Originally Posted by mommafank
I am very aware that physicians get low reimbursement from insurance companies.
I don't think any dr in the USA is going to bed hungry. Here is a basic primer on how billing for medical service works in the USA.
1. there are no set fees or charges for anything. the cost of a service is based on what ins you do or dont carry. If an ins pays 100% for a service, the charge is higher. If the ins pays a % the cost could be lower. I pay at 80% of the cost of any service my dentist charges for at 100% because I carry no ins and pay cash the day of service - 80% is what an 80/20 ins pays -(usually a good BC/BS plan)
2. all ins companys are only accepted by the provider of a service if the provider can make an acceptable deal with the ins co.(there is no rule that a provider has to accept any ins you carry) So, if a provider is giving you an MRI he sets up a base cost, say 1200$. One "deal" with one ins co may say, you can only bill for 800$, the rest is a write off(so 400$ of charge is thrown out and no one pays it). Your bill is now based on 800$ instead of 1200$, your ins coverage is 80/20. You may or may not have a copay, and the ins will pay for 80% of 800 and you owe the balance. Or, your plan might be a 70/30, or 50/50. I've seen plans where on a 1200$ MRI the ins company will only "allow" a 200$ charge (FYI - this is a great plan!) Usually gov't employess had - not have, some things change- these great plans (my MIL had BC/BS from the federal gov't- she worked for the IRS from the 60s forward - she never paid anything on bills)
3. if you have NO ins, YOU will be paying a 1200$ bill! You, who can least afford it will be charged the cost the highest stated base. If you can afford to pay cash always ask up front what all the charges for a service will be (if they state soemthing you dont want or need tell them you do you dont want that)and what kind of deal you can make for paying cash.
I drove my brother to an ER because he thought he was having a heart attack,( he had no ins - long story here, but they told him, after giving him 5 nitro tabs in 3 hrs he had high blood sugar but his heart was fine!!) He got the bill for 1500$ and I went to the billing office and said I d go to the bank and come back with cash if they wanted but I wanted a reduced rate and they took the bill went to the back and came back and said it would be 920$ cash.
so, when you can run a bill from 200 to 1200$ I stand by my staement that no dr in the USA is going to bed hungry- sharet