Ep 51Never Pay Your First Medical Bill - Do This Instead...
Everything is more expensive in the hospital.
Everything is more expensive in the hospital.
Marshall Allen
Never Pay Your First Medical Bill - Do This Instead...
with Marshall Allen
It doesn't mean you never pay your bills. It means you never pay the bill until you've checked it to make sure that it's fair and it's accurately priced.
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Quotes
“If you have a $10,000 deductible, you're effectively uninsured unless you have just more than $10,000 in the bank.”
“Everything is more expensive in the hospital.”
“Your doctor probably doesn't even know it because the doctor is not engaged with how much things cost.”
“What happens if we wait?”
“In healthcare, you're not really the customer. You are a billing unit.”
“There's not a Mercedes level of these things and a Honda level of these things.”
“These numbers are made up to begin with.”
“Hospital financial assistance policies are one of the most underused tools in our arsenal to take care of these bills.”
“So don't assume that you don't qualify for financial assistance.”
“It flips the power structure in favor of the individual patient.”
“Sometimes we need to be the parent in this relationship.”
Takeaways
- 1 Marshall Allen spent more than 20 years as an investigative journalist, 17 of them covering healthcare, before writing Never Pay the First Bill.
- 2 The US spends about twice as much per person on healthcare as other developed countries and gets less for it. Hospital prices have risen fastest over the past 20 years.
- 3 Employer-sponsored insurance traces back to the 1700s (sailors), then railroads, then the WWII wage freeze. About 160 million Americans are on employer plans.
- 4 His mother caught, on a nursing-home bill, a drug given to his father without consent that worsened his dementia. The family then had to fight the bill for that visit until it was waived.
- 5 By some estimates about 25% of medical treatment is unnecessary. A friend told he needed spinal fusion fixed his pain with physical therapy, diet and easing his training, and has been pain-free for four years.
- 6 ER visits are coded level 1 to 5. Upcoding simple visits to level 5 (code 99285) is, in his view, the most common fraud on ER bills. Level 5 is for life-or-death cases.
- 7 The same colonoscopy at the same hospital might be $1,200 on Medicare, $2,500 on one commercial plan and $5,000 on another.
- 8 About 100 million Americans have medical debt, and about $1 trillion of $4 trillion in yearly health spending is waste.
- 9 Nonprofit hospitals must offer financial assistance, often up to about 300% of the poverty level. He has seen 90% forgiven for a family earning over $100,000 and a nearly $250,000 bill wiped out.
- 10 Small claims court works because defending a $1,300 case costs the hospital far more. One mom's ultrasound bill was waived as soon as she sued.
- 11 Debt buyers often pay about 5 cents on the dollar, so a large discount is realistic. Breaking a negotiated payment plan puts the full amount back.