SOS: Speaking of Seniors - End Unfair Medical Billing

health_insuranceIsn’t it unfair that two people are billed at different rates for the very same medical services? I think so. But, that is the system that we have now.

Hospitals, doctors, laboratories, and dentists charge different amounts for the same services to different people. Government and insurance companies get big discounts from the “regular” charges. Why? It seems very unfair when you look at specific cases.

For example, one of our clients bought a dental insurance plan from a major insurance company. The plan had different time periods to be on the plan before the more expensive services were covered. She misread or misunderstood the plan’s coverage, or the staff of the dental office that she used misled her. She got dental services that were rated at different levels. The simpler services were covered by her dental insurance very well. But, for the more complex procedures, she should have waited another 90 days to get more coverage. The staff at the dentist’s office knew or should have known of these rules in dental insurance. The average person could miss the differences. I believe that the dentist’s staff should have checked with the insurance company and explained the details to the patient before the dental work was done. They did not.

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The dentist’s office charged our client’s insurance company a much lower rate for the services that were covered. But, then the dentist’s office increased the price for services that were not yet fully covered by the dental insurance. The dentist’s office actually ADDED MONEY OWED TO THE BILL AND THEN DEMANDED PAYMENT OF THE HIGHER AMOUNT. Why? The patient came to the dentist’s office because she was told that her insurance would be accepted. But, the dentist’s office did not give her the same discount rate for services that it gave her insurance company. Doesn’t that seem unfair and misleading on the part of the dentist toward the patient?

I can be even more specific. The dentist’s office used two separate formulas for computing the bill to our client from Griffith, Indiana. The dentist is billing our client about $1,000 more than what would have been billed to her if the insurance company “discounted” rates were used to bill the patient.

For services that the client’s insurance policy had matured to cover, the dentist used the lower “contracted” discount rate for billing. For anything that the insurance company did not pay because of lack of maturity of the policy, the dentist’s office reverted to the general higher amounts. I believe that it would be much more fair to charge a customer with insurance the rate that applies to the insurance company even if the policy had not yet matured or there were some other technicality that most customers would not understand or be able to distinguish. The dentist did not seek the lower “contracted” rate amount from the patient but reverted to the much higher charges that apply to a patient without insurance. How unfair is that to all patients with less than full dental insurance coverage?

Woodrow Wilcox

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Insurance companies, doctors, hospitals, and government use the multiple rate system in order to make people afraid of getting the healthcare that they need without conforming to the demands of government or insurance companies. Why not change the system so that everyone pays for services at the same rate and remove the fear and scare tactics?


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Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana. That is the largest senior citizen oriented insurance agency in the Midwest. For over six years, Woodrow Wilcox has helped senior citizens with medical bill problems with Medicare and VA clinics. He has saved senior citizens over $1 million in wrongful charges. For more health care articles by Wilcox, visit www.medicareproblems.net or www.woodrowwilcox.com. © 2013 Woodrow Wilcox. Re-published here with the permission of the author.
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