You realize that even with a high deductible plan (which I have) all visits are submitted as claims and adjudicated, right?
The size of your deductible changes nothing on the admin efficiency side. Perhaps you meant that you would like a system where routine charges are not subject to the claims process and only high dollar (i.e. catastrophic) claims go through adjudication. As an amusing anecdote directly related to that, I just had to talk to my doctor office because of a visit on my bill for my daughter. I didn't notice anything at first but then started seeing some weirdness. Like the fact that they charged for a urinalysis and I know my daughter has never had one. And, hey, wait, they just charged me $30 for a pregnancy test for her...and she is 2.5 years old. And now that I look at it, that visit is with a doctor whom we've never seen. All of those things were adjudicated by our insurance and passed and balanced transfered to me as charges against the deductible. And according to our provider, the insurance is supposed to have an age check for things like pregnancy tests. So not only did the adjudication cost everyone money, they didn't actually do any good at finding incorrect charges to my account. Gotta love health care billing. Judah On Thu, Jul 16, 2009 at 12:15 PM, Gruss Gott<[email protected]> wrote: > >> gg wrote: >> So you go to the doctor, the doctor sends the bill to the >> administrator, the admin confirms your eligibility (that ins will pay >> for the services rendered) and then pays the insurance company pays >> the doctor. >> > > This is, btw, why I'd like high deductible insurance: I don't want to > finance stitches or a flu shot through insurance. > > Think of how inefficient that is: the doctor charges $150 for the > stitches, but that bill has to go through the entire adjudication > process just to get paid. > > And part of my premium is going to pay for that admin cost. I'd > prefer to just avoid the admin cost and pay the bill myself, but that > insurance product isn't widely available (well HSAs are more popular > now). > > I'd like to use health insurance the same way I use house insurance: > if a window breaks, I'll fix it myself for cheap (doc-in-a-box). But > my basement gets flooded and collapses (ruptured bladder) due to some > unforeseen event (screwing around in the office with paperclips), then > my house insurance will pick up the tab through my financing > arrangement. > > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~| Want to reach the ColdFusion community with something they want? Let them know on the House of Fusion mailing lists Archive: http://www.houseoffusion.com/groups/cf-community/message.cfm/messageid:300458 Subscription: http://www.houseoffusion.com/groups/cf-community/subscribe.cfm Unsubscribe: http://www.houseoffusion.com/cf_lists/unsubscribe.cfm?user=89.70.5
