I don’t read my replies

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Joined 3 years ago
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Cake day: July 6th, 2023

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  • Trump aside, this is good. Healthcare prices are intentionally obscure and inaccurate in the US.

    For any given procedure or equipment, the manufacturer/provider will have a price called the “billed amount”. This is a fictional number that serves as a negotiating position. The insurance company has an “allowable” which is what they’ve negotiated with providers to actually pay. Every year the insurance companies and medical providers negotiate on the actual price. So providers are incentivized to inflate their costs in hopes of getting a better deal.

    Usually, the difference between the billed and the allowable vanishes. But the patient may be on the hook, depending on circumstances. I know people with decades of experience in the industry who still get confused and struggle dealing with insurers.

    The moral of the story is that if you ever have to pay medical costs out of pocket, the first thing you should do is ask to reduce the prices from the fictional and inflated “billable” down to an “allowable” amount, usually using Medicare’s allowable as a standard.