Over the last few months, CNN's senior medical correspondent Elizabeth Cohen has been doing a series of reports on abuses within the healthcare delivery system. One report dealt with the value of shopping around for healthcare services, showing how much money an individual can save just by asking questions and comparing services from different facilities. In her latest series she dealt with billing abuses. Some of the examples she gives in the video below are such things as $1,000 toothbrush:
Cohen reports that for every dollar we spend on healthcare, fifty cents is wasted. Think about that for a minute. In my last post I shared the need for consumers who are having to share more of the cost of healthcare to ask questions and shop around. There is one additional step the consumer needs to do, and that is review their bills. I know this can be mind numbing but the consumer is the only one who can verify if the charges listed were actually performed. As good as audit software is today, the ultimate audit professional is the consumer. In the past, once the consumer showed their insurance ID card and paid a small $10 copayment that was the only time the consumer had much interaction regarding payment. Rarely did they receive an itemized bill after the services were performed and even if they did, that was the insurance company’s problem.
Let’s use an analogy. If I need my car fixed, I go to a mechanic; one that’s in my PMN network (Preferred Mechanic Network). I walk in and say, my car doesn’t work and I need it fixed. I’m handed a clip board as I hand over my ID card, and I'm asked to fill out a few forms about what is wrong with my car. I fill out the questions on the slightly worn and greasy clipboard and hand it back to the mechanic who looks at it and takes a deep breath and sighs not saying anything. After a few awkward moments he picks up the phone and calls the number on the back of my ID card and discusses what he needs to do with my car. I can overhear him talk about such things as timing belts, struts, and other things I have no idea what he’s talking about. After he hangs up he says he was getting certification from the number listed on the back of my id card. He then says all I need to do is sign a few more forms and pay my $50 copay. As I’m pulling out my wallet to pay him I ask when the work will be completed, and he said it would be done sometime tomorrow. When I placed the two $20 bills and a new $10 bill on the counter I asked if I would need to pay anymore. His comment was, “No, I just file my claim with the PMN and everything is taken care of.” Wow, that sounds great! I don’t need to know about struts, timing belts, etc.; all I needed to do is show up, present an id card and pay this copay.
When I returned the next day to pick up my car I was greeted by the same mechanic and he shared that there were a few other items he identified that needed to be fixed but not to worry, he will just add this to the paperwork he would be filling. When I asked if I needed to pay any more for the additional services he said “No, your mechanics insurance program will take care of it.” Wow, they sure are nice to do that, and I didn’t even have to understand what struts, timing belts , etc meant or even cost to repair. With that he handed my keys and walked me to my car door and said thanks. As I got in my car I asked if there was a “bill or anything” (sounding as if I have had my car repaired many times and knew how this who process worked). “No,” he replied, “You’ll get something from the mechanics insurance program in a few weeks letting you know what they paid. As I drove off from the lot and waved goodbye to my friendly mechanic, I thought to myself, “wow, that was easy,” I didn’t have to know what struts or timing belts or whatever he was saying meant. I just knew my car worked and I was going home.
As I was driving home I noticed a sign in the window of the local NAPA Auto Parts store. In bold letters it said, “Today’s special: timing belts $2,000, struts only $800.” When I saw that I thought, “Wow, they call that a special?” Who would every buy those items at that price….wait a minute!!!!
The story above is fictitious. The $1,000 toothbrush story was not. Look at your bills.