what is a "negotiated rate" in US health care? - USA - International Cannagraphic Magazine Forums

thingshappening · 03-18-2011, 04:41 PM

I have insurance with a high deductible (3K). I was recommended for a procedure that costs 2400 bucks, according to the hospital (I Just called). I called my insurance and they said yes, I will have to meet my deductible for this procedure (ie, fuck you, thingshappening, you pay for all of it).

A friend told me not to fret over the cost because my insurance company, even though I'm not at my deductible, will "negotiate a rate" with the hospital that is usually "much much lower" than the standard price.

wtf? Massive green dots to follow for anyone who can guide me here. Google is confusing me..

Sam the Caveman · 03-18-2011, 05:24 PM

Insurance companies have a lot of power when it comes to negotiating prices because they can send all of their customers to where ever they tell them to go. If a hospital or small practice does not accept the "negotiated" (more accurately put = "dictated") price offered to them by the insurance company, they will not allow their customers to accept care there and use their insurance. Most insurance companies have a "care network" or "recommended prioviders" they use, these are the practices/hospitals that accept their prices.

SuperSizeMe · 03-18-2011, 06:03 PM

I think you may be better off contacting the hospital yourself and crying broke.

Why would the insurance company negotiate on your behalf when they are out of the loop?

Unless they're capitated stricly through this facility, in which case there may be a prearranged/set price.

Best of luck

kmk420kali · 03-18-2011, 07:06 PM

Most Insurance Companies have a Yearly Deductible...yes, yours is quite high, but there is not much you can do about it, you signed the Contract--
However...the after the 3000, they will pay anything else you have done, for the year-- Next year it starts over--
If I was you, I would definitely change Insurance Companies, or buy a better Plan through the same one--
I also had to find out about this the hard way...and paying a slightly higher Premium was really worth it in the long run--

mcattak · 03-18-2011, 08:30 PM

Only reason they would negotiate is if procedure was over 3K...Negotiate yourself and shop it around....

mc

03-18-2011, 04:41 PM	#1
thingshappening Banned Join Date: Jan 2011 Posts: 344	what is a "negotiated rate" in US health care? I have insurance with a high deductible (3K). I was recommended for a procedure that costs 2400 bucks, according to the hospital (I Just called). I called my insurance and they said yes, I will have to meet my deductible for this procedure (ie, fuck you, thingshappening, you pay for all of it). A friend told me not to fret over the cost because my insurance company, even though I'm not at my deductible, will "negotiate a rate" with the hospital that is usually "much much lower" than the standard price. wtf? Massive green dots to follow for anyone who can guide me here. Google is confusing me..
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03-18-2011, 05:24 PM	#2
Sam the Caveman Pimpin witch hoes Join Date: Aug 2009 Posts: 2,368	Insurance companies have a lot of power when it comes to negotiating prices because they can send all of their customers to where ever they tell them to go. If a hospital or small practice does not accept the "negotiated" (more accurately put = "dictated") price offered to them by the insurance company, they will not allow their customers to accept care there and use their insurance. Most insurance companies have a "care network" or "recommended prioviders" they use, these are the practices/hospitals that accept their prices. __________________ Managing disease in Hydro solutions Stem rot, Sclerotinia life cycle and control methods Asprin kills internal plant virus', fungi and bacteria - Cambridge University
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03-18-2011, 06:03 PM	#3
SuperSizeMe A foot without a sock... Join Date: Nov 2009 Location: Buttered like corn on the cob... Posts: 1,731	I think you may be better off contacting the hospital yourself and crying broke. Why would the insurance company negotiate on your behalf when they are out of the loop? Unless they're capitated stricly through this facility, in which case there may be a prearranged/set price. Best of luck __________________ The days grow shorter and the nights are getting long Feels like we're running out of time Every day it seems much harder tellin' right from wrong You got to read between the lines Don't get discouraged, don't be afraid, we can Make it through another day Make it worth the price we pay... ~Fight the Good Fight~ Rest in peace my Precious baby 1994-2011
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03-18-2011, 07:06 PM	#4
kmk420kali Freedom Fighter Join Date: Mar 2006 Location: So Cal Posts: 5,852	Most Insurance Companies have a Yearly Deductible...yes, yours is quite high, but there is not much you can do about it, you signed the Contract-- However...the after the 3000, they will pay anything else you have done, for the year-- Next year it starts over-- If I was you, I would definitely change Insurance Companies, or buy a better Plan through the same one-- I also had to find out about this the hard way...and paying a slightly higher Premium was really worth it in the long run-- __________________ With Red-Eyed Respect--Jim My GH at the pad-- https://www.icmag.com/ic/showthread....=1#post4996785
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03-18-2011, 08:30 PM	#5
mcattak Member Join Date: Jan 2010 Posts: 250	Only reason they would negotiate is if procedure was over 3K...Negotiate yourself and shop it around.... mc
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