The reimbursement plight

April 17, 2007

A sympathetic lawyer writes after receiving his hospital bill:

…I feel like I’m stealing from this doctor and the surgical center….I’m an in-house lawyer, so I make decent money. And that’s probably why I feel so horrible about this situation. When I was in private practice, I never would have agreed to take such a low amount of money on that bill.

Medpundit comments on the reimbursement battle: “We are mice fighting against lions.”



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{ 1 comment }

1 Happyman April 17, 2007 at 7:40 pm

Patients should learn to pay closer attention to their EOBs (”explanation of benefits” statement) they get after seeing a doctor.

Even if they feel their doctor is overcharging (which doesn’t make sense, since what is charged is totally irrelevant to what is actually paid), they should do this simple math:

1) add up total of premiums that come from their paycheck & kicked in by their employer over a year.

2) subtract from this all that was actually PAID out by their insurer (not including copays & deductible which patient had to pay in addition to premiums).

that simple equation gives one the profit to e.g. UnitedHealth for just that one person during that year.

multiply that by the 220 million or so folks with health insurance in the US, and you come up with why insurance execs are raking in the cash while hospitals are closing.

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