Colorado Supreme Court docket principles in favor of woman who anticipated to pay back $1,337 for surgery but was charged $303,709

Colorado Supreme Courtroom rules in favor of lady who envisioned to spend $1,337 for surgery but was billed $303,709

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25 replies on “Colorado Supreme Court docket principles in favor of woman who anticipated to pay back $1,337 for surgery but was charged $303,709”

>“…Hospital chargemasters have become increasingly arbitrary and, over time, have lost any direct connection to hospitals’ actual costs, reflecting, instead, inflated rates set to produce a targeted amount of profit for the hospitals after factoring in discounts negotiated with private and governmental insurers,” [Justice] Gabriel wrote.

This story illustrates why “networks” need to be banned. It shouldn’t be the patient’s responsibility to discern whether everyone who is going to bill them for care in a hospital is indeed “in network.” Twice I have had insurance companies tried to burn me on this when I had gotten the name of the provider off of the insurance company’s list of providers.

>At the time, the hospital had represented to French that the surgeries were estimated to cost her $1,337 out of pocket, with her health insurance provider covering the rest of the bill.

>But the hospital’s estimate was based on French’s insurance provider being “in-network” with the hospital, which it was not. A hospital employee gave a mistaken estimate after apparently misreading French’s insurance card.

Being out-of-network is usually a big no-no, but this time the hospital made the error. I’m glad the Colorado Supreme Court acknowledged this fact.

The fact that this kind of bill is even possible is just plain stupidity. How have we come to just accept these outrageous costs as a society? Our healthcare needs a serious reboot.

To explain US Healthcare to outsiders/non Americans: It’s like you go to buy a car and you ask what is the price of the car and the salesman asks you “How much do you have?” Another attempt to explain it: my dad is a retired professor and since he is over 65, qualifies for Medicare. So he has state educator insurance, Medicare AND private insurance. But he could be bankrupted by medical bills even though he has all this, money in the bank, house and car paid for. Why? Because Medicare only pays for 60 days of hospitalization, after which the next 60 days is paid by the other insurance. If that runs out, he is responsible. If he has a stroke or comes down with dementia, it’s a MINIMUM of $800/day UNTIL HIS ASSETS ARE FULLY DEPLETED, then a facility will care for him in return for all of his monthly retirement income. And Politicians passed laws to go back 5 years–if he signed over the house to me 4 years ago, the govt comes and seizes the house or the proceeds if I had sold it. And get this:the hospital bills and drug charges are all BULLSHIT. It’s arbitrary. It’s what they pull out of their asses. If you go to a US hospital, they have one bill if you pay cash, another for Medicaid, another if Medicare, still another if covered by insurance or HMO.

If you banned insurance “discounts” entirely, and made everyone pay the same “cash price” then suddenly half the stupid disappears immediately.

– In-network/out-of-network: Gone.
– $100 bandaids with 99% discount: Gone.
– Complex pricing: Gone (everyone pays the same).
– Insurance companies and their consumers are now on the same “side” rather than insurance companies making side deals with healthcare companies.
– Price discrimination: Gone.
– Plus it would save tons of cost in terms of eliminating billing complexity, reporting, and negation streamlining the whole thing.

Obviously “Medicare for all” is a better system, but if we cannot have that and must live with this shitty private system then at least we could do is make it better. I’d make two changes to our broken system to make it a lot less broken:

– Everyone pays the same price: Medicare, Medicaid, Insurance, and cash-cash (this puts everyone on the same “side,” all fighting price increases together).
– Ban employer provided insurance entirely. Give everyone a HSA, increase the caps, and allow the HSA’s funds to be used for insurance premiums pre-tax.

Essentially you get the same tax benefits you have now, much more freedom in the open market to pick your insurance company, your insurance company now has an actual reason to keep YOU happy (rather than your employer), and everyone is working together to keep healthcare costs down.

People hate this because “it isn’t medicare for all!” but politically what I said above *could* happen far sooner than M4A because M4A is still considered a fringe idea in the US.

I had to pay a lot more for an emergency room visit in California because the hospital was in my network but the ER doctor on call was not. Of course they denied my appeal. It was ridiculous to me because it’s not like I had a choice which doctor was there to treat me. Years later I get paperwork saying “if you send us these receipts, etc. you can be part of the lawsuit to get your money back”. By then I had already paid it and didn’t have any of the paperwork anymore. I guess it wasn’t cool for them to do that.

Haha, had a emergency Appendectomy one week before Covid turned the world upside down. I lost both jobs and my place of residence in about 2 months time. The hospital sent me several different bills, some for the doctor, some for the hospital, some for shit I don’t even know what for. All in told it was $38,864. They started calling for payment 2 weeks after the bull went out. I laughed and laughed when the person asked of there was anyway I could set up a payment plan. I said listen, I’m trying to get a couple hundred bucks from the government just to pay for food and rent since Ive lost both of my jobs where I was working 60 hour weeks and my lease is up and I have no where to live. Guy said I understand, well call back in a month. lol, keep on calling but I aint got no money!!

This just happened to my partner. Make sure you have a recording of the insurance company telling you your cost. We were told it would be $0.00 for their procedure. And then got a bill for $10,000. Called ins and got the “Yeah we don’t cover that provider.” Told about the $0 and they listened to their own recording and marked it back to $0. We are still getting the $10,000 bill and fighting it. What a headache the US insurance/health care system is.

If non-Americans imagine the dumbest possible way to run Healthcare in a country, they probably haven’t imagined half of what the US manages to come up with.

Funny story “if you hate money” So I had a shoulder surgery done about 4 years ago in June. Surgery went fine everything was great blah blah. Paid our out of packet max which was around $3500. Cool done… So for the rest of the year I went and got EVERYTHING checked out. Had some stomach issues, haven’t had labs and physicals in years so I got all of that done. Had a sinus/ ear issue that I got looked at. Woohoo finally my health insurance is working for me!!! So while trying to figure out my stomach issue they wanted me to have a colonoscopy. Ok whatever we have meet our out of packet max so lets do it! Go in for my scheduled colonoscopy everything goes smooth. About 3 weeks later we get a bill for $1900, turns out the anesthesiologist “I dont know, the person that puts you under…” called off that day and the fill in was “out of network” We fought tooth and nail with these assholes because how is that my problem. Well I ended up paying the $1900. Go insurance?

Just for fun lets do some napkin math. We pay bi-monthly for insurance, so out of my wife’s paycheck comes around $550 month. Her company pays almost $1600/month so $2150 per month for insurance to cover our family of 4. $2150×12=$25,800 plus our $3500 deductible which is now $29,300 per year TO USE FUCKING INSURANCE!


Edit : Another quick funny, So my stomach issue was fixed by a twice a day pill and diet change. Well my insurance denied it for whatever reason “after 1 year of taking it……” so I go to the doctor and get a emergency script, go to the pharmacy and they are like “you have 2 prescriptions would you like them both?” I said “Two? I only need one” Turns out the other prescription was my proper amount and I could pay $512 to pay that one out of packet. Of course I said F that I have my 1 month emergency one that did get covered on my insurance so only give me that one. Paid my $15 bucks on off I went. I get home and my wife works at our insurance company in a department that can look at denied claims. Ready????

She says to me : “Why didnt you pay the $8 just to pick it up?

Me : “Wtf $8???? they wanted $512”

Wife : “O, $8 is our cost so I just expected it to be double that but $512 whhaaa”

So the company/department my wife works for deals directly with the manufacture. The COST OF THIS DRUG WAS $8 and by the time it hit wallgreens and the front counter it was $512. FUCK THIS SHIT!

I’ve happily taken hits to my credit instead of paying the egregious after-insurance amounts that they add up to. I once went to the ER by ambulance, so I had no selection on the facility we went to. 5 hours in the hopsital total and an MRI. $35k bill, $20k responsibility on my part. I had been hit by another driver and their insurance paid me his policy limit of $15k for medical. My personal medical insurance had already paid the difference, so, I sent $1k to the hospital and kept the $14k remainder for my time/pain.

Hospital came at me like a spider monkey, looking for the rest. I told them to eat rocks since they’d already received ~$7000. They sent it to collections and I laughed at their calls. The incident dropped me from 810 to 795 credit score for a few years then jumped back up. i have ZERO moral qualms about how I handled it. No medical service on earth should add up to $7000 per hour of care.

That’s not even the most egregious instance I’ve dealt with. A 4.5 week hospitalization plus the following 9 months of PT/follow-up care was billed $2,487,000 in total. Two. Point. Five. Million. Dollars for 5 weeks in-patient (total) care.

3 years ago I went to my doctor because my adhd meds were giving my heart problems. She wanted to put me on a non-stimulant medication but insurance wouldn’t cover it until I tried a different medication that had the same side effects as the first. So I went away empty handed and am now unmediated. And I pay hundreds a month for the privilege of letting an insurance company decide what treatment I need rather than my doctor.

There should be laws against charges you didn’t consent to. Not just in healthcare, but especially there.

Yah but imagine all the time and energy she wasted to fight this BS. Only for the outcome to be what it should’ve been. Does she get reimbursed for any of that?

What percentage of Americans can afford a $303,709 bill? It’s insanity. People will be paying for this their entire life and then avoid medical procedures all together and just die from something completely preventable. I can’t believe we’ve been made to think that this country is anything but a shithole for everyone but the rich and elected officials.

I realize she didn’t have to pay that total, but the fact that it’s even a thought to charge something like that is ridiculous.

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