Friday, September 10, 2010

Some physicians can get deep discounts for self-pay

I overheard a conversation today in a doctor’s office that brings up another subtle point about health insurance. This was after one of those mandatory all-night fasts before a blood drawing.  (Yes, they make everybody do this on Medicare.)

Some doctors have discount arrangements with certain labs. If an insurance company rejects a claim or part of a claim, sometimes doctors can get discounted prices anyway if the patient self-pays immediately and doesn’t go through insurance.

Of course, this sounds like the reverse of normal health insurance practice. In most cases, large health insurance companies have contracts with major labs and hospitals and get discounted prices up front. That means that a copay is based on a deeply discounted price to start. That’s a major way in which the uninsured get soaked, and I’m not sure that Obamacare has really addressed this.

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