered fairly easily.

Yeah, the US system sucks. We had insurance and I'm still making payments on my hubby's bills.

I'm actually going in for surgery on my back next Tuesday so I'll find out how good our insurance is. The last time we used it for my wife's ankle surgery we were charged zero so hopefully nothing's changed. I thank the $DEITY that my wife's company gives us such an incredible health insurance policy. Even with the new regulations, a lot of people are stuck with pretty crappy insurance.

Yeah, I did some shopping on the national exchange for my sister (in FL), and none of the policies I saw impressed me very much. Huge deductibles- $4-6k. When you compare the price of a plan like that to a more robust employer-sponsored plan, it's roughly equal taking how much is paid into account; the total premium for my family plan cost me (less) + my employer (more) $20k; my sister is certainly not paying that. $6k in medical bills probably wouldn't bankrupt her officially, but it would probably feel that way to someone making $20k a year. And I'm not 100% sure how robust the provider networks are going to be; a lot of plans are still negotiating the exchange contracts because everybody waited until the very last minute to get on the administration of this thing. In our office, we're finding a lot of them are paying very unfavorable rates because they want to keep the networks small.

What is crazy about the system of announcing ridiculous bills, then negotiating -- not to mention the effect of layering in insurance coverage percentages and deductibles -- is that there is no known price. Competitiveness is impossible when the true price is impossible to determine.

A LOT of USAian medical costs would be less if they got rid of the bureaucracy.

But then what would I do for a living? ;)

My insurer (BCBS) shows all the details on its website. For each claim I can see the medical provider's "list price", the discount negotiated by my insurer and then the amount paid by the insurer.

I had an awful time in 2010 when my husband had skin cancer surgery. He has BCBS, but the itemized bill we got from them didn't match the itemized bill we got from the clinic where he had the surgery... or the pathologist... or the dermatologist's office where he was first diagnosed. It was a mess.