Claim administrator ignores hospital’s billed charges – pays cost plus 12%. Article states that discounts off billed charges have increased over the years, yet costs keep going up. A shell game?
What makes more sense – cost plus 12% or a “discount” off billed charges?
Editor’s Note: PPO network representatives, carriers, hospital administrators and bloated insurance brokers are seething. Lucrative revenue streams are threatened. If money drives behaviour, how are hospitals going to fight dastardly cost-plus warriors? Will hospitals “play ball” or gather their marbles and go home?