Hospital Insults Plan Sponsor – Wants 1,947% of Medicare

Hospital demands almost 2,000% of Medicare to settle claim………………….

This claim was incurred in San Antonio, Texas in January:

(RBP Vendor) has received an offer for (Name of Hospital) claim for John Doe for date of service 1/8/2019 claim #123456.  The plan has already applied 120% of Medicare which resulted in a patient responsibility of $309.14.   (Hospital) is asking for an additional payment of 20% off billed charges which would be an additional payment of $4,705.86.    This is 1947% of Medicare.


Billed $6,268.50
Allowed $309.14
Not Covered $5,959.61
Paid by Member $309.14
Additional Payment $4,705.86
Total Payment with Member Payment $5,015.00
Savings $1,253.75
Percent of Medicare 1947%
Discount 20%


Please let us know if you would like for (RBP Vendor) to move forward with the LOA on this case or if you would like (RBP Vendor) to counter offer.

ANSWER: Are you crazy? Not only NO, but HELL NO!