Quote:
Originally posted by bilmore
A contract for insurance isn't a promise of a blank check. It calls for a premium in exchange for a set of known benefits. Why would you not question your clinic as to the charge being too high, instead of questioning what you've explicitly contracted for from the insurer?
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This is probably far afield from your and Wonk's original discussion, but I'm still tempted to ask an Actual Question (arising from a parent's recent hospital trip):
Let's say that the insurer tells me that I can attend a given clinic (or hospital, or doctor, or whatever) and that for a given procedure I'm covered 100% (or my deductible is flat and already paid, etc.)
I go to the hospital, my bill comes, and I see that the hospital charged a zillion dollars, my insurer decided to pay only half a zillion dollars, and my amount to pay at the bottom is zero. WTF?
I'm sure part of this are contracts for services that the insurer negotiates with the applicable health provider about what the insurer will actually pay for procedure XYZ. Still, why are the numbers so out of whack, and why does the provided still choose to send those bills out if they're not at all related to what they actually get paid? Why, RT, why?
