795
What I'm paying to find out I don't have breast cancer. I have insurance. (Ultrasound and mammogram in the USA)
(lemmy.world)
this post was submitted on 03 Feb 2024
795 points (97.8% liked)
Mildly Infuriating
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I have never seen charges like this for breast imaging under insurance before. Something is wrong, either billing or the insurance. The only way I can see this if the imaging was ordered without a proper reason...but likely not.
You seem oblivious to the realities of most insurance plans in the US.
The part I think most Americans don't realize it's this:
In Canada, when I don't feel well, I go get it looked at. I barely need ID (and when I broke my arm I forgot it at home). I don't need to provide proof of insurance or a visa card, butnindomhave a medical number for records segregation.
My point is, healthcare in Canada at its current and worst post-covid state, is still a "here is my body please fix it KThx" setup, and it's comically more easy than the in-network/out-network who-bills-whom and how-will-you-be-paying mess that is America; and comically more easy while Americans don't realize it that I get stressed just remembering it from when I was there.
You don't need good health care for better pricing, although that just happens. You need better healthcare so you don't have to micromanage how you're getting it. Healthcare in the entire rest of the g7 is just so vastly different in ways Americans largely don't even realize.
You’re right. Imagine yourself or a dependent having complicated medical issues. Well actually, don’t imagine it. It’s a nightmare. Worst part of the illness is dealing with the insurance no doubt.
No, ACA has rules for breast screening coverage. If it was a screening mammo and USlike this. If it was done to someone under 40 or not high risk it would not be a screening exam. If it was a diagnostic exam that is completely different. It would be covered under the general policy with copay/maximums etc. Screenings and diagnostic mammograms/US are different and not covered under preventive medicine.
That whole diagnostic vs preventative thing we do is so stupid. The raw cost of most tests is nothing. Labwork for example, they only run one or two tests (sugar, cholesterol) unless you request more, but don't say you're in pain or it becomes diagnostic!
Meanwhile, at the actual lab, the machines run a myriad of tests on each sample as they're designed to. So the back and forth about lab billing is asinine. The machines already calculated the results as a part of their standard operating procedure. Why not just return all results the machine generates regardless of query? Why not a full panel as SOP?
Why not make body scans SOP at a younger age so we have a baseline of what a person's body operates at before they age? Etc.
They've inserted extra steps just for revenue-generating touch points. So damn backwards.
You said it yourself. Co-pays, and deductibles.
It also depends on what lab the imaging was processed. Oftentimes labs adjacent to a hospital but not actually part of the hospital will accidentally (as if) get billed as an on site hospital visit for these types of procedures unless caught. OP could also have an HDHP.
I've also seen some insurance plans will for some unearthly reason have gaps in the contract and some types of tests become billed outside of insurance even on the "better" plans.
Also, fun thing I learned, women don't need mammograms! They can get ultrasounds instead and ultrasound is actually better!...
...Except insurance won't cover it as a wellness visit because apparently medieval tit-smashing is the preferred method for insurance providers.
Thank you for providing some reason. I’m glad the person you’re replying to has never had crappy insurance before. This bill is completely within the US standards especially with a high deductible plan.
I don't like that I've had to learn so much about medical billing to keep from getting fucked over by procedures honestly. I used to just go do things and ignore the cost because health > money. But then the prices started skyrocketing for simple things and I've had to learn to jump and dodge costs. It's asinine having to be your own doctor, lab tech, and billing department just to play within the confines of the US medical system.
I feel pointless overhead like this is designed to keep us so busy, we don't have energy left to realize how fucked we are, let alone react to it. But, "mah freedumb!"