Little did I realize that an Oklahoma-based operation is challenging the current healthcare paradigm.
By creating the Surgery Center of Oklahoma, Smith and Lantier have fought back not only at big hospitals, but also at big insurance. Smith says that “gigantic hospital bills” benefit both entities through what he called “claims repricing.” Say a hospital charges $100,000 for a procedure, but a health insurance company discounts that bill to $42,000. Smith explains that the insurance company can then say it saved the employer group $58,000 and charge a percentage for that savings. The hospital can write off the $58,000 it didn’t get.
“The hospitals use this fictitious loss to bolster their numbers when they apply to the federal government for reimbursement for uncompensated care,” Smith says. “You finally realize that the insurance companies are perversely inclined to seek out the most expensive hospitals they can find.”
That was another reason that the Surgery Center of Oklahoma put its prices online, not only to attract some self-funded businesses that would rather pay $4,000 for a procedure instead of $40,000, but also to “shine some light on what’s going on.”
See: http://www.surgerycenterok.com/
So let me get this straight, when I pay my 20% and the insurance pays 80%, I actually may be paying the whole amount and the insurance pays virtually nothing but continues to collect my premiums and makes me feel relieved that I have insurance and don’t mind those annual increases?
Our Heavenly Father continues to expose “unequal weights and measures”.