Quote:
Originally posted by bilmore
I wonder if there might be a valid legal argument that, when you're carried into an E-room for E-care, and you truly can't drive to the "approved" facility, the charges, no matter how high (as long as they are the facility's usual charges) are per se "reasonable" and thus fully payable by your insurer.
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That may be in standard contracts. Hell if I know. And some indemnity policies don't have "approved" facilities -- you go where you go, and they pay what they pay, and you have to make up the difference. I'm not sure that even "participating" facilities in PPOs necessarily won't charge you more than what the insurer/plan deems reasonable and reimburses, but I could be wrong on that.
In any event, even for non-emergency care, if you read the actual articles, most of the facilities contacted weren't able/willing to provide cost estimates even after the fact, and prices negotiated with particular insurers/administrators are even more unlikely to be disclosed.
If one of the effects of HSAs etc. is to make prices for healthcare more transparent, I wonder whether prices for the insured will go up b/c the hospitals have a hard time justifying charging so much more to uninsured people (who, the hospitals note, often never pay b/c they go into bankruptcy, which brings us back to the bankruptcy issue . . .).
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