#82 | POSTED BY RCADE
#85 | POSTED BY ROADRUNNER22
I used to manage the billing for a dermatologist in NJ. The charge vs payment by the insurance is anywhere from 50 - 70% less depending on the procedure based on what is called "usual and prevailing" rates. Which are state/national based averages of the charge for the same procedure by other docs. It's also referred to as the "accepted" rate. At least back in 1995 it was also considered a breach of contract with both Aetna and US Healthcare to bill anyone less than what was billed to the insurance. So the Doc couldn't charge an uninsured less than 90. Some docs would bill the full amount and accept less as payment in full, some wouldn't, all depended on the Doc.
Patient with insurance (in this case Aetna, US Healthecare, or Medicare)
office visit 90
insurance pay 40
Doc would get 45, and write off the other half.
Someone w/out insurance would be charged 90.00. Sometimes she would allow negotiation, most times not.
Worse for surgical procedures
insurance pay 60
With insurance 5 bucks out of pocket vs 200 w/out insurance.
That's just for a dermatologist.
For a hospital it's even more absurd.
Of course, it doesn't take into account the savings the the uninsured in premium payments of course, but health ins is a choice based on risk, some choose to, some don't. Some have the choice made for them because they can't afford it.