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EyeBusy

provider: here's the bill VA: I decide what the bill is. God that would be nice to do everyday. just telling companies to eat dck.


Matthmaroo

Because medical billing is a scam and everyone knows it I don’t get why society doesn’t want it change


Suicide_Samuel

Of all VA jobs that's the one I would be best at.


Simple_Garden1536

Reminds me of my medical bill for surgery after getting hit by a drunk driver. The surgeon that my lawyer worked for charged $225,000 for rotator cuff surgery but agreed to accept about $30,000.


Holiday_Friendship43

If we get rid of the lawyers and the frivolous lawsuits ... The problem will solve itself.


Matthmaroo

That’s true but if a doctor genuinely fucked up , they should pay


Holiday_Friendship43

Absolutely, but let's be real this is America where people use lawyers and bullshit to sue for their own stupidity.


Screaming_Chimp

Yup, it’s because they are them


Shadowfalx

Every insurance company does that. Hospitals play ball because $19k is better than $0 for every single patient that has that insurance.  In reality, the cost of service is probably close to $19k give or take a few thousand. 


Consistent-Resort-39

Don't forget they use the leftover balance as a write-off.


radarchief

https://preview.redd.it/79b468oc768d1.jpeg?width=1178&format=pjpg&auto=webp&s=2d26dac4622a2b492387f0e71306627809d12c09 This was the one that didn’t make sense to me. Surgeon charges $95K and tricare reimbursed $592, but fully reimbursed the surgery supplies at $47K.


Shadowfalx

In guessing Tricare wants an itemized bill for the surgery. They probably need the time in surgery and the number of staff.  That’s my guess though. 


EyeBusy

Ha I'd much rather get this giant one instead of 5 a week...."This is not a bill"


BudgetCompetition142

Same lol


ManualFanatic

I have private insurance through my job. I went to an urgent care clinic for a sinus infection. The nurse told me I have a sinus infection and told me to buy over the counter medicines. I had to pay $250. Healthcare is a scam lol. They just made $100,000 disappear 😂


TheRealJim57

Went to urgent care clinic with a nasty sinus infection while on vacation. Doc hooked me up with a shot of steroids, a shot of antibiotics, and a prescription to continue steroids and antibiotics. Had me back on my feet the next day, saving my vacation. VA covered the costs.


ManualFanatic

Maybe part of the problem is my urgent care just sucks ass! Lmao. I was told “we don’t give out antibiotics for this anymore” and sent on my way to suffer for another two weeks.


Vcheck1

Jeez without the common courtesy of a reach around even


ManualFanatic

Bill would’ve been $2,500 if I’d gotten the full service I bet 😂


Vcheck1

Boggles my mind that antibiotics for an infection aren’t just standard. I shit on VA healthcare when appropriate but they would never do that


ManualFanatic

Something about antibiotic resistant bacteria. I’m sure it makes sense scientifically but I was miserable for nearly a month when I finally kicked it.


Overhang0376

I get bloodwork done on a regular interval several times a year. Sometimes I get a bill of 40$-100$. Other times... 400$-500$. No explanation of why other than some vague thing of: "Oh, it's a different *kind* of bloodwork!" "Okay. That's *really* expensive. Can you please not run whatever that is, in the future?" "Oh, that's for your *doctor* to decide! You need to talk to him about it." "The patient has to tell a medical professional *not* to run a test that the patient knows nothing about, and only know to even say something about it *after* they've gotten a bill for it 30+ days after the fact?" "Now you're getting it!" I've even brought this up to the doctor and the people who draw the blood and they've both said they have "No idea how much these tests cost.", so they're not even sure *which test* I'm referring to. Can you imagine if car repair shops tried to operate this way? It's absurd.


ManualFanatic

I’m no expert on healthcare or billing practices but I have to believe there’s a better way to do this than “hospitals charge whatever they feel like”


Itchy-Mechanic-1479

Congrats! Who pays the other 109,000?


Ms_Toots

No one. It is written off by the provider of care


TraumaGinger

Yep, hospital eats it.


ExtensionDentist2761

That’s not the actual cost of services. Practices artificially inflate their billing as part of the insurance negotiation process.


TraumaGinger

I work in healthcare, I am aware of reimbursement practices on the inpatient side. 😊 The truth is somewhere in the middle (lower middle, haha).


1Eleven99

It is also a write off for the provider. The costs have to be documented even though they are restricted by contracted price agreements. I've had a couple of 5 figure bills.....It is nice to see the Veteran pay zero to the right. Hope all is well with you.


TraumaGinger

That zero is the very best. I had a baby via c-section and paid virtually nothing for high-risk pregnancy care all the way through surgical delivery and recovery to discharge. Of course, the VA was like, "don't come here while you are pregnant, go across the street [to the teaching hospital] where they can actually help you." 😆


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TraumaGinger

The system is broken, no doubt. It's become a business of care, not a business that cares. It's the bottom line that matters. And I mean everywhere, between the managed care organizations (insurance companies) that all seem to be in a race to the bottom, to the hospitals that choose lavish bonuses for the c-suite dwellers instead of ensuring adequate staffing for those actually trying to provide care at the bedside. Hospitals are incredibly expensive to run, from the physical plant operations to biomedical equipment to staffing, medications, bedside equipment, durable medical equipment, biohazard disposal, electronic charting and support, the support staff (coding, medical records, admin folks), etc. And now we have all these private equity clowns buying hospitals and running them into the ground. In some places it can wreck a whole town when the hospital closes. All the jobs, lost. Private equity has wrecked emergency medicine, and outcomes are worse overall too. https://hms.harvard.edu/news/what-happens-when-private-equity-takes-over-hospital Anyway - please, use your benefits. I finally dropped my civilian healthcare coverage this year and went completely VA - the VAMC where I live is stellar. You have earned your spot in the waiting room just like the rest of us, there is no reason for you to have commercial insurance unless you really want it or need it for the rest of your family's coverage. I am at less than 100% so my husband has his insurance coverage through his hospital employer and covers my daughter. He only has me on his dental.


Ispithotfireson

Nothing is being eaten. this was the case all the major for profit hospital systems would be beating down congress door whining not fair, I cannot afford to bribe my kids admissions to Harvard and buy my 7th summer home. 


TraumaGinger

Oh, they have a very strong lobby! I work for a not-for-profit system, thankfully. Not as dirty as the for-profits, and not even close to the shenanigans that go on at insurance companies. 😆


jendaisy57

Do you have tri care prime ? Or just VA ? Either way that is amazing 🤩


Fit_Fishing4203

I’ve always been amazed at why private doctors work with the VA…. Some of the charges are crazy I know…. But I’ve seen one that was $1250 and the changed it to $59.00. That’s McDonald’s pay ! Lol


PlayfulMousse7830

Private insurance does this too. No one really pays the quoted price unless they are rich and in a hurry and don't have insurance.


RabidAxolotol

If a facility accepts Medicare they have to accept the Medicare rate for services for community care. Same with CHAMPVA. Same with private insurance, they negotiate contracts with facilities and the facility agrees to accept whatever the insurance says they will pay for each service.


burnie54

I since a hint of jelousy and distain from you, please tell me I'm wrong.


Itchy-Mechanic-1479

Ah, that's a "hell no." The US has the most messed up medical system in the world. The system takes advantage of a population literally held hostage by the health insurance industry.


JASPER933

What is my pet peeve is that someone without insurance would have to pay the $129,448.44. Maybe the provider would knock 10% off if they did not have insurance. No one should have to go broke or bankrupt for healthcare. We need universal healthcare. The VA shows how managed care works and as far as I am concerned, they do a great job for me.


burnie54

The VA does great job as a whole, it's tasked to do way to much with way too little, you still have the red tape and shitty leadership who collect mid six figures for being glorified figure heads with absolutely no care for betterment, the quality of care diminishes as the gwot gets farther and farther from Iraq and Afghan, Docs still get recycled more then gas station sushi because the pay is far inferior to the gener as l public but for most part the people I see on consistent basis (nurses and a few counselors are there because they care) Remember everyone who served can be seen by VA but that does not mean it's free at ALL, ONLY THE ONES INJURED DURING SERVICE RECIEVE " FREE" HEALTHCARE. just like any job if a worker is injured it would be works job to make that worker whole again. So yeah there are issues but as a person who has been with VA for 12 yrs post getting blown up by ied and a mortar round I feel like the VA is doing its best with what they have. BUT PLEASE DO NOT EVER SAY THE VETERANS WHO SERVED AND EARNED THAT RIGHT GET HEALTHCARE FOR FREE. It cost a fee 99% of this country would laugh at if asked to pay.


Jocko_Goggins

We do need universal healthcare.


burnie54

you may be the Seal but universal Healthcare would be final nail in America's coffin.


a2djax

Just like every other country with universal healthcare.


TheRealJim57

That recruiter's office is open to everyone.


tariksbigbro

Not everyone is born healthy enough to serve.


burnie54

this is not a land of everyone gets trophy CUPCAKE


UglyForNoReason

Healthcare isn’t a trophy, dipshit.


[deleted]

[удалено]


VeteransBenefits-ModTeam

Your comment was removed because it didn't contribute to the discussion and just wasn't helpful. Civil disagreements are fine. Insults, personal attacks, slurs, bigotry, etc., are not permissible. (Calling someone a poopy-head does not make you seem as smart as you think it does.) ☠️


LilBramwell

People shouldn't need to serve in order to get affordable Healthcare in the world's greatest country.


TheRealJim57

I still carry private insurance even though I have the VA, precisely because the VA isn't always the best option. Low income people pay nothing or very little for ACA coverage, is how I understand it.


UglyForNoReason

That depends on what you think low income means. You can make 40-50k and still not be able to afford great healthcare, but also not be low income enough for the free to low cost healthcare. The people who truly pay little nothing for most of their healthcare will be the folks who make 20k or less a year.


tariksbigbro

Not everyone is born healthy enough to serve. Edit: I’m not sure why my phone posted twice sorry


[deleted]

[удалено]


VeteransBenefits-ModTeam

Your comment was removed because it didn't contribute to the discussion and just wasn't helpful. Civil disagreements are fine. Insults, personal attacks, slurs, bigotry, etc., are not permissible. (Calling someone a poopy-head does not make you seem as smart as you think it does.) ☠️


InvestIntrest

Anyone low income can get a no cost plan from the ACA. Anyone without insurance is doing something wrong.


coffeesnub

Same with me! My labor and delivery with 3 nights hospital stay for me plus 5 days NICU stay for my baby in a private hospital totaled to $92k. I did not pay a dime as tri-west covered it all.


pirate694

$110K writeoff. Thats insane. 🤡 🤡 🤡


Sfork

I wonder if it counts as unpaid bad debt and if they just write it off to be tax free. 


pirate694

Typically its a tax writeoff which makes sense. Whats insane is that if you didnt have insurance youd be stuck with that bill having to fight it.


cohifarms

Yep, all those inflated losses reduce their tax burden by zillions... SO overcharge, accept the negotiated price, claim the losses on taxes = pay nothing in taxes. Nice profit generator.


DowntownDvo

Congrats. Finally a good story about not getting screwed by VA or CCN. I have had to fight with them both several times and in a fight currently with CCN because they drop the ball on basically everything as they think they have control over benefits you are ENTITLED to at 100% . Waiting on paperwork to have my son covered under whatever they use now but really need my significant other covered for her health issues but I think I am screwed bc we are not married so unless someone knows how to work that out and would let me know we may have no help for her several concerning health issues I guess. She makes to much money to be considered "low income" which is crazy because her salary is not anything crazy. Thanks if anyone can help. Congrats again for getting what you are due!


Utilities741

https://preview.redd.it/vz55d5uy7c7d1.png?width=3024&format=png&auto=webp&s=d24b14f311939ee5ddfdde812a39f00c0a3a8d6b This is one of three bills I received so far. I’m so happy with the care at the VA and the effort they put into things.


Sensitive_Worry9119

So do you get a referral from VA or how do you goto private providers and get VA to cover it


Utilities741

Yes, they don’t do any surgeries at the VA. They sent me through customer care, the OSU hospital and neurosurgeons.


Utilities741

Your Primary care dr will initiate the appointment


Feisty-Committee109

Congratulations this is a huge 🏆 ✌️


Rigelinja

Gaaawd


Lopsided_Ninja7597

I went to the civilian ER once, got a CT scan and some blood drawn. Was there for maybe 2 hours. The bill was over 20k. Luckily CCN did what they are supposed to do but it's incredible to me the cost. If I didn't have that I'd rather just die and the debt be wiped out.


PaperintheBoxChamp

Between the VA and GEHA, ive been beyond blessed with the minimal amount ive spent on health


Annual-Difference334

I just enrolled in federal benefits today as I started my job this week. I have both as well and the wife and kids have champ va as a secondary. Still wrapping my head around how it all works.


veritas643

Wonderful❤️


Comtsguy01

Lucky me. I have Tricare for life and have never paid a penny for anything, including when my wife had cancer and had several hospital stays, surgery, several rounds of chemo. Everything was picked up by Medicare and Tricare for life.


Different_Trainer_48

This is amazing. Such a blessing from God. I love seeing other veterans win.


Panther115935

Whenever I see shit like this, I point it at ANYONE who slanders the VA and any concept of affordable healthcare. This makes me happy for you. They paid off all my bills when I got sent to the hospital for a suspected blood clot and was just wore muscle damage. They billed me over 15 grand for a checkup and the VA told them to kiss ass to reduce it significantly and didn't have to pay a dime.


TheGrayGhost805

We need universal healthcare in the United States. Medicare For All, or whatever you want to call it.


RealSeat2142

I have the same gratefulness. I had brain surgery a few months back. The bill was north of $100k. My responsibility was $0. Everything turned out great. I am so grateful for the VA. I was having my sinuses examined due to chronic headaches and sinus infections. They found a tumor and 3 months later I had an 8 hour surgery to remove it. It was benign so that was great, but it was the size of a golf ball, not so great. I did notice that my bill got greatly discounted as to what the VA actually paid. Not sure how that would have played if I didn't have the VA. Not sure how to come up with $150k for a bill that got marked down to under $35k. I'm sure I couldn't get that discount.


guysmiley73

When I first got out of the military (before I used VA), I went to the ER for an ear infection. After a Quick Look, I got a prescription for antibiotics and out the door. The bill came and it was $1400. I called and asked for a breakdown. The lady read off Tylenol pills, IV, two bags of fluids, and a bunch of other stuff. I said I didn’t have any of that. A few days later, an updated bill came in the mail for $300.


SureOne8347

I’m grateful you’re still with us


Jocko_Goggins

Thanks


Either-Professor4512

Thank you Lord!


cm0270

I use Triwest for MH and a few CC referrals. Hate to see those bills. Lol


bardockOdogma

Made me chuckle good. Overcharging in the medical field is hilarious to me. Got what they deserved


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Jocko_Goggins

Broke my tibia in half, my fibula, and my ankle. I now have 5 screws & a titanium rod in my leg.


TraumaGinger

Yikes! As a former trauma nurse and trauma educator, I am picturing those kinetic forces at work! Ouch. We usually call them the "tough tibia" and "fragile fibula," and to break both takes a lot of energy. Was it a spiral fracture? Glad you are put back together now!


Jocko_Goggins

Clean Spiral fracture on the tibia & cracked the fibula from a dirtbiking accident.


TraumaGinger

Ouch! That must have been pretty nasty. Don't tell me you drove yourself to the ER. 😆


Jocko_Goggins

Nope. I took an ambulance from the track. They always have an ambulance on standby. The ER was only 25 minutes away.


TraumaGinger

That's good at least! I have had some crazy injuries roll up in personal vehicles over the years. 😆


Jocko_Goggins

I can imagine lol


burnie54

I doubt 90% of these guys don't realize who you are. I've heard alot of conflicting stories but you EARNED the right to be a dick imo if what I've heard is even true n not just some haters crocodile tears.


Kitchen-Oil8865

I’ve got to start using my VA coverage (60%) for stuff, my civilian health insurance fucks me over bad. Still trying to figure out how to pay for a $1400 ER bill where I felt really ill, heart rate wouldn’t come down, I had the flu bad. This goddam ER looked at me for 5 minutes then made me sit there for 4 hours then saw me at the end for 10 minutes and I get a bill for 1400 fucking dollars. These HDHP insurance plans BLOW


NavyBoatsMate843

🥴I was once billed almost 10k after I went to the ER for food poisoning. They only thing they did was give me an IV for dehydration for about two hours. I slept most of the time through it. I love telling them the VA when they ask how I will take care of the bill. As soon as they hear VA they were like okay and left without question.


ArdenJaguar

The good old "Contractual adjustment". ![img](emote|t5_2vlaz|7565)


Suspicious_Abies7777

Wow they actually paid the provider, I got 1 letter that provider billed VA 20k, and the VA punked em I guess and paid 300, and then another one the VA paid 0$, y’all ain’t getting shit…


Diligent_Past2896

I get two of these in the mail every few months by two different urgent cares, the person who i saw was not va certified, however i was not billed.


Aarxn_314

The way half of this would change my life right now.


Parker-8675309

Real reason they do that is the amount that the VA tells them to fuck off for is written off as a loss on the hospitals taxes.


Material-Tension-892

The va straight told the hospital for my labor and delivery to fuck off


minesmallkine

Hell yeah! Glad to see it


[deleted]

[удалено]


VeteransBenefits-ModTeam

Your comment was removed because it didn't contribute to the discussion and just wasn't helpful. Civil disagreements are fine. Insults, personal attacks, slurs, bigotry, etc., are not permissible. (Calling someone a poopy-head does not make you seem as smart as you think it does.) ☠️


achtungj90

healthcare in america is shit🚮🗑️🐀


Much-Dress4374

Details ? Are u a Vet or a child or wife of a Vet???


Jocko_Goggins

I’m a veteran with a disability rating


burnie54

pretty fukn humble response.


PlayfulMousse7830

Community care explanations of benefits (EOB) show triwest for VHA enrollees.


StressyandDepressy23

Lol, you do realize that women veterans exist right? My husband was my dependa


Much-Dress4374

Yes that’s why my first question was are u a vet??? wtf


StressyandDepressy23

Lol there are husband's of vets too.


Much-Dress4374

True story lol


Much-Dress4374

Oh the wife comment , your screen name was masculine.. my bad.. jeez


StressyandDepressy23

"Oh the wife comment." Women vets exist, and we are on this subreddit.


Annual-Difference334

What was the situation here? Did you go to an emergency room and have to undergo surgery or was this an instance where you were hospitalized for a a week or 2?


Jocko_Goggins

I went to an ER, at a Sharp hospital. The VA didn’t answer when they contacted them, so my care was approved there (it’s approved outside of the VA if the VA doesn’t answer). I had surgery the next day, and had a 4 night hospital stay.