- 3,863
Not absurd at all for a BLUE. I am amazed around the country how much better negotiating power they have.
Lab & X-Rays (Best Insurer)
- Thread starter Consultant
- Start date
Not absurd at all for a BLUE. I am amazed around the country how much better negotiating power they have.
- 10,276
Almost TOO much power sometimes. They virtually shut down a lot of the health providers in this area for a few months a few years ago when they were negotiating a deal.
- 314
Excellent thread. I make sure that the customer is aware of and understands that x-ray and lab are usually their responsibility to pay toward deductible/co ins. The two major services that do lab work in CO are Quest Diagnostics and Lab One. They have merged but remain separate entities. A number of private labels now include a Lab One card that will reduce the lab costs down to about 1/3 of what they would be if using Quest Dia or some other lab co.
I have seen people complain that they don't want to go through the extra hassel of having to show the Lab One card and request that the blood work be sent there or that they don't want to go to a facility to have it done. That's fine, I let them know that they are not required to use it - just let the Doc send it out where ever they want and pay the normal price. They look shocked - people need to accept the fact that they are responsible for keeping their health care costs down. If it's too much of a hassel for them to take a financial interest in themselves, that's their problem not mine.
The other issue I have seen is when the client receives an EOB for lab work, it does not necessarily have a network discount applied. I think I read on this forum that 90% of all claims need to be resubmitted for billing issues. I am starting to believe that it is a normal ploy by the carriers to overbill, knowing that very few clients will request that the bill be resubmitted. Most people will just pay whatever the charges are and complain about it to the next person who doesn't know anything about it either. Misery loves company.
Like most of you, I always let them know to contact me and discuss anything they have questions about - I wonder how many people can call Ehealth and receive personal attention when they have questions.
I have confirmed with Aetna - that if a person receives service at an Urgent Care Center, the $50 co pay will cover all services rendered including X-rays. Lab work would be billed separate if sent out. One of the first things I teach clients to do is know where the nearest Urgent Care centers are - never go to an emergency room if you have a choice. The same services received at an emergency room could easily run a couple thousand bucks - applicable toward deductible. Much better to pay $50 and receive the same care. I'm not talking about heart attacks or strokes - just normal run of the mill things like broken bones, dog bites, cuts etc.
Anthem BC/BS is not much of a player here. I am appointed with them but have not placed anyone into any of their plans. I usually take people off of their plans. The Anthem plans are weaker than most others and charge 30 - 50% more. Easy money.
I have seen people complain that they don't want to go through the extra hassel of having to show the Lab One card and request that the blood work be sent there or that they don't want to go to a facility to have it done. That's fine, I let them know that they are not required to use it - just let the Doc send it out where ever they want and pay the normal price. They look shocked - people need to accept the fact that they are responsible for keeping their health care costs down. If it's too much of a hassel for them to take a financial interest in themselves, that's their problem not mine.
The other issue I have seen is when the client receives an EOB for lab work, it does not necessarily have a network discount applied. I think I read on this forum that 90% of all claims need to be resubmitted for billing issues. I am starting to believe that it is a normal ploy by the carriers to overbill, knowing that very few clients will request that the bill be resubmitted. Most people will just pay whatever the charges are and complain about it to the next person who doesn't know anything about it either. Misery loves company.
Like most of you, I always let them know to contact me and discuss anything they have questions about - I wonder how many people can call Ehealth and receive personal attention when they have questions.
I have confirmed with Aetna - that if a person receives service at an Urgent Care Center, the $50 co pay will cover all services rendered including X-rays. Lab work would be billed separate if sent out. One of the first things I teach clients to do is know where the nearest Urgent Care centers are - never go to an emergency room if you have a choice. The same services received at an emergency room could easily run a couple thousand bucks - applicable toward deductible. Much better to pay $50 and receive the same care. I'm not talking about heart attacks or strokes - just normal run of the mill things like broken bones, dog bites, cuts etc.
Anthem BC/BS is not much of a player here. I am appointed with them but have not placed anyone into any of their plans. I usually take people off of their plans. The Anthem plans are weaker than most others and charge 30 - 50% more. Easy money.
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Most people are very poor consumers of health care. The copay has made everyone brain dead.
I read something not too long ago about extending copays to clothing. The article speculated that if clothing were converted to copays it wouldn't take long before people forgot just how much a suit or shirt cost.
Give a $10 shirt and a $20 shirt. Throw in a $40 suit while you are at it. Bill my clothing carrier for the balance.
We live in a monthly payment, copay world.
While on the topic of labs, a buddy sent me this a few weeks back. Forgot about it until this thread.
Direct Labs, discount prices
SC Local LAH Agent
Expert
- 61
If a patient when he goes to a DR's office requests in his paperwork that any lab work sent out be sent to Direct Labs it will save them a ton.
Direct Labs, discount prices
I did it myself.
Direct Labs, discount prices
I did it myself.
I always do this but it doesn't keep the client from acting all surprised when they get their bills. Just had a client call me last week asking how come this wasn't covered? I tell them it was, if it paid down their deductible then it was a covered service.
- 795
Another vote for directlabs...
Ironically, I went into a Walmart the other day (first time in about 4 years, I hate shopping). They had doctors in the store. A doctor visit? $49. Physical Exam? $99.
They could do various tests (I don't read 'medical', outside of some routing things, couldn't tell how complete they got), all at very good rates.
I was thinking to myself, now, I've sold plans with $40 doctor visit copays, but here, you can just walk in, no insurance (or no office visit coverage) and pay $49 and get your cold/sniffle/flu checked and treated.
What a bargain. Chalk one up for Walmart.
My other alternative is to go to the medical clinic down the street. If I didn't have insurance, I'd have to put $300 cash down as a deposit, they send me back whatever they don't use, or a bill if it goes over this. I think walking in the front door is $150.
Hmm, take one away from traditional medicine. Of course, they do the labs right there, xrays, etc. Anything you need, one stop shop for medicine. With doctors visits covered (I'm on my wifes excellent group plan) I can still avoid Walmart, pay my $10, and get whatever I need done.
There are a lot of alternatives out there, depending on your neighborhood. Helping your clients shop is a great idea.
Dan
They could do various tests (I don't read 'medical', outside of some routing things, couldn't tell how complete they got), all at very good rates.
I was thinking to myself, now, I've sold plans with $40 doctor visit copays, but here, you can just walk in, no insurance (or no office visit coverage) and pay $49 and get your cold/sniffle/flu checked and treated.
What a bargain. Chalk one up for Walmart.
My other alternative is to go to the medical clinic down the street. If I didn't have insurance, I'd have to put $300 cash down as a deposit, they send me back whatever they don't use, or a bill if it goes over this. I think walking in the front door is $150.
Hmm, take one away from traditional medicine. Of course, they do the labs right there, xrays, etc. Anything you need, one stop shop for medicine. With doctors visits covered (I'm on my wifes excellent group plan) I can still avoid Walmart, pay my $10, and get whatever I need done.
There are a lot of alternatives out there, depending on your neighborhood. Helping your clients shop is a great idea.
Dan
Quite a few options, particularly with primary care.
Most consumers are lazy and/or misinformed about health care. They make foolish choices based on a copay mentality.
Odd thing is, many generics & older (less expensive) meds work just as well (sometimes better) than newer (more expensive) meds.
Also, you don't always need a pill. Many conditions such as cholesterol, HTN, diabetes, anxiety/depression can be treated/prevented with proper diet & exercise.
Yes, exercise can prevent/treat anxiety & depression.
Of course it is way easier to take a pill . . . especially when it only costs $30.
Keep your BMI under 27 or so, exercise (even if it is only a daily brisk walk), eat healthy. Lot's we can do to avoid pill dependence.
In addition to WM, many Rx stores have walk in mini-clinics. Most folks can take care of primary needs, including meds if needed, for a lot less than they are paying carriers to provide them a copay plan.
margostl
Super Genius
- 186
I have found that UHC has the best plan for Labs &Xrays along with MOST HMOS. There are a lot of Docs that write for test to cover themselves in this lawsuit happy world of ours. A sinus infection could indicate something more etc. Most clients need to be told they can have the Doc write the labs shop around for prices then have them drawn according to price. There soo many besides the big ones that offer discount prices
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