Who gets paid what: The ABC’s of health care pricing

Filed Under: Costs, Health plans, Patients

Who gets paid what: The ABC’s of health care pricing

Pricing is byzantine in the U.S. health care system. For any given procedure or item at any given hospital or clinic, there may be a dozen prices or more. Why? We have what’s called a third-party payer system — many bills are paid not by the patient (the recipient of the service or medication) but […]

A behind-the-scenes look at how contracts are made in health care

Filed Under: Costs, Health plans, Patients

A behind-the-scenes look at how contracts are made in health care

“An Open Letter to My Patients Who Have Insurance Coverage Through EMI” is the headline of the blog post, by Randy G. Delcore, M.D., medical director, Cedar Orthopaedic Surgery Specialty Clinic, on the  Cedar Orthopaedic Surgery Center web site, describing to patients the end of a contract with an insurer. The blog post ends with […]

Is it cheaper to pay cash than to use your insurance? Maybe.

Is it cheaper to pay cash than to use your insurance? Maybe.

(Updated, 2019) Are you paying more for health care because you have health insurance than a cash customer pays? It’s definitely happening for some people. Many of us are accustomed to thinking that we pay insurance premiums to get access to a lower cost for health care procedures — that being the “negotiated rate” or […]