How do I find out what discounts hospitals offer insurance companies?
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Mom had an emergency surgery four months ago plus three set backs. Needs another major surgery to finish the first procedure once she is healthy enough. She is under 60 so does not qualify for medicare or medicaid. Applied for disability but that will take at least 3 mos to process, and if approved still won't be enough to meet the $3300/mo payment plan. Current monthly income is $911.00 from dad's social security. House is paid for but cannot get a reverse mortgage (too young) or a home equity loan (income too low). Parents have cashed in their IRAs and stocks (losing 40% in fees, penalties and taxes). NOTHING is left. About to be turned over to collection tho they've always had the best credit rating. Hospital has offered a 25% discount if they could pay the entire initial bill, but there wasn't enough stock/IRA money to cover even that.
Can we get the bill down to what an insurance company would pay for the same services? How do I find out what are "customary and reasonable fees"?
How do I find out what discounts hospitals offer insurance companies?You're not likely to find out exact contracted rates. Hospitals don't even have the same rates across all insurers. (And they have some incentive to keep those rates somewhat secret - don't want to let Insurer A know that you're giving Insurer B a better rate, otherwise Insurer A will be knocking on your door to renegotiate.)
When I worked in a contracting department, we'd try to ballpark the rates that other insurers were getting by using EOBs that we had access to.
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