Those are some SERIOUS network discounts!

Wheetsin · 03-10-2006, 12:50 PM

Holy crap! My processed claim for my surgery just posted to my online insurance account. Check this out:

Quote:

Total charge = $29,076.25
Network discount = $27,402.25
Allowed amount = $1674.00
Paid by plan = 100%/$1674.00
Patient copay = $0.00
Patient responsibility = $0.00

So am I reading this right? If I had been self-pay, I would have been charged about $30,000. But my insurance company has such a significant discount that they only pay $1674?

MollyMolly · 03-10-2006, 11:13 PM

That sounds awfully fishy to me!

3loves · 03-11-2006, 12:03 AM

That is just unbelievable if that's true. :faint: I've never seen such large discount, but you never can tell about insurance companies. BTW, who is your ins co?

Read your signature and wondering if you've lost 32 lbs since the first of March? Regardless, that is awesome....good job!!!

Poodles · 03-12-2006, 11:17 PM

Contractual adjustments. Most are at least 50%, most are more. I was a Medicare biller for a while and for an $80,000.00 open heart surgery they would pay about $850.00, most of the time putting $780.00 to the patients deductible. Please be aware this was quite some time ago, but the numbers are still outrageous.

Also know that if you know you are going to need treatment you can ask the hospital to give you a discounted rate if you pay up front. They do that for deliveries a lot.

I did ask once why the insurance companies rec'd such discounts, yet we would bill others for the whole price. The manager muttered something about volume makes up for it. So 100 sick bcbs members = 1 self pay.

You would think that I pay over $6000.00 a year, they should cough up the $2000.00 for my surgery.