Hospital - Insurance Carrier Price Negotiations Explained

[@garyschreiber695]

An excellent series. Ive been practicing medicine for over 30 years. I knew that billed charges had no connection to reality but never knew how price negotiations worked.

[@ahealthcarez]

Super! Thank you for your feedback.

[@tuvale]

This was amazing. I just came out of an admission for pneumonia and also, my insurance is in negotiations with the facility I normally go to. Full circle! Very relevant info and opened my eyes.

[@ahealthcarez]

Thank you for watching. Hope you are doing better.

[@petergrimes9252]

Eric, thank you for the trip down memory lane. DRGs, per diems etc r terms from the 90s. Love the "landmine" references

[@ahealthcarez]

Thank you for watching and for your comment.

[@eliortegax]

i like the slide show presentations. i’m a healthcare management student and this channel has sparked my interest 10 fold, keep it up

[@ahealthcarez]

Thank you for watching!!

[@petergrimes9252]

Eli, we need you as the next generstion of health care leadership ! 🍎

[@sourcebest]

Dr.Bricker, great work! Can you make a video talking about insurance reimbursement on outpatient freestanding imaging? They might not charge $2000 for an MRI exam? What's the future for those walk-in clinics and op imaging center? Thank you!

[@ahealthcarez]

Thank you for watching and for your suggestion.

[@gardnmi]

Now that all the plans are publicly available for every provider, procedure, and payer due to that Transparency in Coverage mandate, do you see any major changes that will occur on how these plans will be negotiated?

[@ahealthcarez]

Likely will continue to be hidden, IMO. Thank you for watching and for your question.

[@LeeAnneGomes]

Can a plan administrator access the actual discounts per service instead of aggregate?

[@ahealthcarez]

No. Thank you for watching and for your question.

[@petergrimes9252]

Yes 🍎

[@LawOfAttraction536]

Does the allowed amount equal to all insurance coverage and patient payment(deductibles, copay, out of pocket). So when we talked about savings? What are we talking about savings for whom?

[@ahealthcarez]

Great question. You are correct. Therefore, may be totally patient responsibility if part of the deductible or totally plan responsibility if after out-of-pocket max or some combination of patient and plan if in between deductible and out-of-pocket max. Clear as mud. 😉🤦‍♂️

[@Iwonder2]

please discuss the marketplace plans that either through premiums or deductibles or a combo of both you pay at least 10,000.00 out of pocket if you need any care beyond preventative care?So basically we pay to have insurance but are paying for things like kidney stones out of pocket.Then the year is over and you start over with anew deductible. Folks then can't afford any more care cuz they are broke after paying the 10,000.00 dollars the previous year.

[@ahealthcarez]

You are correct. Thank you for your comment.