The exact method for determining the cost of medical treatment has become a perpetual problem and patients are continuously being surprised with exceedingly high hospital and medical bills. According to the article, “Many Face Huge Bills after Insurance Gets Quietly Cut,” written by Greg Smith, “more insurance companies are quietly switching the way they calculate the cost of medical procedures-which lowers how much they reimburse patients for out-of-network treatment.”
On average, your insurance provider will cover approximately seventy percent of what they determine to be “market rate” for a particular treatment. However, not all health care providers will agree that what your insurance companies claim as “market rate” is accurate and will charge significantly more. As a result, many individuals receive a devastatingly high medical or hospital bill.
For example, New York resident Jane Collen experienced this when her insurance company originally agreed to pay 70% of her son’s $47,485 dollar jaw surgery. However, a year later, she was threatened to be sued by her surgeon for a total of $42,820 dollars because her insurance company had not agreed to pay what it originally claimed as a result of them changing their method to determine “market rate” for medical treatment. Dr. Andrew Keinman, treasurer of the Medical Society of New York stated, “They’re (insurance companies) going to lower the reimbursement rate to the point where it’s unaffordable for most people to go out of network.”
It has been reported that hospital and medical bills contain significant errors approximately eighty percent of the time. Having your medical or hospital bill professionally audited is an optimal solution to ensuring your caregiver has not grossly inflated medical fees in addition to guaranteeing that you are not being billed for a procedure you did not receive, or being billed multiple times for the same treatment or medication. By comparing the costs of your medical procedures to other hospitals for the same procedure in the same region, we can successfully determine whether or not your medical or hospital bill has been outrageously overpriced. Contact Relamatrix Medical Bill Review, LLC for more information or for a free consultation regarding your high medical or hospital bill at (800)-653-7526.
Citation: Smith, Greg. New York Daily News. “What a Sick Trick: Many Face Huge Bills After Insurance gets Quietly Cut.” March 11, 2012.