“It doesn’t make sense until you understand that the giant hospital bills gave the PPOs an opportunity to profit from their repricing scam, charging for the extent to which they are successful in “discounting” these inflated bills.”
Editor’s Note: Working the spread between Hospital Charge Master Rates and allowed amounts is how third party intermediaries earn billions of dollars in the United States – http://blog.riskmanagers.us/?p=11527 The higher the “sticker price” and the greater the “discount” = increased fee revenue off the spread.
Continue reading If You Like Your Scam, You Can Keep It: the Attack on Out-of-Network Doctors.