How do doctors get away with charging more for uninsured patients than for those who are insured?

Mar 18

This seems like a real rip-off. Doctors bill for outrageous fees, then accept significantly lower payments from insurance companies. I assume the doctors then get to write off the difference on their taxes. Uninsured patients get no such break, yet they are the least able to pay. I’ve read that uninsured patients should ask for a lower rate, but they often do not get it. Also, uninsured patients have to pay cash, while insurance companies can take months or years to pay off. How come nobody is protesting or doing anything about this scandal? I would appreciate any insights from folks who work in a doctor office and can explain how and why this situation exists. Thanks!! BTW, this is not a homework assignment, but a serious question.
I understand that insurance companies get better prices because they can negotiate prices and provide patients in “bulk,” but it still doesn’t seem fair. As for doctors tending to “forgive” bills for patients without insurance, forget about it! Meet Mr. collection agency. My advice to “cash” patients: Ask for a cash discount.

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Comments

cinnatigg

March 18th, 2010 at 3:24 AM

Actually, its the other way around. Especially if the patient is on a government insurance and the patient isn’t charged at all. Doctor’s rip off their patients insurance company. My company sends me a copy of what the dentist/doctor bills them for. I have seen where there was a bill for the same thing, more than once. When I was on Prenatal Medicaid, they billed the insurance for double the pain medication I was given, and also for treatments that I wasn’t. And once again, when I was younger, I needed a root canal. I was prepped for it, but the dentist had already billed the insurance as if he completed the procedure and for capping. Needless to say, I never even got the root canal. Uninsured patients don’t get charged that much, plus there is a strong concept that their bill will be forgiven and not have to be paid.
CHARITY G

March 18th, 2010 at 3:59 AM

Insurance companies make the Doctors sign a contract with pre-set pricing before they refer or authorize patients to use that office. The uninsured pay higher prices because they are not organized in a bulk fashion. For instance, BCBS will send 1000 patients your way for a fixed billing amount, while treating one uninsured patient does not come with same guarantee. You must claim income before you can claim a loss so its a wash on your taxes.
tom5251972

March 18th, 2010 at 4:45 AM

maybe my experience is different than most. when i got ins from work the level of quality and attention from my family dr went down. the same was true of my dentist who suddonly wanted me to come in repetedly for consultations even though he had been my dentist for years and knew what was going on.
TG

March 18th, 2010 at 5:33 AM

Insurance companies increase their profits by aggressively negotiating lower prices from doctors and other medical professionals. Few doctors these days practice on their own. Most are part of large medical groups, which have the advantages of being able to share some costs, but which leave business decisions such as negotiating with insurance companies up to corporate managers. Large medical practices are usually very dependent on insurance companies, and managers will often accept these deals, instructing doctors to make up the difference by seeing more patients, shortening the time spent with each patient. Doctors see no reason to offer these discounted rates to other patients.

It’s not unlike the deals big chains such as Wal-Mart get from their suppliers. They can negotiate better deals because they provide so much business. The corner hardware store feels that it’s unfair that they have to pay more for the same merchandise, but it’s the nature of capitalism.

Viva la revolucion!

Uninsured RX