Progressive Media Resources Group

upaloopa

(11,417 posts)

4. I was a controller of a medical clinc

Sat May 17, 2014, 01:31 PM

May 2014

Each year insurance companies would contract with us. They had a reimbursement rate for every procedure. As does Medicare and Medicaid.
If we agreed with the reimbursement rate we would enter a contract. Once done the reimbursement amout is all we received for a procedure. We did not charge patient anything except a deductable.
If the reimbursement rate was too low then we would not contract with the insurance co. In that case we took the reimbursement paid and charged the patient the difference.
This is exactly like in the OP. It is not new and it is not the ACA doing this!

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"New Obamacare Loophole Shows Failure of For-Profit Health System: Critics".. [View all] truth2power May 2014 OP

I don't understand why an insurance company upaloopa May 2014 #1

Yes, right now a patient pays the deductible (or nothing) and the provider and the insurer work out djean111 May 2014 #2

It sounds like you have a sense of what's really involved here... truth2power May 2014 #5

The insurance companies WROTE the ACA Doctor_J May 2014 #8

I think there's some confusion here... truth2power May 2014 #3

I was a controller of a medical clinc upaloopa May 2014 #4

It will apply to the ACA... truth2power May 2014 #6

We billed a patient's insurance company upaloopa May 2014 #9

As I said, if the reimbursement rate was too low, yu took the money anyway... truth2power May 2014 #11

Medical pricing makes absolutely no sense at all IronLionZion May 2014 #10

I really thought that the the insurance companies would play fair once Heritage Care passed Doctor_J May 2014 #7