re: #57 reine.de.tout

Insurance companies work out various rates of reimbursement with various providers. You can be sure that what the insurance paid, plus whatever your co-pay was, was sufficient reimbursement for the services you received.

If I recall my college days, when I wored as a Medicaid claims processor, Medicaid paid providers based on a percentage of the provider’s PREVIOUS YEAR’s usual and customary rates (UCR)

So, providers would jack up their stated rates to affect the UCR, in order to get a higher reimbursement next year.

Their stated rates were rarely what they ever actually got in reimbursement from insurance companies, Medicare or Medicaid.

Even folks with no insurance - if you talk to the provider, many will give you a different rate than what their stated rated is. It will still be a lot, but not nearly as much as what their stated rate is.

It’s like with plumbers. There’s normally some discount they say they work in, but normally they planned that discount from the first. I sometimes do the same thing when I am selling.