Molly Mulebriar vs Hospital Admissions Clerk
Employer sponsored cash pay health plans save more money on health care services than do the best PPO discounts on the planet. It’s better pricing than Blue Cross, United Healthcare, Cigna and Aetna (BUCA). Everyone knows that including hospitals.
Hospitals generally like cash pay health plans because they are paid immediately and don’t have an accounts receivable problem due to chasing patient share. But, in really rare instances in dealing with dumb and robotic in-take admissions clerks, hospitals have been known to refuse cash in lieu of higher reimbursement through insurance plans.
“Sorry Ms. Mulebriar, we can’t accept cash because you have insurance. Our contract with your insurance company requires us to file under your policy, and besides that it’s the law!” says the nice little in-take clerk at Friendly Community Hospital (FCH).
Yes, that actually happened to me several years ago, verbatim.
“No, you’re wrong. That’s not true at all” I calmly explained. Public Law Section 13405 places certain restrictions on disclosure of health information. Here’s a copy, read it and weep, see pages 39-40. I prohibit you from disclosing my personal health information to my insurance company!”
This is a power hammer for plan sponsored cash centric health plans, giving teeth to the strategy “Screw insurance, I’ve got cash instead. Give me your best cash price and I’ll pay you now!”
Cash pay centric health plans can save a lot of money. Hospitals have been known to provide steep discounts for cash, steeper discounts than all the BUCAs. Our experience has shown cash pay average hospital reimbursement is approximately 115% of Medicare. Compare that to the BUCA’s where pricing averages double or triple that.
There is a happy ending to my encounter with the hapless but nice insurance admissions clerk. Facility charges for my colonoscopy were about $750. Professional services were approximately another $500. If I had used my BCBSTX insurance I would have been responsible for my $2,500 deductible. As luck would have it I was bull riding the following day at the annual Tamaulipas bull riding contest in Matamoros without complications. I won.
Molly Mulebriar is a free-lance investigative reporterette from Waring, Texas and former Miss Texas runner up and champion bull rider. She is an infrequent contributor to this blog.
You failed to mention you are the Texas Jalapeno Eating Champion five years in a row. You also left out you saved Jimmy Carter from a killer rabbit attack before you were born.