How might waste and fraud cause premiums to go up?

Hospital Billing Inconsistencies?

The difference between the Hospital’s Price and Negotiated fees that I have seen on EOB’s (Explanation of Benefits) have often looked ridiculous.  Here’s more information from another angle.

Billing Codes – Satire or how it really works?

Hospital Fair Pricing Act Low Income Uninsured Get Discounts!Insurance Fraud

Cut through Confusion and Not Pay more than necessary LA Times 4.2013

Excerpts from LA Times 5.28.2012

  • The cash discounts evolved over time after hospitals were criticized in recent years for charging the uninsured their highest rates and then hounding them at times with overzealous collection efforts.
  • Many hospitals and physicians offer steep discounts for cash-paying patients regardless of income. But there’s a catch: Typically you can get the lowest price only if you don’t use your health insurance.
  • It frustrates people because there’s no correlation between what things cost and what is charged
  • Health insurance still offers substantial value for consumers by providing preventive care at no cost and offering protection from major medical bills that could bankrupt most families

Resources & Links

Filed Hospital Rates – State of CA

true cost of health care.orgMassive Waste – The Atlantic.com  9.7.2012   Fraud

Spending likely to remain high.  LA Times 9.8.2012Fraud

ICD 10 Codes find a code.com dr chrono.com

icd9 data.com/

CPT (Current Procedural Terminology) Code/Value Search Medicare Billing Codes & Reimbursement

Medicare Billing Codes

Fraud FAQ’s 

Medicare Fraud

Our Main Page on Fraud

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