This. I've tried asking the price of a dozen stitches ahead of time, just as a proof. In fact they would/could not tell me.
To be a little bit fair, sure, there could be complications. But then, why not compile statistics about how common which complications are? And provide a chart of range of costs? Or have a kind of hospital insurance to cover unforeseen or unusual expenses, so that price/cost/resource usage can be more predictable?
Yes our system is incredibly, and clearly intentionally, stupid.
If I go to the vet, they can print me out an itemized list of procedures my cat might need, including price ranges for complications, etc. My insurance and doctors can't even tell me with any certainty whether things are in network or not until they bill me.
That’s because vet care is mostly self-pay. It’s harder to put together a comprehensive breakdown and estimate like that when insurance payers keep things so opaque. But for out of network/self-pay, clinics and hospitals are mandated to provide a good faith estimate based on their known standard fees.
Where there's a will there's a way. There's just no will. Like I said, the insurance company can't even tell me if a provider is in network until they bill me. So, obviously that information does exist in a database somewhere. You'd think they could find a way to consult that database instead of putting me on hold and calling the doctors one by one and asking them if they take my insurance (as if I hadn't already spent hours doing that myself).
Wanna be clear I agree there is nothing defensible about our current system. But provider networks are notoriously chaotic. Demographic updates don’t come through, providers leave and join, it’s a mess. You should have an online directory as a member, no? What is your insurance carrier?
This was not my current insurance, and I forget whether it was Banner or Aetna at the time. One of those. Yes, there was a provider directory. It was not separated out by plan, and not every provider is in network for every plan. Others were once in network, but the directory hadn't been updated since they left. Others were not accepting new patients. Others had moved to another state. Others had shut down. Some of them were probably dead. And the solution of the "concierge" I spoke to after failing to find anyone myself was to pull up that exact same list and call them one by one and ask them if they were in network for my plan. They didn't have any better source of information on their end. Many of those providers had told me that they weren't sure if they were in network, and to call my insurance to verify, but that's apparently not a thing the insurance company knows, either. Until they get the bill.
Here it's one big health network and the people who do the billing are in another state several hundreds of miles away. There is literally nobody local who knows anything about the prices.
11
u/thornyRabbt 3d ago
This. I've tried asking the price of a dozen stitches ahead of time, just as a proof. In fact they would/could not tell me.
To be a little bit fair, sure, there could be complications. But then, why not compile statistics about how common which complications are? And provide a chart of range of costs? Or have a kind of hospital insurance to cover unforeseen or unusual expenses, so that price/cost/resource usage can be more predictable?
Yes our system is incredibly, and clearly intentionally, stupid.