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Re: [IP] Re: Apria's billing

    Your percentage is of what the insurance pays. Believe me, I have
already checked into all that. If you remember when I first joined the group
this was my biggest gripes. Health Cor, the company I had to get my pump
through tried to bill my insurance company $12,000.00 and this scared the
pudding out of me, at that time. I made more than just a few calls before it
was over, too. I finally got in touch with one lady with my insurance
company that knew what she was talking about, 90% of the people you talk to
on the phone don't know castor oil from wild honey, and she explained that
there is a set amount for each item like this and the Insurance companies
charge such high prices to "write off" some of their losses ????? I have yet
to find out. In reality my insurance company only paid like $4000.00 to
Health Cor for the $4500.00 dollar pump and I was supposed to pay 10% of
that. They finally sent me a bill in the past thirty days for, get this,
$117.00. Talk about the head not knowing what the tail is doing ??????
    Another thing I wanted to mention is that we are changing insurance
carriers next month and I think the transition is going to be real smooth.
The company my wife works for has been bought out (leased) by another
organization and as a matter of fact we may be trading up.

Take care,

Buddy '-)
- -----Original Message-----
From: email @ redacted <email @ redacted>
To: email @ redacted <email @ redacted>
Date: Sunday, November 30, 1997 11:14 PM
Subject: Re: [IP] Re: Apria's billing

>I know that the insurer does not pay the "billed" price, Gina, but if you
>have a percentage copay, or a cap to the dollar amount, that billed price,
>from what I can tell, is what they go by.  I have both.  I am not the only
>one.  I too, work in health care.  I believe that it is CRIMINAL and I hope
>illegal somewhere to "bill" one amount and actually get paid a different,
>secret amount.   Especially when capped amounts and copay percentages are
>calculated at the billed rate.  Let's think for a minute.  They billed
>$16,000 for a $4500 item.  Regardless of whether they collected that amount
>or not.  Insane.
>: )   Deep sigh on the part of the patient advocate.