One of life’s greatest mysteries is healthcare pricing in the US. You have a list price that patients are supposedly charged if they do not have insurance, you have an insurance negotiated price, then there is the co-pay that the patient is responsible for. I tried looking at my dialysis and emergency room statements and I can’t figure them out. BTW, I have a MBA degree in Finance.
For acupuncture, the provider’s website says they charge $90 for the first visit (consultation), then $60 for subsequent visits. It doesn’t say whether that’s for acupuncture or chiropractor so I assume it’s both. My co-pay for each session is $40, so I thought my insurance is paid $50 for the first session, then $20 for subsequent visits. Nope.
For the first visit, the provider billed $290, which has an insurance price of $125. Out of that amount, my insurance paid $85 and I paid $40. For subsequent visits, they billed $180, which became $75. My insurance paid $35 and I still paid $40. Why aren’t they billing $90 and $60 per their website? My insurance will only pay for 30 sessions. Does that mean they make less money if they bill me directly without insurance?
Life with chronic diseases 