From: frissell@panix.com
Date: Fri, 31 Oct 1997 20:46:13 +0800
To: Dave Emery <tcmay@got.net>
Subject: Re: Protocols for Insurance to Maintain Privacy
In-Reply-To: <v03102809b07e63edadc1@[207.167.93.63]>
Message-ID: <3.0.2.32.19971031065319.03c39b24@panix.com>
MIME-Version: 1.0
Content-Type: text/plain



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At 08:11 PM 10/30/97 -0500, Dave Emery wrote:
>On Thu, Oct 30, 1997 at 09:33:52AM -0700, Tim May wrote:
>
>> Turns out that Blue Cross and Blue Shield have negotiated, through 
enormous
>> buying power, daily rates of about $700 a day. (These numbers come from my
>> memory of a "60 Minutes" report a few years ago. Details and current
>> figures may vary.)
>> 
>	My wife is a pathologist, and she tells me that some of the more
>aggressive HMOs get away with paying 15-20% of the posted "official" prices
>for procedures and tests.    The difference between what insurance
>organizations pay and the nominal price is usually 2 to 3 to 1 for most
>things these days.   And for many years Medicare has set defined prices
>for medical reimbursement that less than the gold plated bill amount
>as well.

The WSJ had an article about a guy who found out that his HMO had negotiated 
a payment rate which was less than his *copay* on the procedure so the 
insurance company paid nothing for his hospitalization at all.

DCF
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