insurance

Hospital Charges

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When you see a hospital charges an average of 2.5 .Medicare, did you know there are 5 pay rates?

Independent ambulatory surgery centers ASCs and PCPs only get 1/3 to 1/2 system owned clinics and remote surgery centers. But charges (retail we are billed for by system owned) can be 4x , 8x or unlimited x —even though they don’t expect to get that? “Chargemaster” rates are considered a trade secret but are how much every hospital marks up Medicare rates to bill us and our insurance.

When you read the AHA – the hospital lobby- sued POTUS to fight transparency mandates by Executive Orders, it revolves around these types of secrets.

Excerpt

CPT code Current rate Proposed
99201 (Level 1) $45 $44
99202 (Level 2) $76 $135
99203 (Level 3) $110 $135
99204 (Level 4) $165 $135
99205 (Level 5) $211 $135

 

New Healthcare Is Restorative

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New Healthcare is restoring two sacred trusts that the Bigs have almost destroyed.

  • The doc/patient exam
  • The employer/ employee pact

The Golden Triangle of doctor, patient /employee and employer is our pivot point to best holistic answers repairing sacred trusts.

New wave benefits restore the pact that working for a company – “ good insurance “ saves from financial and health ruin. Nest vs the Wild.
We employers find healthcare buried treasure

  • Reduced spends of 20-25% easy 40-60% tougher.
  • Friction is eliminated
    1. zero deductibles/ copays
    2. texting or calling or seeing a PCP 24/7.

    So once I found 18 more days per employee of reduced absenteeism I broke even

  • Retention savings
    • I had no downtime
    • training
    • recruiting
  • Presenteeism is down. Med/doc access is easy now

Excerpt
…trust is established, a conversation occurs as if two friends are talking since the initial wall between doc and patient is broken down, and more intimate things are shared—in that intimacy that the sacred trust manifests, and unfiltered conversation happens, even if just for a little while.

Medicine: A profession of sacred trust