Monday, July 13, 2009

2498 Medical Bills, Freelance Writing

Monday, July 13, 2009

The real reason that we can't have the Ten Commandments in a Courthouse: You cannot post "Thou Shalt Not Steal," "Thou Shalt Not Commit Adultery" and "Thou Shall Not Lie" in a building full of lawyers, judges and politicians! It creates a hostile work environment.

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Back in the early '70s, when a customer had a problem with the mainframe operating system, we'd get a printed core dump, so we could examine control blocks and registers. The dumps usually also included the data that applications would have been processing at the time of the error, the text of reports, and so on.

One of the customers I was supporting** handled medical billing. I was shocked to discover from the data and reports in the dumps that what people were charged for identical procedures varied based on what insurance they had.

If a patient had insurance company A, they were charged $100 for procedure 123-4. Another patient with insurance company B was charged $150 for the same procedure. What was most shocking was that patients with Medicare were charged $250, and people with no insurance at all were charged $300!

The insurance companies paid out of premiums and investment proceeds (and still made a profit). Medicare paid out of taxes. Uninsured individuals paid out of pocket.

It all seemed very unfair to me.

So, in the past several months, what with the breast scare and various other tests and lab work, I've racked up some significant medical charges. The form I get from the billing entities shows
a) What the lab, hospital, or doctor charged,
b) The discount on that charge negotiated by my insurance company,
c) The amount actually paid by my insurance company, and
d) My copay.

Let's take the bone density scan for example. The hospital radiology department normally (I guess) bills $441.95 for the procedure. My insurance company has apparently negotiated a $250.01 discount on that procedure, so the insurance company and I are responsible for only $191.94. The insurance paid $153.55, and I had a copay of $38.39.

Someone without insurance is paying almost two and a half times what insurance and I paid.

That bothers me a whole lot.

The uninsured are subsidizing the insurance companies! The more a lab charges the uninsured, the higher the discount insurance companies can get. That feels so wrong.

[By the way, the reason the bill is broken out that way is because there was a class action suit about eight years ago against a very large well-known medical insurance company. Their clients had a 20% copay across the board. But the insurance company figured the copay on the amount before the discount (in fact few patients were aware there was a discount), so that in many cases, the patient paid closer to 40% rather than 20% of the actual final charges. The insurance company lost. The patients each got a few dollars from the multi-million dollar award. The lawyers raked in the rest. So now in bills it's usually very clear who's paying what.]

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I came across something called "SEO writing" the other day. It's writing short essays or descriptions for websites using terms and words specifically chosen so that search engines will find that site. I heard it pays $35-$100 per hour. Here's a link to a description.

Anyone know anything about it?

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**Later note: The customer doing medical billing that I mentioned above was not someone working out of their den. It was a subsidiary of a huge corporation in the St. Louis area, better known for building airplanes and space shuttles.
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1 comment:

~~Silk said...

Felix: Those are just billing companies. It has more to do with the arrangements between the insurance companies and the providers, "in network" and "out of network". "In network" means the insurance company has negotiated discounts with the provider. The billing companies would be aware of any such contracted discounts when they run the bills for the providers.