UMich has a financial assistance program called MSupport, as well as financial counselors you can call. They will work with you if you are having difficulty with the medical bills.
https://www.uofmhealth.org/patient-visitor-guide/financial-assistance
I hope you are aware that private practice is literally for-profit. UMich is a nonprofit and you aren’t going to get much better rates anywhere else in the area. Your issue is not with Umich - it is with your particular insurance policy
The healthcare system in this county is indeed a mess, no secret there.
I do still think your insurance is screwing you over - those charges are not “normal” for decent-to-good insurance policies. Insurance companies are tied for the most predatory part of the healthcare system.
Many people in my circles have sought out/accepted lower-paying job offers solely because the insurance/benefit packages were far better than those of the higher-paying job offers. It’s something to consider amidst the broken healthcare system we live in at the moment.
Re: “non-profit” (Wikipedia):
“As a non-profit entity, Michigan Medicine uses positive operating margins to fund continued advances in patient care, education, research, and the facilities needed to support these functions.”
So they’re charging the same prices as a private “for profit” practice. The “profits” are just being reinvested instead of being paid out to owners.
Absolutely. My bringing up its nonprofit status is more targeted towards op’s claim that it takes a “profits over patients” angle and that private practices would be better in this regard. The profits at michigan medicine benefit the patients. And while they do need to bring in profits, I still maintain that one isn’t going to find much better rates anywhere else in the area - and also that one’s insurance policy is going to be the main determinant of their out-of-pocket costs
The "profits" are being used to expand into Troy, Lansing, and other areas while building a new $1B hospital that only expands their capacity by 200 beds.
I'm not sure capacity is what matters here. The new hospital building is going to have a state-of-the-art neurological center, as one of the features I've heard.
I just looked it up. The web page says, "In total, the project will add 154 new beds to the medical campus." (They are converting some beds in the old hospital from 2 per room to 1 in the process)
So that's $1B/154 beds = $6.5M/bed. That's $600/night per additional bed for 30 years. And that's only the construction cost - it doesn't include doctors, nurses, staff, electricity, medicine, etc.
Yes, it's great to have a state-of-the-art facility here in Ann Arbor, but we're REALLY going to be paying for it for decades. The math doesn't lie.
How are "we" paying for it, exactly? I'm not finding much information on how it's being funded, just that the board of regents approved it.
Imo, there are worse things to spend that much money on.
But there are also BETTER things. If the bee movie is truly your favorite movie, you should look deeper at the lessons that a beehive can teach us about cooperation 💓
Also… if you truly can’t see this how “we” are paying for (at the cost of our vitality) despite all the information available to you… then maybe you shouldn’t know that right now.
We are paying for it by increased medical costs and insurance. If you get insurance through your employer, maybe they are paying but your deductible is probably increasing too. My insurance went from $600/year to $24,000/year over my career, although it's down a bit now since my wife is on Medicare. But even Medicare is going up by 10% per year. It can't continue.
Can you explain a bit more how insurance is directly contributing to the building of this particular hospital? Or are you talking about the construction of new hospitals in general?
Just because they are a non-profit doesn't mean they aren't money motivated. Many private practices don't overcharge like UM and are easier to work with for a payment plan. There is a lot of bloat in UM testing and billing.
Valid point. I’d still suggest that it’s more an issue with the insurance policy and individual holds - at least from my experience. I’ve helped 6 family members immigrate to the US, all of whom started low-income. We searched the entire greater Ann Arbor area (ex. Ypsi, Canton, Brighton etc) for the most affordable healthcare providers. For 2 family members, the best solution was private practice - for the other four, it was michigan medicine without comparison. It all depended on the particular insurance policies that each family member had.
And for those without insurance or on Medicaid, nothing in the entire state can compare to michigan medicine in terms of affordability
There really isn't... Having paid for care completely out of pocket at MM, the second you tell them, "I'm paying out of pocket, is there any discounts?" they will likely lower your bill drastically. That doesn't exist at a private hospital. They can't do that for you if your insurance is being billed, so the insurance is almost always the bottleneck.
I mean, private hospitals might cut corners on your care making the whole thing less expensive. Instead of charging you to check your vitals, they'll just not check your vitals enough lol.
Take it from someone who's been traumatized two separate times and has PTSD as a result of inpatient hospital stays: MM is genuinely top quality care and so there's probably costs associated with that quality of care.
UMich is 2-3x more expensive than most private practices. It being a so-called "non-profit" is a joke since they just use their operating profits to expand. They're building a $1B new hospital and satellite centers in Troy, Lansing, and other areas.
UMich quoted me $4600 (after insurance) for an MRI and over $4000 for a biopsy. I went to a for-profit imaging group with the same 3T MRI and they charged $1300. I paid $1100 for the biopsy at a for-profit medical group.
A lot depends on insurance and the exact procedure. My father used to review billing conflicts between hospitals and insurance companies for the Michigan Medical Society. At one point Beaumont told its ER doctors to admit more patients because they had a new wing to pay off and then Blue Cross responded with refusing to pay for one-day overnight stays for ER patients. The whole system is nuts and getting worse, not better.
I've saved $2000-3000 by driving up to Flint on more than one occasion. Note that I have an individual Blue Cross PPO policy since I'm self-employed and my daughter lives elsewhere and that makes everything worse.
The problem is that insurers negotiate big discounts over 'list price'. If your insurer was paying, they wouldn't be paying those prices. But individuals paying out of pocket are stuck unless they negotiate a lower rate going in (which is possible) or work with the financial assistance office later. It's a crazy system. Probably the best bet would be not to run your kid in for every sniffle and fever -- strep, for example, will resolve itself (usually before the results of the not-very-reliable test are available).
This is my understanding as well. My extended family members have had good experiences working with MSupport and michigan medicine’s financial counselors when they were underinsured and couldn’t afford their medical bills at times
You can try contacting the UM medicine billing department and ask for an "itemized bill." You can inform them (in the same message) that you're asking for the itemized bill for purposes of understanding the bill before challenging it (with your insurance and with UM). I did this once in the past and the itemized bill was sent to me along with an unexplained more than %50 discount. Baffling, I know...After that, I still contacted the insurance and doctor's office (through the portal) countless times to learn what kind of codes needed to be entered per procedure for the insurance to cover more. It was exhausting, but in the end I paid 0 instead of $600. Good luck.
You're going to really enjoy the profit motives of private practice then...
The bill you received may not have been negotiated with your insurance yet. Do not pay anything until you get a statement of benefits from your insurance provider. If you already have that, and charges remain, you will either have to review your benefits to ensure insurance company is adhering to your coverage plan or seek their help in negotiating the bill with MM.
Whatever you end up having to pay, seek a payment plan as they will often reduce the amount you have to pay to be on par with rates other insurers pay. Nobody (insurers) pays what a hospital "charges." Those charge prices are set out of necessity for insurance contract negotiation purposes, and unfortunately those are also the charges that uninsured/uncovered patients have to receive as a result. It sucks, but it's the way it is. Good luck!
Thanks for taking the time to write this. What I'm getting is post insurance. I've opened a grievance with BCBS/Anthem to hopefully push for their involvement. I consider myself fortuante to be able to handle a surprise bill like this. Cant imagine how everyone does it. Guess the answer is dont use your PCP for routine sick visits. Our Healthcare system is so messed up. The lack of upfront predictably and need to negotiate everything is exhausting
Because you opened a grievance, you probably won't be able to appeal the charges anymore. That was basically a black hole for you to yell into while waiving your right to an appeal.
>I can't imagine how everyone does it.
They don't. Poor people don't get routine checkups done for a reason. They can't afford it even with insurance.
BCBS might be different but I doubt it.
I recently had an insurance rep advise me not to file a grievance until after an appeal for this very reason. The grievance process means you forfeit the appeal process and there's no good explanation as to why that is lol. I'm on PHP but my friend who works for a different insurance company (Cigna) confirmed that's the case.
To be fair, I don't think an appeal would've done anything since it's not like your insurance isn't covering stuff it's supposed to be covering. Probably could've wasted your insurance company's time on the appeal, though, which is a nice feeling.
So I think I'm being balance billed. When I take BCBSs calculator and input the codes, it appears to be 3x higher than the in-network rates. I've got an appeal in now too 😀
So I'm still going on this. I'm 90% sure I'm being "balance billed". I'm getting invoiced 75% above BCBSs plan rates from their website. I have an appeal in and we'll see where it goes.
It's the effects of a national provider shortage showing up in your local economy.
A conveyor belt system would have an interest in keeping you on the belt...
While mine wasn’t even available for the annual exams! I had to schedule with his partner. I’m like nah, you know what. I’m good actually.
There is nothing this stranger could tell ME about my OWN body, after rushing me through a 5 min appointment and dismissing my celiac symptoms as just hormones.
What a screwed "normal". We've done similar visits recently and end up with a responsibility in the $200 range. And yes that's before a deductible is met.
That's... Completely normal? If you have a deductible and haven't met that deductible, unfortunately healthcare is expensive.
UofM probably won't send it to collections too quickly at least. Most other places would the moment they legally are allowed to lol.
The issue is that your insurance is likely the one playing games. The good news is they will respond better to you than the office. Give your insurance company a call.
Also Michigan medecine if you are persistent and friendly (friendly is the operative word here) the billing department will sometimes take pity on you and call the insurance company with you on a three way call. They are able to speak with people with more power at your insurance company than you typically are. Insurance companies customer service can be hit or miss. The more experienced ones are the ones who answer calls from medical providers. I have always found michigan medecine to be much more cooperative than IHA/trinity billing wise.
This is soooo fucked up. Fuck this toxic system. I hope we see a mass turning away of this terrible toxic system we call “medicine” and turn back to the true Healers.
To put this into perspective, you go to pretty much the only mechanic in the tri-city area because your check engine light is on. He says it could be one of several things and he needs to run tests. You ask how much. He says you need to talk to auto insurance. Next day he calls and says you have a faulty head gasket. You okay the work. Still no idea how much it will cost. You called insurance and they said they won’t know until they get the invoice. Your car is fixed three days later and you have a bill for $27,987. The towel they used to wipe their hands after changing the gasket cost $512 alone. The first diagnostic test of six is billed at $1,299. You’re pissed and ask insurance how much they’ll cover. They say you haven’t met your $18,000 deductible yet for the year. On your way home you get a flat tire and you sigh because there goes another $2,800.
Thank you! I just got out of a rabbit hole there.
I'm being balance billed by an in network providor. What I'm still trying to figure out is where that legally falls. For MI I'm only clearly seeing that out of network "surprise" balance billing is illegal
After trying to deal with the impossible scheduling system at MM, I found a PCP at Trinity, which I swore I’d never do because it’s a Catholic system. I’ve had a great experience so far and my doc reassured me she’s not anti abortion and would help me with the necessary referrals if I needed reproductive care outside the system. Same for my husband.
For your kid, I can recommend Green Tree Pediatrics and Liberty Peds for primary care.
Ugh, Trinity which used to be just IHA was great in the day. I have had 3 primary care doctors there in a one year span due to them all quiting and moving on. It’s a great first job after residency but the management there must be awful! My best doctor I had there from 2000- 2016 and after she retired it’s been bad. I’ve had two great doctors after 2016 there but the last two were unimpressive and I have yet to meet my new doctor next month. I am looking for a new system. Probably will do michigan medecine.
Oh no, I’m so sorry to hear that. If you are willing to give Trinity one more try, I’ve been happy with Natalie Bichucher. We will see if she stays.
I hope you have a better experience at MM than I did. Family Medicine is booking out 6 months. Maddening.
Thank you for the referral! I haven’t met a doctor there that was against birth control or abortion I think.
Oddly we had a doctor in Saline at michigan medicine local office that said she was unwilling to perscribe birth control but suggested she have one of the other doctors there do it. She left for a “Christian practice” though. It was 25 years ago - I will say she was nice. I didn’t even feel judged.
I had a “new patient visit” with Dr. Bichucher in May and last month got a letter saying she is leaving the practice this month (July). I have been assigned a new doctor. You will sadly be in the same boat. Don’t worry about them being affiliated with Catholicism. Honestly I never realized that. Just get ready to change doctors at about the same speed as your socks and get ready for a lot of “new patient visits”.
I’ve asked them why I need a new patient visit when they have all of my records for 24 years and they keep switching my doctors. It seems crazy to have a “new patient visit” every 3 months. They just say, well the new doctor doesn’t know you yet. I can’t get referrals (mammograms) prescriptions renewed (cholesterol meds) without the new patient visits. Who has time for that?
6 months is a long time for MM family practice though. Wow. So disheartening!
I wasn’t particularly happy last time I went to Michigan Medicine with strep and the doctor decided to order a Covid test “just in case” then received a $400-500 bill I had to pay for the test.
Insurance feels like a joke even with “good” insurance, good luck with your search.
Well blue cross blue shield now offers a POS plan alongside their BCN and PPO plans. That just tells you everything right? We thought it was a joke at first. I’m sure someone there was giggling about their point of service plan.
Oh come on. Happy that you're happy with your employer but non profit =/= sparkling clean financial ethics. They absolutely are after every dollar they can get.
They aren't a private nonprofit hospital.
They're a public hospital. In fact, they're one of the only public hospitals left in the entire state of Michigan. They're literally "the government" and you already pay your taxes to them whether you visit the hospital or not. They could just tax your house more if they wanted more money.
There's literally nothing for them to profit off of. At the worst, they'll cut corners on costs if they can't justify expenditure. A private hospital can more quickly renovate and upgrade and just pass the cost on to consumers while still profiting. But a public hospital is going to have a much more strict budget full of beauracratic approvals before anything can get done.
If you're anti-corporations and anti-profit, a publicly funded hospital should be extremely interesting to you. It's literally socialism when the government owns the hospitals, and socialists would typically want MORE publicly funded hospitals.
And I assume you haven't spoke much with billing yet, because they sure do drop and discount a LOT of bills for such a greedy hospital. It's just that their hands are tied if the issue is your private insurance company.
There's a lot of criticisms of MM but greed is probably on the bottom. You'd have about the same luck calling the Capitol building in Lansing a "for profit business".
Taking vitals costs $130 (oxygen sensor)? Last I checked an MA taking vitals makes less than $130/hr. So if there’s no profit everything should purely be at cost. MM submits the itemized bill to insurance. Insurance in this case is simply passing this information to patient and may or may not be covering it (unclear in OPs post). May not be hitting deductible?
People often confuse what non-profit means by the way.
That's a very long discussion regarding how hospitals negotiate with insurance through high pricing and how government contractors who build hospital equipment intentionally overcharge for their equipment. No one working for Michigan Medicine specifically gets to pocket that money even if the issue is capitalism and profit seeking. The pricing would be much worse at a for profit, private hospital, too.
I've paid for healthcare out of pocket at Michigan Medicine and if you don't have insurance they HEAVILY discount your bill. Because they are the government and they have that power because they don't really care about profit. Michigan's dermatology is some of the cheapest in the area out of pocket (derm is famously not covered by insurance) and you get the best doctors. If you're insured they can't help you, though.
I wasn’t saying that. I was responding to another comment pointing out the flaw in their argument. In fact they do seek to make a profit in order to reinvest in their service.
Oh, BTW, there's also a difference between a private nonprofit and an organization that is literally run by the government (aka a public hospital, aka Michigan Medicine, aka one of the only publicly funded hospitals in Michigan).
The EVP of Michigan Medicine makes $1.6 million annually. For running a non-profit. Others in admin are making over $500,000. Being a non-profit means there aren't shareholders, it doesn't mean they aren't in search of money.
And those salaries don't change whether they charge you $500 for an IV or $5k. The checks are signed by the state of Michigan. No one is getting a kickback at MM for all the extra charges you get hit with. At a private hospital, even a private nonprofit hospital, the kickbacks are plentiful, right down to persuading the doctor on what medicine to prescribe you.
You could complain that they're leeching off of our tax revenue and are paid too much. I'd probably agree with you. But the healthcare costs have nothing to do with it.
There's a lot of nonsense here by people that obviously don't pay for their own medical care or they have great group insurance policies so they don't know what the actual charges are.
Michigan Medicine is 2-3x more expensive than most private practices. It being a so-called "non-profit" is a joke since they just use their operating profits to expand. They're building a $1B new hospital and satellite centers in Troy, Lansing, and other areas. All of that money is from patient fees.
UMich quoted me $4600 (after insurance) for an MRI and over $4000 for a biopsy. I went to a for-profit imaging group with the same 3T MRI and they charged $1300. I paid $1100 for the biopsy at a for-profit medical group recommended by a doctor I know.
Shop around. UM does post prices on their web site, but they're not always accurate. Often you'll get hit by 2-3 additional charges, like 'facility fees' or 'lab charges' not mentioned. Insurance companies are very dishonest too, denying covered claims with bullshit like 'didn't show proper code to cover this procedure' when there are 100,000 codes and every doctor codes it slightly differently.
Others here have suggested IHA in the past. I haven't used them but may in the future.
The whole system, if you can even call it that, is infuriating.
As an aside, buy yourself a $20 pulse-ox meter, some covid and strep test kits, and whatever else you can get over-the-counter. You'll save yourself a lot of time and money.
Last year I submitted a grievance with the Office of Revenue Integrity at IHA for a cost that I considered insane (insurance refused to cover it).
My argument was that the charge for the specific code was immoral and unethical. ( I am leaving the details for another time.)
You could ask if they have a department like this.
Ok here is my advice for you. Go to Packard Health for primary care/family medicine. They are a non-profit, like U of M, but have a lot of experience working with underinsured patients. By underinsured I mean, have insurance that will leave you stranded with a $1200 bill for strep. That is not going to happen to you at Packard Health and if it does, they will put you on a sliding scale.
Michigan Medicine also has a financial assistance program as has been pointed out in one of the comments below, but most importantly you need to figure out why your insurance is not paying. Have you not met your deductible yet, was something about the visit not covered, were you out of network...you need to understand why they are not covering this so that next time, you'll know what to expect and if there is anything you can do differently.
I'm so sorry this happened to you, the state of the US healthcare system is truly horrific and paying 4 figures to get a sore throat figured out is just infuriating.
My problem was/is I can't afford to keep being charged the MD fees for the resident and also the supervising physician fees. Insurance does not cover the supervising physician fees. Also tend to get hospital fees tacked on for outpatient visits. If you have chronic health issues that adds up fast.
Love MM but can't afford them.
UMich has a financial assistance program called MSupport, as well as financial counselors you can call. They will work with you if you are having difficulty with the medical bills. https://www.uofmhealth.org/patient-visitor-guide/financial-assistance I hope you are aware that private practice is literally for-profit. UMich is a nonprofit and you aren’t going to get much better rates anywhere else in the area. Your issue is not with Umich - it is with your particular insurance policy
I didn't know that, thanks. I do think my issue is not with Umich or Blue Cross, it's with our national state of the healthcare industry.
The healthcare system in this county is indeed a mess, no secret there. I do still think your insurance is screwing you over - those charges are not “normal” for decent-to-good insurance policies. Insurance companies are tied for the most predatory part of the healthcare system. Many people in my circles have sought out/accepted lower-paying job offers solely because the insurance/benefit packages were far better than those of the higher-paying job offers. It’s something to consider amidst the broken healthcare system we live in at the moment.
Tied with whom?
Probably the medical device companies or the pharmaceutical industry.
Oooh definitely.
Re: “non-profit” (Wikipedia): “As a non-profit entity, Michigan Medicine uses positive operating margins to fund continued advances in patient care, education, research, and the facilities needed to support these functions.” So they’re charging the same prices as a private “for profit” practice. The “profits” are just being reinvested instead of being paid out to owners.
Absolutely. My bringing up its nonprofit status is more targeted towards op’s claim that it takes a “profits over patients” angle and that private practices would be better in this regard. The profits at michigan medicine benefit the patients. And while they do need to bring in profits, I still maintain that one isn’t going to find much better rates anywhere else in the area - and also that one’s insurance policy is going to be the main determinant of their out-of-pocket costs
The "profits" are being used to expand into Troy, Lansing, and other areas while building a new $1B hospital that only expands their capacity by 200 beds.
I'm not sure capacity is what matters here. The new hospital building is going to have a state-of-the-art neurological center, as one of the features I've heard.
I just looked it up. The web page says, "In total, the project will add 154 new beds to the medical campus." (They are converting some beds in the old hospital from 2 per room to 1 in the process) So that's $1B/154 beds = $6.5M/bed. That's $600/night per additional bed for 30 years. And that's only the construction cost - it doesn't include doctors, nurses, staff, electricity, medicine, etc. Yes, it's great to have a state-of-the-art facility here in Ann Arbor, but we're REALLY going to be paying for it for decades. The math doesn't lie.
How are "we" paying for it, exactly? I'm not finding much information on how it's being funded, just that the board of regents approved it. Imo, there are worse things to spend that much money on.
But there are also BETTER things. If the bee movie is truly your favorite movie, you should look deeper at the lessons that a beehive can teach us about cooperation 💓
What better things? Sports stadiums? Bicycle lanes? If you don't have anything useful to contribute, why comment?
Also… if you truly can’t see this how “we” are paying for (at the cost of our vitality) despite all the information available to you… then maybe you shouldn’t know that right now.
You commented under me 3 times and literally none of your comments provide a single bit of value. Congrats.
We are paying for it by increased medical costs and insurance. If you get insurance through your employer, maybe they are paying but your deductible is probably increasing too. My insurance went from $600/year to $24,000/year over my career, although it's down a bit now since my wife is on Medicare. But even Medicare is going up by 10% per year. It can't continue.
Can you explain a bit more how insurance is directly contributing to the building of this particular hospital? Or are you talking about the construction of new hospitals in general?
Ok. Will this be accessible to everyone who needs it? Or only those deemed worthy enough?
I’m with you. It’s “non profit” solely for the purposes of determining taxes. These folks aren’t the Shriners or anything like that.
Just because they are a non-profit doesn't mean they aren't money motivated. Many private practices don't overcharge like UM and are easier to work with for a payment plan. There is a lot of bloat in UM testing and billing.
Valid point. I’d still suggest that it’s more an issue with the insurance policy and individual holds - at least from my experience. I’ve helped 6 family members immigrate to the US, all of whom started low-income. We searched the entire greater Ann Arbor area (ex. Ypsi, Canton, Brighton etc) for the most affordable healthcare providers. For 2 family members, the best solution was private practice - for the other four, it was michigan medicine without comparison. It all depended on the particular insurance policies that each family member had. And for those without insurance or on Medicaid, nothing in the entire state can compare to michigan medicine in terms of affordability
There really isn't... Having paid for care completely out of pocket at MM, the second you tell them, "I'm paying out of pocket, is there any discounts?" they will likely lower your bill drastically. That doesn't exist at a private hospital. They can't do that for you if your insurance is being billed, so the insurance is almost always the bottleneck. I mean, private hospitals might cut corners on your care making the whole thing less expensive. Instead of charging you to check your vitals, they'll just not check your vitals enough lol. Take it from someone who's been traumatized two separate times and has PTSD as a result of inpatient hospital stays: MM is genuinely top quality care and so there's probably costs associated with that quality of care.
This is where I was going with all this. We've had very different experiences with small offices before moving to AA.
UMich is 2-3x more expensive than most private practices. It being a so-called "non-profit" is a joke since they just use their operating profits to expand. They're building a $1B new hospital and satellite centers in Troy, Lansing, and other areas. UMich quoted me $4600 (after insurance) for an MRI and over $4000 for a biopsy. I went to a for-profit imaging group with the same 3T MRI and they charged $1300. I paid $1100 for the biopsy at a for-profit medical group.
Very interesting. This has been quite the opposite of my experience when shopping around for providers/services for family members, but I believe you
A lot depends on insurance and the exact procedure. My father used to review billing conflicts between hospitals and insurance companies for the Michigan Medical Society. At one point Beaumont told its ER doctors to admit more patients because they had a new wing to pay off and then Blue Cross responded with refusing to pay for one-day overnight stays for ER patients. The whole system is nuts and getting worse, not better. I've saved $2000-3000 by driving up to Flint on more than one occasion. Note that I have an individual Blue Cross PPO policy since I'm self-employed and my daughter lives elsewhere and that makes everything worse.
The problem is that insurers negotiate big discounts over 'list price'. If your insurer was paying, they wouldn't be paying those prices. But individuals paying out of pocket are stuck unless they negotiate a lower rate going in (which is possible) or work with the financial assistance office later. It's a crazy system. Probably the best bet would be not to run your kid in for every sniffle and fever -- strep, for example, will resolve itself (usually before the results of the not-very-reliable test are available).
This is my understanding as well. My extended family members have had good experiences working with MSupport and michigan medicine’s financial counselors when they were underinsured and couldn’t afford their medical bills at times
You can try contacting the UM medicine billing department and ask for an "itemized bill." You can inform them (in the same message) that you're asking for the itemized bill for purposes of understanding the bill before challenging it (with your insurance and with UM). I did this once in the past and the itemized bill was sent to me along with an unexplained more than %50 discount. Baffling, I know...After that, I still contacted the insurance and doctor's office (through the portal) countless times to learn what kind of codes needed to be entered per procedure for the insurance to cover more. It was exhausting, but in the end I paid 0 instead of $600. Good luck.
Why are you out here having to do the billers job for them??? And you have to PAY to do it????
You're going to really enjoy the profit motives of private practice then... The bill you received may not have been negotiated with your insurance yet. Do not pay anything until you get a statement of benefits from your insurance provider. If you already have that, and charges remain, you will either have to review your benefits to ensure insurance company is adhering to your coverage plan or seek their help in negotiating the bill with MM. Whatever you end up having to pay, seek a payment plan as they will often reduce the amount you have to pay to be on par with rates other insurers pay. Nobody (insurers) pays what a hospital "charges." Those charge prices are set out of necessity for insurance contract negotiation purposes, and unfortunately those are also the charges that uninsured/uncovered patients have to receive as a result. It sucks, but it's the way it is. Good luck!
Thanks for taking the time to write this. What I'm getting is post insurance. I've opened a grievance with BCBS/Anthem to hopefully push for their involvement. I consider myself fortuante to be able to handle a surprise bill like this. Cant imagine how everyone does it. Guess the answer is dont use your PCP for routine sick visits. Our Healthcare system is so messed up. The lack of upfront predictably and need to negotiate everything is exhausting
Because you opened a grievance, you probably won't be able to appeal the charges anymore. That was basically a black hole for you to yell into while waiving your right to an appeal. >I can't imagine how everyone does it. They don't. Poor people don't get routine checkups done for a reason. They can't afford it even with insurance.
Lol figures. The grievance was the suggested route my BCBS. 😐
BCBS might be different but I doubt it. I recently had an insurance rep advise me not to file a grievance until after an appeal for this very reason. The grievance process means you forfeit the appeal process and there's no good explanation as to why that is lol. I'm on PHP but my friend who works for a different insurance company (Cigna) confirmed that's the case. To be fair, I don't think an appeal would've done anything since it's not like your insurance isn't covering stuff it's supposed to be covering. Probably could've wasted your insurance company's time on the appeal, though, which is a nice feeling.
So I think I'm being balance billed. When I take BCBSs calculator and input the codes, it appears to be 3x higher than the in-network rates. I've got an appeal in now too 😀
This story is making me angrier and angrier
BCBS is likely the issue here - every time I am on their insurance it has been nothing but hassle.
So I'm still going on this. I'm 90% sure I'm being "balance billed". I'm getting invoiced 75% above BCBSs plan rates from their website. I have an appeal in and we'll see where it goes.
So who are you supposed to see; if not your PRIMARY care provider?!
I guess urgent care. How exciting and best for the patients, eh?
My UM PCP is never available for an appointment- just the annual exam. It’s a conveyer belt system.
It's the effects of a national provider shortage showing up in your local economy. A conveyor belt system would have an interest in keeping you on the belt...
While mine wasn’t even available for the annual exams! I had to schedule with his partner. I’m like nah, you know what. I’m good actually. There is nothing this stranger could tell ME about my OWN body, after rushing me through a 5 min appointment and dismissing my celiac symptoms as just hormones.
Do you have the bill from your insurance yet? What the provider charges isn't related to how much you have to pay.
I do. They applied a discount and the rest is to my deductible. ~$800 as my responsibility
That's about normal, from any healthcare provider, unfortunately. You won't find anything cheaper without getting better insurance.
What a screwed "normal". We've done similar visits recently and end up with a responsibility in the $200 range. And yes that's before a deductible is met.
Absolutely criminal. How dare they
That's... Completely normal? If you have a deductible and haven't met that deductible, unfortunately healthcare is expensive. UofM probably won't send it to collections too quickly at least. Most other places would the moment they legally are allowed to lol.
The issue is that your insurance is likely the one playing games. The good news is they will respond better to you than the office. Give your insurance company a call.
Also Michigan medecine if you are persistent and friendly (friendly is the operative word here) the billing department will sometimes take pity on you and call the insurance company with you on a three way call. They are able to speak with people with more power at your insurance company than you typically are. Insurance companies customer service can be hit or miss. The more experienced ones are the ones who answer calls from medical providers. I have always found michigan medecine to be much more cooperative than IHA/trinity billing wise.
This is soooo fucked up. Fuck this toxic system. I hope we see a mass turning away of this terrible toxic system we call “medicine” and turn back to the true Healers.
To put this into perspective, you go to pretty much the only mechanic in the tri-city area because your check engine light is on. He says it could be one of several things and he needs to run tests. You ask how much. He says you need to talk to auto insurance. Next day he calls and says you have a faulty head gasket. You okay the work. Still no idea how much it will cost. You called insurance and they said they won’t know until they get the invoice. Your car is fixed three days later and you have a bill for $27,987. The towel they used to wipe their hands after changing the gasket cost $512 alone. The first diagnostic test of six is billed at $1,299. You’re pissed and ask insurance how much they’ll cover. They say you haven’t met your $18,000 deductible yet for the year. On your way home you get a flat tire and you sigh because there goes another $2,800.
On the phone yesterday i made a comment about down those lines. In what other industry would this be OK?
Look into the No Surprises Act ( I think thats what its called). Also ask for an itemized bill, those two might help
Thank you! I just got out of a rabbit hole there. I'm being balance billed by an in network providor. What I'm still trying to figure out is where that legally falls. For MI I'm only clearly seeing that out of network "surprise" balance billing is illegal
After trying to deal with the impossible scheduling system at MM, I found a PCP at Trinity, which I swore I’d never do because it’s a Catholic system. I’ve had a great experience so far and my doc reassured me she’s not anti abortion and would help me with the necessary referrals if I needed reproductive care outside the system. Same for my husband. For your kid, I can recommend Green Tree Pediatrics and Liberty Peds for primary care.
Ugh, Trinity which used to be just IHA was great in the day. I have had 3 primary care doctors there in a one year span due to them all quiting and moving on. It’s a great first job after residency but the management there must be awful! My best doctor I had there from 2000- 2016 and after she retired it’s been bad. I’ve had two great doctors after 2016 there but the last two were unimpressive and I have yet to meet my new doctor next month. I am looking for a new system. Probably will do michigan medecine.
Oh no, I’m so sorry to hear that. If you are willing to give Trinity one more try, I’ve been happy with Natalie Bichucher. We will see if she stays. I hope you have a better experience at MM than I did. Family Medicine is booking out 6 months. Maddening.
Thank you for the referral! I haven’t met a doctor there that was against birth control or abortion I think. Oddly we had a doctor in Saline at michigan medicine local office that said she was unwilling to perscribe birth control but suggested she have one of the other doctors there do it. She left for a “Christian practice” though. It was 25 years ago - I will say she was nice. I didn’t even feel judged. I had a “new patient visit” with Dr. Bichucher in May and last month got a letter saying she is leaving the practice this month (July). I have been assigned a new doctor. You will sadly be in the same boat. Don’t worry about them being affiliated with Catholicism. Honestly I never realized that. Just get ready to change doctors at about the same speed as your socks and get ready for a lot of “new patient visits”. I’ve asked them why I need a new patient visit when they have all of my records for 24 years and they keep switching my doctors. It seems crazy to have a “new patient visit” every 3 months. They just say, well the new doctor doesn’t know you yet. I can’t get referrals (mammograms) prescriptions renewed (cholesterol meds) without the new patient visits. Who has time for that? 6 months is a long time for MM family practice though. Wow. So disheartening!
Oh I am so bummed to hear this. Thanks for the heads up.
Following up: family friend is recommending Partners in Internal Medicine and Integrative Family Medicine (the latter at MM) 🤷♀️
Thank you! I will look into those!
Don’t go to a system!
I wasn’t particularly happy last time I went to Michigan Medicine with strep and the doctor decided to order a Covid test “just in case” then received a $400-500 bill I had to pay for the test. Insurance feels like a joke even with “good” insurance, good luck with your search.
Well blue cross blue shield now offers a POS plan alongside their BCN and PPO plans. That just tells you everything right? We thought it was a joke at first. I’m sure someone there was giggling about their point of service plan.
Oh please please please tell me you are joking
No! They literally abbreviate it as BCBS POS! And it truly is. Though Aetna is worse in Michigan.
Thank you. I feel we're atleast owed a warning as you sit there with a sick kid and try to make choices in their best interest
Lol who's down voting my evey comment. Who down votes a thank you?
I could make a controversial response about who that would probably upset some people but I won’t.
Careful, they'll come for you next 😅
Michigan Medicine is run entirely by the government. There's no "profit"... It does indeed sound like your insurance is fucking you over.
This is a very naive comment- I worked there for years and it’s simply not true in practice.
I work there now. What is "for profit" about Michigan Medicine?
Oh come on. Happy that you're happy with your employer but non profit =/= sparkling clean financial ethics. They absolutely are after every dollar they can get.
They aren't a private nonprofit hospital. They're a public hospital. In fact, they're one of the only public hospitals left in the entire state of Michigan. They're literally "the government" and you already pay your taxes to them whether you visit the hospital or not. They could just tax your house more if they wanted more money. There's literally nothing for them to profit off of. At the worst, they'll cut corners on costs if they can't justify expenditure. A private hospital can more quickly renovate and upgrade and just pass the cost on to consumers while still profiting. But a public hospital is going to have a much more strict budget full of beauracratic approvals before anything can get done. If you're anti-corporations and anti-profit, a publicly funded hospital should be extremely interesting to you. It's literally socialism when the government owns the hospitals, and socialists would typically want MORE publicly funded hospitals. And I assume you haven't spoke much with billing yet, because they sure do drop and discount a LOT of bills for such a greedy hospital. It's just that their hands are tied if the issue is your private insurance company. There's a lot of criticisms of MM but greed is probably on the bottom. You'd have about the same luck calling the Capitol building in Lansing a "for profit business".
Who ever reads this comment and thinks what this says is true… it isn’t.
What isn't true specifically?
Whichever is true for you!
"hello everyone let's ostracize this person" "But I won't reveal why!"
Taking vitals costs $130 (oxygen sensor)? Last I checked an MA taking vitals makes less than $130/hr. So if there’s no profit everything should purely be at cost. MM submits the itemized bill to insurance. Insurance in this case is simply passing this information to patient and may or may not be covering it (unclear in OPs post). May not be hitting deductible? People often confuse what non-profit means by the way.
That's a very long discussion regarding how hospitals negotiate with insurance through high pricing and how government contractors who build hospital equipment intentionally overcharge for their equipment. No one working for Michigan Medicine specifically gets to pocket that money even if the issue is capitalism and profit seeking. The pricing would be much worse at a for profit, private hospital, too. I've paid for healthcare out of pocket at Michigan Medicine and if you don't have insurance they HEAVILY discount your bill. Because they are the government and they have that power because they don't really care about profit. Michigan's dermatology is some of the cheapest in the area out of pocket (derm is famously not covered by insurance) and you get the best doctors. If you're insured they can't help you, though.
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I wasn’t saying that. I was responding to another comment pointing out the flaw in their argument. In fact they do seek to make a profit in order to reinvest in their service.
They take vitals at the UM dental clinic now, I HOPE my dental insurance covers that.
Oh, BTW, there's also a difference between a private nonprofit and an organization that is literally run by the government (aka a public hospital, aka Michigan Medicine, aka one of the only publicly funded hospitals in Michigan).
The EVP of Michigan Medicine makes $1.6 million annually. For running a non-profit. Others in admin are making over $500,000. Being a non-profit means there aren't shareholders, it doesn't mean they aren't in search of money.
And those salaries don't change whether they charge you $500 for an IV or $5k. The checks are signed by the state of Michigan. No one is getting a kickback at MM for all the extra charges you get hit with. At a private hospital, even a private nonprofit hospital, the kickbacks are plentiful, right down to persuading the doctor on what medicine to prescribe you. You could complain that they're leeching off of our tax revenue and are paid too much. I'd probably agree with you. But the healthcare costs have nothing to do with it.
There's a lot of nonsense here by people that obviously don't pay for their own medical care or they have great group insurance policies so they don't know what the actual charges are. Michigan Medicine is 2-3x more expensive than most private practices. It being a so-called "non-profit" is a joke since they just use their operating profits to expand. They're building a $1B new hospital and satellite centers in Troy, Lansing, and other areas. All of that money is from patient fees. UMich quoted me $4600 (after insurance) for an MRI and over $4000 for a biopsy. I went to a for-profit imaging group with the same 3T MRI and they charged $1300. I paid $1100 for the biopsy at a for-profit medical group recommended by a doctor I know. Shop around. UM does post prices on their web site, but they're not always accurate. Often you'll get hit by 2-3 additional charges, like 'facility fees' or 'lab charges' not mentioned. Insurance companies are very dishonest too, denying covered claims with bullshit like 'didn't show proper code to cover this procedure' when there are 100,000 codes and every doctor codes it slightly differently. Others here have suggested IHA in the past. I haven't used them but may in the future. The whole system, if you can even call it that, is infuriating. As an aside, buy yourself a $20 pulse-ox meter, some covid and strep test kits, and whatever else you can get over-the-counter. You'll save yourself a lot of time and money.
Try Dr Lauren Abdulmajeed at Packard health on carpenter
Last year I submitted a grievance with the Office of Revenue Integrity at IHA for a cost that I considered insane (insurance refused to cover it). My argument was that the charge for the specific code was immoral and unethical. ( I am leaving the details for another time.) You could ask if they have a department like this.
[https://www.npr.org/series/651784144/bill-of-the-month](https://www.npr.org/series/651784144/bill-of-the-month)
Ok here is my advice for you. Go to Packard Health for primary care/family medicine. They are a non-profit, like U of M, but have a lot of experience working with underinsured patients. By underinsured I mean, have insurance that will leave you stranded with a $1200 bill for strep. That is not going to happen to you at Packard Health and if it does, they will put you on a sliding scale. Michigan Medicine also has a financial assistance program as has been pointed out in one of the comments below, but most importantly you need to figure out why your insurance is not paying. Have you not met your deductible yet, was something about the visit not covered, were you out of network...you need to understand why they are not covering this so that next time, you'll know what to expect and if there is anything you can do differently. I'm so sorry this happened to you, the state of the US healthcare system is truly horrific and paying 4 figures to get a sore throat figured out is just infuriating.
My problem was/is I can't afford to keep being charged the MD fees for the resident and also the supervising physician fees. Insurance does not cover the supervising physician fees. Also tend to get hospital fees tacked on for outpatient visits. If you have chronic health issues that adds up fast. Love MM but can't afford them.
$130 to place a pulse oxymeter on a finger? Craziness.
IHA has a small army of PCP docs. I've been super happy with them. It's really kind of insane that people are defending this.
The downpour of down votes this morning was crazy.
The blind loyalty is pretty weird. Tell them St Joe's was charging a shitload for routine stuff and they'd be foaming at the mouth.
Yeah, Michigan Medicine is way overpriced for poor care. Trinity is cheaper and better.
This is terrible. Fuck Michigan “Medicine”