GoFuckYourself.com - Adult Webmaster Forum - View Single Post - Two very different costs for the same medical procedure from two hospitals

sarettah · 05-09-2013, 11:31 AM

All of this is largely smoke and mirrors.

The Medicare payment rate is re-computed every year or couple of years (I don't recall the schedule and I am too lazy to go google it). The computation for each procedure is a percentage of the average billing for that procedure across a certain time period.

Most insurance companies use the Medicare rate as the beginning of their negotiations with their various vendors.

So Doctors and Hospitals generally publish and charge a much higher cost then they ever actually get paid because that raises the average billing amount going into the next round of computations.

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05-09-2013, 11:31 AM
sarettah see you later, I'm gone Industry Role: Join Date: Oct 2002 Posts: 14,071	All of this is largely smoke and mirrors. The Medicare payment rate is re-computed every year or couple of years (I don't recall the schedule and I am too lazy to go google it). The computation for each procedure is a percentage of the average billing for that procedure across a certain time period. Most insurance companies use the Medicare rate as the beginning of their negotiations with their various vendors. So Doctors and Hospitals generally publish and charge a much higher cost then they ever actually get paid because that raises the average billing amount going into the next round of computations. . __________________ All cookies cleared!