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

[Nobody]

caseydog wrote

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.

And that Glen is the crux of the matter! We have been conditioned in this country (perhaps others too?) to accept the judgment/decisions of 'professionals' without question, especially in the medical field. Many (too many?) folks also never question charges made especially when insurance is 'taking care of it', & when a 'layman' asks for or demands an explanation or details, the provider is 'outraged' that anyone would question them. I don't have any better suggestion for you re 'shopping for a better price' than what you're doing with the phone calls. I wish you success & I'd like to know your results (not details, just general) as I may soon be in the same boat re dental work.

[Fenlason]

We have good insurance, that and maybe combined with the way things are here. I have never had to pay ahead for anything.

I shop for Doctors.. but not for price. My wife is in accounting.. and pays attention to what we are charged. Like if the hospital charged for a private room and I did not have one. She does not let it go, just because insurance is paying for it.

I am good with my Doctors.. but I don't put up with crap, I am an active participant in my health care. If I don't like a Doctor I move on. I wish it was easier to interview a Doctor. Generally you have to pay, for an appointment, in order to "interview" them.

I go to a Dentist that charges more, than many others in the area. He is the best Dentist I have ever gone to. To me [and my wife he is worth paying the extra we do] He is better at keeping up with the lastest.. as far knowledge, and as far as equipment.

There is always someone that will do something cheaper than someone else...and all to often you get what you pay for.

There is someone here that has set up his own "clinic" for doing colonoscopies. He is interested in the money. I would not go there.

I do think it is time that people take back control of the care of their health.

[Gaelen]

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 know how to negotiate with car dealers, realtors, plumbers and all sorts of other businesses, but medical providers have me stumped.

CD, medical providers and insurance are their own world--but if you can negotiate with other service providers, you can negotiate with the medical provider and insurance company. The only caveat for that is that I will not, do not negotiate with insurance (for me, it's usually been negotiating with insurance) about the costs for services from unique providers, i.e., the specialists who are the only and/or tops in their fields to whom I'm referred. Those services are typically not available here in CNY; I've got to go to NYC.

So my 'negotiating' style with my old insurer when arguments over bills came up was that this doc or surgeon was the best in his/her field, or the best place for me to get the planned treatment or surgery. Oh, and BTW, my prognosis without this treatment is terminal, so if they still wanted me to negotiate lowered fees with the people who were trying to save my life, they were welcome to bring it on--as soon as the docs involved were done saving my life. It took a few tantrums, but the insurers approved the procedures and paid the docs' and hospital's charges (for the most part.) Then I went to the hospital billing department and worked out an agreement with them for the balance. The hospital was a lot easier to negotiate with than the insurer--they reduced my balance to 10% of what was owed, I send them X amount every month, and if I live to pay it off, we'll all come out ahead. No whining, no tantrums, no screaming--just 'this is what I can pay per month' (from me) and the hospital saying, 'okay.' However, they're a comprehensive cancer treatment center, and I'm guessing they go through this process a lot.

My new insurer does all of the negotiating, and I've only had to go hand-to-hand with a couple of labs over mis-billed co-pays and lab charges. I refused to pay them, cited their agreement with my insurer chapter and verse, and won.

BTW, I also just got $2.2K in re-issued checks from insurer #1, the company (BCBS) which wanted me to get the doctor to lower his surgery fee. Turns out that at least some of the checks they said they'd reimbursed hadn't ever been cashed (hmm...do you suppose they were never *sent*?) So sometimes, someone even at the worst of companies realizes that they are incorrect. Sometimes.

If this isn't a life-or-death emergency (in which situation I do NOT waste time negotiating first--save me and we'll talk afterwards!) I agree with those who suggested that your best course is to:
-- find out who is on Unicare's list of MRI providers
-- call each provider
-- don't ask 'what are you going to charge.' Ask what their co-pay is for the MRI. Make it cleaer that you already KNOW what Unicare will reimburse for an MRI.
-- then tell them the minimum you're willing to pay up front (and be willing to go up 10% if you need to...)
And if the provider acts as if they've never had the conversation before, go in knowing that's simply not the case. Hospitals and imaging places and labs and doctor's offices have to negotiate with insurers every single day. They know the moves. What usually takes them by surprise is when YOU (i.e., the patient) know the moves, too.

BTW--CD, please don't be horrified, but I don't negotiate for a car, at least, not in the conventional back-and-forth dickering way. I do homework before going in about the cost of the vehicle(s) I want to buy, and about the worth of any vehicle I'm trading in. I know what I can afford (price, price + interest, and payment max per month that will fit my budget.) I tell the salesperson which vehicle(s) I'm interested in, present what I'm willing to pay to the salesperson. The *second* that person tries to leave the room to 'go talk to the manager about this' I let him/her know that I'm on a deadline (usually lunch break), and I've got somewhere else to be in X minutes (usually 15--I know how long it takes to set up a car deal.) I tell the salesperson that s/he's welcome to leave or phone to discuss the deal with a supervisor, but I'm going to be gone in X minutes, so if s/he wants the sale, s/he'd better come back with the final answer about the sale. And I do and have gotten up and walked out, making sure that everyone in the dealership knows exactly WHY I'm leaving. "Say what I mean, do what I say I'll do" and "I don't have time for you to waste" is my negotiating style.

In other words, I don't go into a car dealership looking to play lets-make-a-deal. I don't dicker. I've invested all the time I plan to waste up front doing research. I know what vehicle(s) I'm interested in, what a fair price is for each one, and what I can afford to spend. I don't go in looking to waste a salesperson's time trying to buy a tricked out Mustang for $10K, or test drive vehicles out of the price range I've already determined...and I won't tolerate my time being wasted by dealership games. I won't even discuss or look at vehicles or upsells that are out of my budget, and I tell the salesperson that, up front. The dealer wants to throw in an upsell as a no-charge freebie, fine--otherwise, don't waste my time and I won't waste yours. I will get up and walk away...even if I need the vehicle and even if it's right there on the lot. There are a bazillion sources of vehicles in my area; I've got options. I guess you'd call that self-centered dickering--work with what I offer, or I walk.

It's the same way with medical providers (unless something life-or-death is on the line; then I go with the first best choice and talk $$$ later.)

[Fenlason]

I have friends that are self employed, they raise perennial plants for wholesale, they had no insurance. [they now have something for a catastrophic policy] Rachel had to have emergency appendix surgery. It was after the fact, but they were able to negotiate a barter with the surgeon for a landscaping job.

[caseydog]

I have friends that are self employed, they raise perennial plants for wholesale, they had no insurance. [they now have something for a catastrophic policy] Rachel had to have emergency appendix surgery. It was after the fact, but they were able to negotiate a barter with the surgeon for a landscaping job.

I hope your friends really took time to understand their "catastrophic" policy and it's implications.

I bought into a plan that has a $3,000 annual deductible, and then the plan pays 75-percent of all my medical bills. That seemed pretty reasonable to me for all the years I was healthy. That was my "catastrophic" coverage.

Well, three years ago, I learned the hard way that 25-percent of the cost of cancer treatment is a whole lotta money.

This type of plan still offers a good value to the consumer, but the consumer needs to think about the "what if" scenarios before "what if" happens.

CD

[caseydog]

Thanks for the tips, Gealen.

BTW, when I am choosing an MD to perform surgery on me, price is NOT my first priority. But, an MRI is an MRI, in my opinion.

Time to start making phone calls.

CD

[Kurt (Indiana)]

CD, I had an MRI done a couple of years ago and don't remember any of the problems that you are having.

Do they have some "issues" with Unicare insurance. I'd discuss it with the insurance provider to see what can be done.

This sounds as if they want the money up front in case the insurance isn't willing to cover it.

Good luck.

[caseydog]

CD, I had an MRI done a couple of years ago and don't remember any of the problems that you are having.

Do they have some "issues" with Unicare insurance. I'd discuss it with the insurance provider to see what can be done.

This sounds as if they want the money up front in case the insurance isn't willing to cover it.

Good luck.

No, Unicare is a very reputable insurer. What I have encountered in the past is that a provider will try to get as large of a "down payment" as possible, and then bill the insurance company. Once the insurance company pays it's share, and send me a statement, I find out that I paid too much "down payment" to the provider, meaning the provider owes me a refund.

That's the real problem. It can take many months to get that refund -- if you ever get it.

In my case, Unicare negotiates the actual price that will be paid for the service. But, I won't know that price until after the provider submits the bill to Unicare. Unicare then sends me a statement telling me how much I owe the provider.

My goal is to pay nothing, or as little as possible until Unicare tells me what I owe. That way, I can't overpay the provider, and spend months fighting the provider for a refund.

[Fenlason]

I have friends that are self employed, they raise perennial plants for wholesale, they had no insurance. [they now have something for a catastrophic policy] Rachel had to have emergency appendix surgery. It was after the fact, but they were able to negotiate a barter with the surgeon for a landscaping job.

I hope your friends really took time to understand their "catastrophic" policy and it's implications.

I bought into a plan that has a $3,000 annual deductible, and then the plan pays 75-percent of all my medical bills. That seemed pretty reasonable to me for all the years I was healthy. That was my "catastrophic" coverage.

Well, three years ago, I learned the hard way that 25-percent of the cost of cancer treatment is a whole lotta money.

This type of plan still offers a good value to the consumer, but the consumer needs to think about the "what if" scenarios before "what if" happens.

CD

yes they are aware.. i think their deductible is more like 10,000.

what they have is better than their years of NO insurance.

In your situation, I would be looking around for other places for an MRI also.

[sledge]

Sounds like a scam to me, I would ask the Dr. who set it up, to hunt me someone else. . and NEVER sign anything unless your ready, They Can't make you sign.... LOL

[Elumia]

My wife's insurance doesn't pay for a mammogram. The usual cost is about $500. She relayed this info to one of the ladies at her Doctor's office. She said to ask for the "cash price" as if you had no insurance. Apparently they only charge those w/o insurance about $100.

It seems like with health care we are too accustomed to some one else footing the bill to really care about the cost. Imagine if you had a flat rate taken out of your pay for car repair insurance. So when your car broke down, you took it to the shop. Would you care how much it cost to fix it over your deductible or co-pay?

Mark

[caseydog]

My wife's insurance doesn't pay for a mammogram. The usual cost is about $500. She relayed this info to one of the ladies at her Doctor's office. She said to ask for the "cash price" as if you had no insurance. Apparently they only charge those w/o insurance about $100.

It seems like with health care we are too accustomed to some one else footing the bill to really care about the cost. Imagine if you had a flat rate taken out of your pay for car repair insurance. So when your car broke down, you took it to the shop. Would you care how much it cost to fix it over your deductible or co-pay?

Mark

That's odd, because I've heard just the opposite. When someone does NOT have insurance, providers quote a "full retail" price that is quite a bit higher than what insurance pays.

Maybe with a very common service, like a mammogram, there is competition for business.

CD

[Rem]

i sent you a pm just had 2 mri's in 3 months in dallas

[Miriam C.]

My wife's insurance doesn't pay for a mammogram. The usual cost is about $500. She relayed this info to one of the ladies at her Doctor's office. She said to ask for the "cash price" as if you had no insurance. Apparently they only charge those w/o insurance about $100.

It seems like with health care we are too accustomed to some one else footing the bill to really care about the cost. Imagine if you had a flat rate taken out of your pay for car repair insurance. So when your car broke down, you took it to the shop. Would you care how much it cost to fix it over your deductible or co-pay?

Mark

Thanks! I think I will ask before I get mine.

[S. Heisley]

Elumia wrote:

My wife's insurance doesn't pay for a mammogram. The usual cost is about $500. She relayed this info to one of the ladies at her Doctor's office. She said to ask for the "cash price" as if you had no insurance. Apparently they only charge those w/o insurance about $100.

I have a friend who can't get insurance. When she broke her leg, she did something similar and couldn't believe how much lower the price was for her than what was originally quoted. It seems as though those who have insurance help pay for those who can't get it or can't afford it.