Online suppliers don't take insurance?

[StuUnderPressure]

I still submit that online suppliers are missing out on a huge amount of business by not taking insurance.

I agree!

Even more interesting is that the Supplier #1 that everyone refers to actually has some brick & mortar physical locations that do accept insurance.

It would be very easy for them to also accept insurance online (at least the insurances they accept in their physical stores).

In fact, they only started accepting insurance at their physical stores because of the large number of insureds in a couple of very large plans that they could not sell to because they did not accept insurance.

[Sleepster]

Maybe there are legal restrictions that prevent this from happening.

[PaulaO2]

It is also because they could not possibly take every insurance policy/companies that is out there. To keep track of them all would be a huge task. A brick and mortar place would only have to deal with the prominent insurance companies in their area.

[zonk]

Even more interesting is that the Supplier #1 that everyone refers to actually has some brick & mortar physical locations that do accept insurance.

Are prices the same or they charge more in the store than they do on line

[StuUnderPressure]

Even more interesting is that the Supplier #1 that everyone refers to actually has some brick & mortar physical locations that do accept insurance.

Are prices the same or they charge more in the store than they do on line

The BCBS insurance set combined prices for a complete S9 AutoSet (with Climateline Hose & the Washable tub & mask) was about $70 LESS than the online price in late 2011. BCBS paid 80% & I paid 20%.

If they accepted my insurance online, I would have just bought it that way & had it shipped directly to me - so I would not even have to talk to the DME.

[Sleepster]

Are prices the same or they charge more in the store than they do on line

I don't know. But it's routine in the US for the prices to be much lower for patients with insurance. (The insurance companies have successfully lobbied for legislation that allows this to happen.)

In my opinion, this is the number one flaw in the US health system. We never know what we have to pay for services or equipment, and neither do the providers, until the charges are actually submitted to the insurance company and payment is made.

For example, a doctor's visit might cost $100. The insurance company "disallows" $45, pays $35, and the patient pays $20.

So the provider receives $55 for the service. But if the patient were not insured the provider would receive $100.

It's a ridiculous state of affairs.

[StuUnderPressure]

In my opinion, this is the number one flaw in the US health system. We never know what we have to pay for services or equipment, and neither do the providers, until the charges are actually submitted to the insurance company and payment is made.

For example, a doctor's visit might cost $100. The insurance company "disallows" $45, pays $35, and the patient pays $20.

So the provider receives $55 for the service. But if the patient were not insured the provider would receive $100.

It's a ridiculous state of affairs.

The Doctors & other Providers have gotten much better at this.

Before I leave their office, they know the exact amount that "I" need to pay because they "check" your coverage almost instantaneously.

For the Doctors, I still need to wait for the EOB (Explanation of Benefits) to determine the ridiculous amount the Doctor said his service was worth & how much BCBS wrote it down. But the amount I am responsible for is almost always the exact same amount that I paid them before I left the office. There are a couple of exceptions who just never seem to get it right - but it is getting better every day.

The invoice from my DME provider for my APAP showed the Total Charges, The lower amount BCBS would pay, & what my 20% is.

In fact, before they even check, they ask you if you have met your deductible. If you say Yes, they can tell you you will owe $ XXX.XX
That is because they sell so many of these & to others in my plan, that they have memorized that amount.

[Sleepster]

Before I leave their office, they know the exact amount that "I" need to pay because they "check" your coverage almost instantaneously.

That's not good enough. You should be able to determine the price before you decide to enter their office.

And pricing should be competitive, not pre-determined by the insurance companies. They are the third party in the transaction, yet they dictate the price.

The reason they get away with this is that they lobby the legislatures. Heavily.

[StuUnderPressure]

Before I leave their office, they know the exact amount that "I" need to pay because they "check" your coverage almost instantaneously.

That's not good enough. You should be able to determine the price before you decide to enter their office.

And pricing should be competitive, not pre-determined by the insurance companies. They are the third party in the transaction, yet they dictate the price.

The reason they get away with this is that they lobby the legislatures. Heavily.

Well, I just have the experience with this one plan - because I have been in it for eons. And no, I do not work for the insurance industry.

But, I for one, am glad that BCBS dictates the price - because prices are routinely discounted more than 50% from what the "competition" has determined the price should be. And the BCBS prices are less than other plans in the area - because this plan is such a large plan. Providers accept those prices because they want access to the large number of people in this plan.

Medical costs increase much faster than the inflation rate or even the rate of increase of anything else - without any real justification for those insane increases. IMHO, "competition" has not & will not do anything to reduce those prices.

[Sleepster]

But, I for one, am glad that BCBS dictates the price - because prices are routinely discounted more than 50% from what the "competition" has determined the price should be.

Prices would be lower yet if insurance companies weren't dicatating prices.