Surgeons at work

Inflated Medical Bills Mask True Cost of Healthcare in the U.S.

How can we get a real sense of the cost of healthcare in the U.S. when medical charges are so incredibly inflated?  These inflated charges mask the true cost of care.

And to make matters more confusing, the charges for a procedure for one patient can vary greatly depending on who is responsible for paying for that procedure.  Is the payor the patient? An insurance company? Medicare? Workers Compensation? Are the charges Out-of-Network?  Medical charges differ vastly depending on who the payor will be.

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blue tunnel

Chapman Consulting provides Fairness & Price Transparency in Hospital & Medical Charges

Chapman Consulting provides the data and expertise needed to bring fairness and price transparency in hospital and medical charges for our clients.  If you want to buy most anything in the U.S. it is relatively easy to shop, compare prices and make an informed decision to purchase based on several factors including price options.  But shopping is not so easy when it comes to hospital procedures and services.

However, we may begin to see more transparency emerge in hospital charges as consumers, consumer advocate groups, and the media continue to press for greater transparency from healthcare providers.

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Beware: Urgent Care Clinics May Charge Emergency Room Rates

Insist on knowing charges and billing practices before treatment at an Urgent Care Clinic.  Many patients are surprised when they are charged Emergency Room rates at these facilities.

The Urgent Care Association of America released a report in 2011 estimating there are 9000 urgent care clinics in the U.S. with 300 new centers opening each year.  Use of these clinics has gained in popularity due to many factors such as not requiring appointments, short wait times, open 7 days a week, offering a wide range of non-emergency non-life threatening services, and billed charges similar to a physician office visit.

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Decorative Scales of Justice in the Courtroom

Inflated Hospital Liens

Injured Patients Discover Hospitals Seeking a Piece of Their Accident Settlements

Lawyers state that liens often are much higher than what hospital would normally be paid for services.

By Mary Ann Roser

AMERICAN-STATESMAN

March 28, 2011

A hospital official admits that the hospital’s list price is a starting point for negotiations.  No one should be paying those over-inflated hospital list prices.  Hospitals have become more creative in determining the price of services and more aggressive in collecting their charges.  This has lead to inflated hospital liens.

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Healthcare Price

Time Article – Bitter Pill: Why Medical Bills Are Killing Us

Bitter Pill: Why Medical Bills Are Killing Us
By Steven Brill
Time Health & Family
February 20, 2013

Rarely do we see a health care related article cause such a stir. This well researched article written by Steven Brill is a must read. Colleagues sent us emails making sure we read it. Twitter, LinkedIn, and other social sites had thousands of reposts. And just after one week, many related articles and commentary have quickly been published based on Brill’s research and report. Of particular interest to all readers is the lack of transparency in hospital charges. But Brill’s research exposes the lack of relevance of the hospitals’ “Chargemaster”. Read more

Build hospital

Observation vs Inpatient: Maximizing Reimbursement for Hospital Stays

By Marc Chapman

The way work comp patients are classified as “observation” or “inpatient” can have an effect on the amount the hospital is reimbursed. We reviewed one claim that was classified and billed as an inpatient to a work comp carrier, where the patient was in the hospital a total of 4 hours.

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Health Care Costs

High-Deductible Plans Are a Growing Problem for Both Patients and Hospitals

The enrollment in high-deductible health insurance plans is becoming more and more commonplace as employers are searching for ways to curb their ever increasing spend on healthcare benefits for their employees.  Employees covered under high-deductible health plans find themselves spending more out of pocket on healthcare than ever before as more of the financial responsibility is shifted to them.

A recently released Kaiser survey reported that in 2006 only 4% of employees in employer sponsored health benefit plans were enrolled in high-deductible plans where today 20% are enrolled in these plans.  That is a significant increase.  The launch of the Affordable Care Act in 2014 is expected to further raise the number of enrollees in high-deductible plans.

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Insurance Bankruptcy Signs

Impending Issues with Increased Enrollment in High-Deductible Health Insurance Plans

Here is a concerning thought…As many Americans enroll for health insurance coverage under the Affordable Care Act (ACA), a large percentage may choose to enroll in the high-deductible health insurance plans associated with low monthly premiums offered through the exchanges.  What is going to happen when these patients receive bills from their hospitals and doctors that they cannot afford to pay?

While there has already been an uptick over the last decade in enrollment in high-deductible plans by insured Americans, many analysts foresee that the numbers will increase exponentially in 2014 and beyond with the enactment of the ACA.

The plans we reviewed on the exchanges for 2014 offered deductibles between $1000 and $6350.  Even with good intentions of choosing a plan that is affordable, a low income family could easily find it difficult to Read more