Advanced Maternal Age. Geriatric Pregnancy. As if they don’t insult us enough. Expectant mothers over 35 are labeled with one of these (or another unfortunate tag) by their providers. We also get to endure an onslaught of extra tests, ultrasounds, and insane warnings about all the ways we and/or the baby could die if we don’t induce at a certain point. Awesome. Anyway, one of the extra blood tests is a genetic test to see if there are any markers for disorders in the fetus. The original test I took with Banks was the Harmony test, now there are many companies/competitors doing the same sort of blood test. The only highlight is that we can tack on a small upcharge and find out the gender of the baby at about 8 weeks.
Banks was my first pregnancy so when my OB offered me this test and strongly encouraged me to have it done I thought, “Why not?” so we tacked it on. Insurance didn’t cover it but I wasn’t cutting any corners the first go round {I didn’t even know how to cheat on the glucose test yet}. You can image my surprise a few weeks later when I received a bill for $3,500. The bill said Charged: $3,500. Insurance Adjustment: $0. Amount owed: $3,500.
A few weeks ago I wrote about how I saved thousands of dollars simply by realizing the healthcare system was attempting to take advantage of my trust. You can read about the whole exchange here. This is where I learned to make that call.
I called the Harmony test company and told them I wasn’t going to pay the bill. They said there was a misunderstanding; they thought insurance was going to be responsible. They immediately sent me an adjusted bill for $350. I was relieved, but also astonished that the cash price was 10% of what the insurance price was.
Now, pregnant for the 3rd time, this week I received my bill for genetic testing. The bill read; Charged: $3,900. Network Savings (Insurance adjustment): $3,195.93. Deductible (Amount I owe): $704.07.
So now that insurance is covering this test it’s going to cost me twice as much? I don’t think so. I had a nice chat with a man we’ll call Hashiem.
Me: I’m just trying to understand why this test is $700 when I have paid cash before for it and it was about half that.
Hashiem: I understand, that is higher than our cash price but it is what insurance has agreed to.
Me: I didn’t agree to it and I am the one paying; what is the cash price?
Hashiem: I can lower the price by 25% if you can pay today.
Me: Yeah, I’m not paying more than $350 for this test.
Hashiem: I am authorized to give you a 50% discount.
Me: Are you authorized to give me more than that?
Hashiem: No ma’am, I’m sorry.
Me: That’d be great, thanks.
I paid: $352.03 after a 3 minute conversation.
So insurance agrees to an astronomical price for services and then negotiates that they will never pay those prices so they can print on our bills that the prices were “adjusted” because we have insurance {talk about marking up to put it on sale}. And we are supposed to pay high premiums and deductibles, sing their praises and thank them for negotiating us out of these crazy prices {which they set}?
The third party payer system is so broken, because they are spending someone else’s money but possibly even more troublesome; because they assume we are all stupid. This is supposed to be the provider you trust when you are hurt, need care & can rely on. Instead they just add insult to injury.
I would like to yell from the mountaintops how Consumer Driven Healthcare really is the answer. Until we control our own spending, negotiating, etc. the system will continue to be broken. If you haven’t signed up for an HSA yet, get one. Get one now. Hope this encourages you to question every high bill you receive and push for the right thing, which is the standard we should be holding our providers to: doing the right thing.
Make the call, be stubborn, it’s worth it.
Banks was my first pregnancy so when my OB offered me this test and strongly encouraged me to have it done I thought, “Why not?” so we tacked it on. Insurance didn’t cover it but I wasn’t cutting any corners the first go round {I didn’t even know how to cheat on the glucose test yet}. You can image my surprise a few weeks later when I received a bill for $3,500. The bill said Charged: $3,500. Insurance Adjustment: $0. Amount owed: $3,500.
A few weeks ago I wrote about how I saved thousands of dollars simply by realizing the healthcare system was attempting to take advantage of my trust. You can read about the whole exchange here. This is where I learned to make that call.
I called the Harmony test company and told them I wasn’t going to pay the bill. They said there was a misunderstanding; they thought insurance was going to be responsible. They immediately sent me an adjusted bill for $350. I was relieved, but also astonished that the cash price was 10% of what the insurance price was.
Now, pregnant for the 3rd time, this week I received my bill for genetic testing. The bill read; Charged: $3,900. Network Savings (Insurance adjustment): $3,195.93. Deductible (Amount I owe): $704.07.
So now that insurance is covering this test it’s going to cost me twice as much? I don’t think so. I had a nice chat with a man we’ll call Hashiem.
Me: I’m just trying to understand why this test is $700 when I have paid cash before for it and it was about half that.
Hashiem: I understand, that is higher than our cash price but it is what insurance has agreed to.
Me: I didn’t agree to it and I am the one paying; what is the cash price?
Hashiem: I can lower the price by 25% if you can pay today.
Me: Yeah, I’m not paying more than $350 for this test.
Hashiem: I am authorized to give you a 50% discount.
Me: Are you authorized to give me more than that?
Hashiem: No ma’am, I’m sorry.
Me: That’d be great, thanks.
I paid: $352.03 after a 3 minute conversation.
So insurance agrees to an astronomical price for services and then negotiates that they will never pay those prices so they can print on our bills that the prices were “adjusted” because we have insurance {talk about marking up to put it on sale}. And we are supposed to pay high premiums and deductibles, sing their praises and thank them for negotiating us out of these crazy prices {which they set}?
The third party payer system is so broken, because they are spending someone else’s money but possibly even more troublesome; because they assume we are all stupid. This is supposed to be the provider you trust when you are hurt, need care & can rely on. Instead they just add insult to injury.
I would like to yell from the mountaintops how Consumer Driven Healthcare really is the answer. Until we control our own spending, negotiating, etc. the system will continue to be broken. If you haven’t signed up for an HSA yet, get one. Get one now. Hope this encourages you to question every high bill you receive and push for the right thing, which is the standard we should be holding our providers to: doing the right thing.
Make the call, be stubborn, it’s worth it.
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