The discussion revolves around the fairness of a $12,000 bill for an MRI (head with contrast) received from a hospital. Participants explore the pricing of medical imaging procedures, comparing costs in the U.S. to those in other countries, and seek advice on how to address the bill and evaluate its fairness.
Participants do not reach a consensus on whether the $12,000 bill is fair. There are multiple competing views regarding the pricing of MRIs and the practices of hospitals versus independent imaging centers. The discussion remains unresolved with various opinions and experiences shared.
Limitations in understanding arise from the complexity of insurance negotiations, hospital billing practices, and the lack of clarity on what constitutes a fair price for medical imaging. Participants express uncertainty about the implications of insurance coverage on the final bill.
Evo said:I'm also surprised that the doctor did not send you to an outpatient imaging center, or at least give you an option. It's possible the doctor gets a kickback from the hospital for sending them business.
humanino said:The insurance did agree to pay 80% of the $12k so the provider can not be out of network (unless I misunderstand).
edward said:Sometimes your insurance company will offer to pay an out of network provider what they would pay an in network provider. It is difficult to negotiate with an insurance company.
If you were indeed sent to an out of network facility, talk to your doctor and ask why. A call from your doctor to the MRI Lab may heavily influence whether or not the lab will negotiate the bill, especially if he refers a lot of patients to them.
My son successfully negotiated $3000 off of his bill. Actually in my sons situation the supervisor of his doctors billing office ended up calling the supervisor of the labs billing office and the lab agreed over the phone to write off the $3000.
Don't talk to the person at the desk in the Lab's billing office. Ask to speak to a supervisor.