I received an explanation of benefits from Medicare today for my annual urologist visit last month.
The doctor billed Medicare $243 for performing a prostate exam, with an additional $15 for urinalysis. Medicare paid $92. I have to pay $18. The entire visit with the doctor took less than 5 minutes.
If I have to pay someone to stick a finger up my ass I would hope it lasted more than 5 seconds lol
$243 prostate exam cost + $15 for urinalysis = $$258 total cost
Medicare paid $92 and you paid $18 =$120 paid
Who paid the $138 difference? Private insurance? Medicare negotiated cost?
I can’t get get a plumber out just to look for much less than $250. It’s not just five minutes of the doctors time. The urologist has a nurse, receptionist, med techs for analysis, liability insurance, accounting/billing, patient history review and post visit summary to write, processing plus loss for no-shows etc - not saying the system is right, but that’s the way it is now, and I doubt it will change. There are layers and layers of BS cost built in.
We have Medicare, wife had a drug infusion and the nurse showed us the invoice around $60,000 just for the drug ( not including the 4 hrs in the transfusion room and staff costs). She said the Hospital settles with Medicare for @ $17,000 total, we paid nothing. Without Medicare, we would have been responsible for the full amount, drugs, transfusion room and nurses. The drug and hospitals don’t strike deals with indiduals like they do with insurance companies