30 Second Insurance Tips©

Tip 68- Let’s Make A Deal

I’m reviewing claims reports again. Here’s a dandy.

A hospital billed $129,807 for an episode of care. After insurer negotiated discounts, they were paid $77,884. Sounds pretty darn good except this was a “do over”; after infection set in, routine hernia surgery turned into a major ordeal.

Here’s another.

The line item on a hospital bill showed a charge of $28,138 for a surgeon that turned out to be only an assistant. The correct charge: $1,476. Interesting “mistake”!

I’ve read that about one third of all health care spending is for waste, fraud and abuse. We can
redirect that money to cover the under and un‐insured.

It’s called payment reform.

There. That took 30 Seconds. Not 2700 pages!