What Is A Fair Reimbursement Rate For Hospital Claims?

Almost all hospitals accept Medicare patients. Medicare reimburses hospitals 100% of the Medicare fee schedule. As a private payer, what do we pay for hospital care as compared to Medicare? Do we know? Do you know?

You probably have no idea what your insurance plan is paying as compared to what Medicare would have paid for your claim. You dont have the data because you have not asked for it. You should.

Is guaranteeing the hospital a profit of 12% fair? Or 50%, 80%, or 500% fair? Is Medicare + 300% fair? Or +1,000%? What is a fair price to pay for your hospital care?

If you want to know what a fair price is, try asking your local hospital administrator. Or for a direct, no holds barred answer, write RiskManager@sbcglobal.net

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