At the intersection of our failed healthcare system (20% of GDP compared to 4% in Singapore) and United Healthcare…. Quest tried to charge our family $102.95 for a test. The fair price for this service was $5.86, their “negotiated rate” with United Healthcare. United paid nothing so Quest sent us a paper bill for $5.86, out of which they will have to pay about 55 cents for postage alone (a discount from the 73 cents that peasants pay for stamps).
The beauty of this system is that nobody questions why it starts with a vendor attempting to charge 17.5X the fair price.
Loosely related, a friend in Maskachusetts recently registered on the Quest web site for a pre-employment drug test:
I’m wondering what the lab technicians do with this information. Is there a “Genderqueer” setting on a Roche blood testing machine? “Additional gender category or other” reagents?
I paid the Quest bill, described above, as part of an biannual desktop clearing process. I found another bill. It was an X-ray for which $36 had been charged. United Healthcare’s price is $10.92 of which they paid… $0. So there was a paper bill for $10.92. Plus a second reminder bill, also for $10.92. Even if they’d gotten $10.92 via ACH from United Healthcare I don’t see how that enables the X-ray folks to keep the machine plugged in and the tech paid.
Did you ask the UH why they had not paid even the puny $10 ? From sheer curiosity ?
Aetna at least provides an explanation (“EOB”) of why certain benefits were withheld. One can even dispute the denial and have them pay(personal experience).
Another bizarre example: a surgery to fix a broken vertebra: the surgeon charge for the actual job: $40K, Aetna pays him $17K. The hospital charge for a two night stay and an out-of-network anesthesiologist plus some supplies: $150K, Aetna pays $43K.
By biannual you mean twice a year I believe, not every two years. Reminds me of a Chomky’s interview:
https://youtu.be/fOIM1_xOSro