I am a medical biller and have been working from last three years. We just worked on doctor account to get paid their provided service yo patients.
As per my mind, if health insurance does not exist, people of USA not able to get services directly from doctor because their rate are more than insurances or to high.
Which details the mechanics of the health insurance scam, and how the CrowdHealth model is different, aligning incentives and providing a super motor customer experiences. Part 2 is about how the crowdfunding model is so much less $, will post on Thursday or Friday
Keep up the great work - everyone needs to know what’s going on and what there options are
Not sure if anyone has mentioned this yet, but a similar thing is happening in California. They’ve passed a law (or laws?) allowing for cheaper rates for uninsured people. Which, in theory, I guess I understand….but still seems weird.
That's ridiculous. I went to the doctor in NZ yesterday and paid $72 NZD. I had a colonoscopy a couple of years ago, my private insurance paid it all and it was only $1200NZD. A friend who works in insurance said that the big worldwide insurers won't go into the USA because the practices are unethical plus the insurers will do anything not to pay out.
Oh, and for people who don't have medical insurance in NZ, operations etc. are free, but you do have to go on a long waiting list. The medical system in the US is appalling.
Comment on the additional billing from providers that weren’t in network-I got a $400 bill from the pathologist who examined a biopsy and he wasn’t in my network( who would ever think to check on who the pathologist was, let alone if he was in network)!! I was outraged and fought it and fought it all the way to the head of everyone and they finally wrote it off. No one who I asked for help along the way had any clue how to help me. I was stonewalled at every step. And to make matters worse I worked for the institution that performed the biopsy.
The worst part is feeling so helpless! What can we do? Who do we talk to? I’m with you about starting a revolution (and so is EVERYONE) but what is step one?
CrowdHealth is what I use - I can text or call them any time and they’re great. It’s a crowdfunding system. 12k members and growing fast. Here’s the link with a referral code attached https://www.joincrowdhealth.com/?referral_code=BIGWIN
My dentist actually TEXTED me that I owe them $400 from the last year. I found that unprofessional and irresponsible of them not to even let me know about it last year. WTF fuck.
May you resolve it all with an inner peace that feels good to you.
When you checked in at the MRI center, did they have you sign something giving them permission to bill your insurance? If they did not have your written permission to bill it, they did indeed committed a violation. Here is the website to report that with the OCR: https://www.hhs.gov/hipaa/filing-a-complaint/index.html
I just had surgery and the original bill was $141,000.00. I was like WTH - it wasn't brain surgery. And amazing - my part was just my individual out of pocket - $5000.00. But I offered to pay up front and it went down to $4000.00. It is all a scam.
Navigating healthcare/insurance is a nightmare. I'm curious which insurance company you're with? (Feel free to DM me if you don't want to say publicly.)
It’s unbelievable. I just on Friday had Walgreens try to charge me $180 “with insurance” for something I can get for $10 if I use GoodRX (a company that has no reason to exist.)
“And here I am, five months later, fighting with them because OF COURSE they submitted it to my insurance without my authorization (a blatant HIPPA violation) and they’ve changed the price I’m supposed to pay (bait & switch), and they say my account is past due and they’re going to send it to collections! Despicable!”
Lawyer up. I’m sure the provider has great lawyers but if you blatantly break the law those great lawyers tell you to settle fast.
Don’t let it go! I know it’s frustrating but at some point enough of us have to stand up and say “enough!” for anything to ever change. It’s highway robbery is what it is.
I’m in the middle of the same dance. It’s crazy frustrating. We used cash for years (medi-share program like your friends) and no problems, ever, even with several procedures, planned and unplanned.
(Now there is a subtle, and sometimes not-so-subtle, bias when paying cash from office staff and doctors; there truly can be a different level of care for those who are cash/no insurance.)
I went on high-deductible insurance plan with new job and suddenly the headaches dealing with insurance companies and billing started; it is unreal and so time consuming.
Just had a conversation with a friend who is a medical specialist and he said he spends his days battling insurance companies to get paid for his work and then his evenings battling his insurance company to get the actual coverage he pays for.
Can you bill them for your wasted time?
Thank you for that article.
I am a medical biller and have been working from last three years. We just worked on doctor account to get paid their provided service yo patients.
As per my mind, if health insurance does not exist, people of USA not able to get services directly from doctor because their rate are more than insurances or to high.
I just wanna add that point here
Thank you
Very timely post - I’m writing and sharing Solving Healthcare part 2 this week, a follow up to part one https://acceptable.substack.com/p/solving-healthcare-what-luigi-could
Which details the mechanics of the health insurance scam, and how the CrowdHealth model is different, aligning incentives and providing a super motor customer experiences. Part 2 is about how the crowdfunding model is so much less $, will post on Thursday or Friday
Keep up the great work - everyone needs to know what’s going on and what there options are
I’m looking forward to reading and restacking it!
This is SO fucked up. And infuriating.
My sentiments exactly!
Not sure if anyone has mentioned this yet, but a similar thing is happening in California. They’ve passed a law (or laws?) allowing for cheaper rates for uninsured people. Which, in theory, I guess I understand….but still seems weird.
Health insurance is being made obsolete by new models like CrowdHealth and the healthshares - just a matter of time
It should be criminal!
Why PENALIZE the people already supporting the industry?
That's ridiculous. I went to the doctor in NZ yesterday and paid $72 NZD. I had a colonoscopy a couple of years ago, my private insurance paid it all and it was only $1200NZD. A friend who works in insurance said that the big worldwide insurers won't go into the USA because the practices are unethical plus the insurers will do anything not to pay out.
Oh, and for people who don't have medical insurance in NZ, operations etc. are free, but you do have to go on a long waiting list. The medical system in the US is appalling.
It truly is.
The insurance companies make MEDICAL DECISIONS ON WHAT PROCEDURES WE CAN HAVE!!! As if they know better than surgeons!
So many issues.
What? I didn't know that. Disgusting.
This sounds like similar grounds to the class action suit that Walgreens agreed to pay a big settlement on:
“Yes, I do. I’m curious.”
She clacked on her keyboard for a minute then said, “If you paid cash it would be $161.80.”
“Wait a minute,” I said. “If I go through insurance, I have to pay $800, but if I skip insurance I only pay $162?”
Really? I haven’t to go read up on that!!
Comment on the additional billing from providers that weren’t in network-I got a $400 bill from the pathologist who examined a biopsy and he wasn’t in my network( who would ever think to check on who the pathologist was, let alone if he was in network)!! I was outraged and fought it and fought it all the way to the head of everyone and they finally wrote it off. No one who I asked for help along the way had any clue how to help me. I was stonewalled at every step. And to make matters worse I worked for the institution that performed the biopsy.
ABSURD!!!! What the actual hell!!?
The worst part is feeling so helpless! What can we do? Who do we talk to? I’m with you about starting a revolution (and so is EVERYONE) but what is step one?
CrowdHealth is what I use - I can text or call them any time and they’re great. It’s a crowdfunding system. 12k members and growing fast. Here’s the link with a referral code attached https://www.joincrowdhealth.com/?referral_code=BIGWIN
The medishare model is a good start.
I need to know more about this.
Wow, this is absolute horse shit.
My dentist actually TEXTED me that I owe them $400 from the last year. I found that unprofessional and irresponsible of them not to even let me know about it last year. WTF fuck.
May you resolve it all with an inner peace that feels good to you.
Thank you. 💕
When you checked in at the MRI center, did they have you sign something giving them permission to bill your insurance? If they did not have your written permission to bill it, they did indeed committed a violation. Here is the website to report that with the OCR: https://www.hhs.gov/hipaa/filing-a-complaint/index.html
Thank you!!!🙏🏻
One of those links people in the Chronic Illness community always has handy!
I just had surgery and the original bill was $141,000.00. I was like WTH - it wasn't brain surgery. And amazing - my part was just my individual out of pocket - $5000.00. But I offered to pay up front and it went down to $4000.00. It is all a scam.
All. A. Scam.
Navigating healthcare/insurance is a nightmare. I'm curious which insurance company you're with? (Feel free to DM me if you don't want to say publicly.)
It’s unbelievable. I just on Friday had Walgreens try to charge me $180 “with insurance” for something I can get for $10 if I use GoodRX (a company that has no reason to exist.)
“And here I am, five months later, fighting with them because OF COURSE they submitted it to my insurance without my authorization (a blatant HIPPA violation) and they’ve changed the price I’m supposed to pay (bait & switch), and they say my account is past due and they’re going to send it to collections! Despicable!”
Lawyer up. I’m sure the provider has great lawyers but if you blatantly break the law those great lawyers tell you to settle fast.
CrowdHealth solves this https://www.joincrowdhealth.com/?referral_code=BIGWIN
Don’t let it go! I know it’s frustrating but at some point enough of us have to stand up and say “enough!” for anything to ever change. It’s highway robbery is what it is.
12k+ of us have joined CrowdHealth, it’s way better
I’m in the middle of the same dance. It’s crazy frustrating. We used cash for years (medi-share program like your friends) and no problems, ever, even with several procedures, planned and unplanned.
(Now there is a subtle, and sometimes not-so-subtle, bias when paying cash from office staff and doctors; there truly can be a different level of care for those who are cash/no insurance.)
I went on high-deductible insurance plan with new job and suddenly the headaches dealing with insurance companies and billing started; it is unreal and so time consuming.
Just had a conversation with a friend who is a medical specialist and he said he spends his days battling insurance companies to get paid for his work and then his evenings battling his insurance company to get the actual coverage he pays for.
Ugh.