UPDATE: How does one "shop around" for medical ser

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UPDATE: How does one "shop around" for medical ser

Postby caseydog » Fri Apr 03, 2009 5:48 pm

Okay, My doctor sent me to a specialist, who wants an MRI done on me. So, his office sets up an appointment for the MRI, and they call me to confirm the appointment, and tell me to bring $2,800 with me for a "down payment". :shock: I have health insurance, but the MRI provider still wanted that much in advance.

So, being that we have a "free market" health care system here, I cancelled the appointment to look for a better deal.

So far, I'm getting the impression that "shopping" for a good deal on health care services is not something that is done in America -- or at least, in the North Dallas suburbs.

Has anyone done this before? How?

CD
Last edited by caseydog on Mon Apr 13, 2009 3:56 pm, edited 1 time in total.
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Postby DrCrash » Fri Apr 03, 2009 6:30 pm

If you have health insurance, and there wanting that much cash then it is a scam. A reputable provider will bill your insurance and then you. I made the mistake of paying upfront once. Never did get my money back after the insurance paid -choped it up to a life experiance but if this was me I'd go elsewhere.
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Postby Creamcracker » Fri Apr 03, 2009 8:34 pm

DrCrash wrote:If you have health insurance, and there wanting that much cash then it is a scam. A reputable provider will bill your insurance and then you. I made the mistake of paying upfront once. Never did get my money back after the insurance paid -choped it up to a life experiance but if this was me I'd go elsewhere.


Not if the reputable provider has dealt with that particular insurance company before and has had difficulty being paid for the work. It is after all the patient who has the responsibility to pay the bill not the insurance company...it is the patient who must see that the insurance company pays on his/her behalf and not expect the provider to have to "pester" the insurance company until the bill is paid.
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Postby Miriam C. » Fri Apr 03, 2009 9:21 pm

:thumbsup: Find a provider who accepts your insurance or call the insurance company and ask then who to work with......... :thumbsup:
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Postby Creamcracker » Fri Apr 03, 2009 9:28 pm

One other question.....how much is your deductible and does your policy routinely approve of MRI's? Have you called your insurance company to see what they will pay on an MRI?
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Postby caseydog » Fri Apr 03, 2009 10:01 pm

Creamcracker wrote:One other question.....how much is your deductible and does your policy routinely approve of MRI's? Have you called your insurance company to see what they will pay on an MRI?
Philip


From both of your posts, it appears you didn't bother to read my question. I really wasn't looking for someone to defend the actions of the MRI provider that I don't want to go to. I'm asking if anyone has shopped around for these kind of services, and whether they have had any luck with it.

BTW, if any provider does not want to do business with my insurance company, they don't have to. They can choose NOT to take my insurance. It is NOT my responsibility to make sure that their business decisions work out for them.

CD
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Postby caseydog » Fri Apr 03, 2009 10:05 pm

Miriam C. wrote::thumbsup: Find a provider who accepts your insurance or call the insurance company and ask then who to work with......... :thumbsup:


Actually, AuntieM, they do accept my insurance. They just wanted me to give them way too much up front. I'm not angry with them about that, I just want to TRY to use the free market to get a better deal, and I'm not getting anywhere. I'm hoping some folks out there have done this before, and can give me some tips.

If I wreck my car, I can go to several body shops and get competitive bids. This is proving difficult for an MRI. But, surely, somebody has done it, right?
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Postby caseydog » Fri Apr 03, 2009 10:11 pm

DrCrash wrote:If you have health insurance, and there wanting that much cash then it is a scam. A reputable provider will bill your insurance and then you. I made the mistake of paying upfront once. Never did get my money back after the insurance paid -choped it up to a life experiance but if this was me I'd go elsewhere.


I agree. I am a cancer survivor, so I learned the hard way how providers try to get some extra money out of patients by charging more than the insurance company allows. That's why I canceled my MRI appointment. And, yes, I know very well (also learned the hard way) that if you get overcharged, you will grow old waiting for a refund that you will never get.

In the past, I was able to put a minimal amount down -- a couple hundred bucks -- with providers, until my insurance company told me what I owed the provider. Then, I would pay that amount. This provider would not budge, so I walked.

I know how to negotiate with car dealers, realtors, plumbers and all sorts of other businesses, but medical providers have me stumped. :thinking:
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Postby Miriam C. » Fri Apr 03, 2009 10:21 pm

caseydog wrote:
Miriam C. wrote::thumbsup: Find a provider who accepts your insurance or call the insurance company and ask then who to work with......... :thumbsup:


Actually, AuntieM, they do accept my insurance. They just wanted me to give them way too much up front. I'm not angry with them about that, I just want to TRY to use the free market to get a better deal, and I'm not getting anywhere. I'm hoping some folks out there have done this before, and can give me some tips.

If I wreck my car, I can go to several body shops and get competitive bids. This is proving difficult for an MRI. But, surely, somebody has done it, right?


Most of us don't get a choice. We do ours at the Hospital we are assigned or pay 40%. Now you can probably call the area hospitals and speak to Patient Services to make a deal.

If our hospital wanted to much money from me I would call and negotiate. They have never turned me down. Only one time did they question it but were told we had a Flex Pay and that was the end of it. They billed and I payed
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Postby caseydog » Fri Apr 03, 2009 10:43 pm

Miriam C. wrote:
caseydog wrote:
Miriam C. wrote::thumbsup: Find a provider who accepts your insurance or call the insurance company and ask then who to work with......... :thumbsup:


Actually, AuntieM, they do accept my insurance. They just wanted me to give them way too much up front. I'm not angry with them about that, I just want to TRY to use the free market to get a better deal, and I'm not getting anywhere. I'm hoping some folks out there have done this before, and can give me some tips.

If I wreck my car, I can go to several body shops and get competitive bids. This is proving difficult for an MRI. But, surely, somebody has done it, right?


Most of us don't get a choice. We do ours at the Hospital we are assigned or pay 40%. Now you can probably call the area hospitals and speak to Patient Services to make a deal.

If our hospital wanted to much money from me I would call and negotiate. They have never turned me down. Only one time did they question it but were told we had a Flex Pay and that was the end of it. They billed and I payed


Mine is a PPO, so I can go to any provider that accepts Unicare. But, any provider that wants to be a Unicare provider has to accept Unicare's prices. Some providers try to get some extra profit by telling the patient what Unicare allows and charging the copay up front -- and they are always wrong. So, I try not to pay anything, or as little as possible, up front. I want to wait until Unicare tells me what I owe, not the provider.

The MRI provider I had the appointment with wouldn't budge. They wanted $2,800 up front, which I knew was too much.

So, now I am on a quest to find a better deal. I called a few places and asked if they took Unicare, and then for their best deal, and they seemed shocked that I was asking such a thing. It was a s if nobody had ever asked them to compete for customers.

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Postby Miriam C. » Fri Apr 03, 2009 10:48 pm

caseydog wrote:
Miriam C. wrote:
caseydog wrote:
Miriam C. wrote::thumbsup: Find a provider who accepts your insurance or call the insurance company and ask then who to work with......... :thumbsup:


Actually, AuntieM, they do accept my insurance. They just wanted me to give them way too much up front. I'm not angry with them about that, I just want to TRY to use the free market to get a better deal, and I'm not getting anywhere. I'm hoping some folks out there have done this before, and can give me some tips.

If I wreck my car, I can go to several body shops and get competitive bids. This is proving difficult for an MRI. But, surely, somebody has done it, right?


Most of us don't get a choice. We do ours at the Hospital we are assigned or pay 40%. Now you can probably call the area hospitals and speak to Patient Services to make a deal.

If our hospital wanted to much money from me I would call and negotiate. They have never turned me down. Only one time did they question it but were told we had a Flex Pay and that was the end of it. They billed and I payed


Mine is a PPO, so I can go to any provider that accepts Unicare. But, any provider that wants to be a Unicare provider has to accept Unicare's prices. Some providers try to get some extra profit by telling the patient what Unicare allows and charging the copay up front -- and they are always wrong. So, I try not to pay anything, or as little as possible, up front. I want to wait until Unicare tells me what I owe, not the provider.

The MRI provider I had the appointment with wouldn't budge. They wanted $2,800 up front, which I knew was too much.

So, now I am on a quest to find a better deal. I called a few places and asked if they took Unicare, and then for their best deal, and they seemed shocked that I was asking such a thing. It was a s if nobody had ever asked them to compete for customers.

CD


:twisted: 8) Times are a changing. 8) If I had the option I would shop. We did with Mikes eye surgery and came out ahead.
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Postby ATXKJ » Sat Apr 04, 2009 12:04 am

Our PPO insurance - has a list of the Proffered Providers - it's sorted by area - so you can check who's close - for an MRI - there are only a few options (although DFW area would have a lot more)
Then call and ask.
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Postby starleen2 » Sat Apr 04, 2009 12:56 am

I did some "shopping" when it came to my LASIK eye surgery. This was something that I was going to pay for and I did some price comparing and even asked about "warranty work" if that became necessary. I found an optometrist that quoted me a price for his services - I countered with another offer from another physician - He said that he would low ball the other guy just to get my business - And as it turned out i got a good deal, a good optimistist - and no longer have to wear glasses. I did have to go back after about a month to get and "adjustment on one eye - but there was no charge!. Go got it - is what I say! :thumbsup:
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Postby starleen2 » Sat Apr 04, 2009 1:05 am

Ooo - CD, we can have a good ole discussion on this - Some Dr's forget who the consumer is. I don't Have to wait for an hour to see a Dr - Nor do I have to put up with their BS - I make that very clear when I walk or call for an appointment - My time is just as valuable as theirs. Once I saw a sign in a dermatologist office that quoted that a $25.00 charge would be applied to patients accounts for missed appointments. I was kept waiting with no reason giver for almost an hour. My appoint with the Dr. was missed by the Dr! - did I get a $25.00 credit - h3ll no - all I got was belligerent attitude from the Dr. How Dare I question Him! - since then I have a new dermatologist who never keeps me waiting more than ten minutes - and its their policy to inform you if you do have a longer wait. - I say try another part of Dallas - Many Dr's are moving to north Dallas area due to the lucrative clientele.
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Postby S. Heisley » Sat Apr 04, 2009 7:25 am

CD:

Hospitals are nearly famous for getting the extra buck. I think I'd try finding out from Unicare which hospitals or X-ray places have agreed to accept Unicare insurance and then use the telephone to find out what the cost is at each place and how they charge their fees. An MRI can usually be done as outpatient care. That means you will be able to drive to facilities in nearby towns and cities. If driving a few extra miles means you can save a bunch of $, why not?! For instance, if you can find a mini-metropolis within a couple hours drive, they might have the needed equipment yet might charge less.

If you are able to think positive in this situation, you might even take the opportunity to combine the trip and have a mini-vacation. My reasoning is that life is short and we need to make the best of the circumstances we are given, regardless of what they are.

Wishing you the Best.
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