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Jesup, IA | From experience on the county hospital board, don't be too quick to let the insurance companies off the hook on the health care vs. ins cost debate.
What a rural community hospital charges for various services has everything to do with what an insurance company, or Medicare, will reimburse the hospital for providing the service. If a "Critical Access" (small community health care provider) gets generously reimbursed by Medicade for providing a service, then the insurance company will not be far behind.
Non, or lesser-reimbursed procedures get billed out at full freight. Maybe full freight plus 25% or more because that's about the only place you can go off the chart and look for more revenue.
Whether or not you can arrange a discount has everything to do with (1) if the hospital has much room left in its Community Care (charity) budget, (2) how much the community uses the Emergency Room for primary care, and (3) what your odds are of paying if insurance won't or isn't going to cover you charges.
I'm not saying I like any of this. But when rural hospitals need laboratories, MRI machines, etc, they have to figure out how to pay for it. And it is the most convuluded scheme I have ever encountered. To keep ahead of the curve, they must bill more than they know they will be reimbursed, accept the discount, endure the insurance company or Medicare try to cut the reimbursement rate, so they have almost guaranteed medical inflation so that they can get the same reimbursement as last year at the reduced rate.
Yeah, it's really like that. Take two aspirin and think about it in the morning. | |
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I have an in town job also and insurance is very high!
