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The NHS 'is the world's best healthcare system'....

The NHS 'is the world's best healthcare system'....

Old Jul 9th 2014, 4:47 pm
  #166  
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Default Re: The NHS 'is the world's best healthcare system'....

Originally Posted by hungryhorace View Post
Would this have been the case with your wife's scan do you think?
No.

They would have done the scan, submitted the bill, insurance wouldn't pay, we would get the bill, we would then kick up a fuss and they would sell it on to collections and cause more fuss.
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Old Jul 9th 2014, 4:52 pm
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Default Re: The NHS 'is the world's best healthcare system'....

Originally Posted by Bob View Post
No.

They would have done the scan, submitted the bill, insurance wouldn't pay, we would get the bill, we would then kick up a fuss and they would sell it on to collections and cause more fuss.
Were they an out of network provider? I know with my insurance that if an in network provider has a bill declined they are prohibited from submitting it to the patient for payment. Maybe different insurers have different rules?
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Old Jul 9th 2014, 4:58 pm
  #168  
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Default Re: The NHS 'is the world's best healthcare system'....

Plenty of examples here to suggest that often the can and will obtain reimbursement.
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Old Jul 9th 2014, 5:28 pm
  #169  
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Default Re: The NHS 'is the world's best healthcare system'....

Originally Posted by hungryhorace View Post
Were they an out of network provider? I know with my insurance that if an in network provider has a bill declined they are prohibited from submitting it to the patient for payment. Maybe different insurers have different rules?
No, they were in network, but only x number of scans offered within y period of procedure.

The money game is a bit of a nightmare...you really do need to know what and who is covered...but that's often easier said than done as you're often not in a great position to shop around or bargain with when it's a bit of an emergency or when you're recovering and they know that.
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Old Jul 9th 2014, 5:38 pm
  #170  
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Default Re: The NHS 'is the world's best healthcare system'....

Originally Posted by Boiler View Post
Plenty of examples here to suggest that often the can and will obtain reimbursement.
I am pleased my insurer bars them from doing so. Here's an extract from my EOB:

"Message Code: 5S
Message Description: This Charge Is Denied. The Plan Considers This Procedure To Be Experimental Or Investigative. Unless The Member Has Executed A Valid Waiver, Prior To Service(S) Rendered, The Member May Not Be Billed."
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Old Jul 9th 2014, 5:39 pm
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Default Re: The NHS 'is the world's best healthcare system'....

Valid waiver, nuff said.
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Old Jul 9th 2014, 5:46 pm
  #172  
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Default Re: The NHS 'is the world's best healthcare system'....

Originally Posted by Boiler View Post
Valid waiver, nuff said.
Refuse to sign the waiver then?
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Old Jul 10th 2014, 12:23 am
  #173  
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Default Re: The NHS 'is the world's best healthcare system'....

Originally Posted by hungryhorace View Post
Refuse to sign the waiver then?
Would they still provide you their services if they don't have a waiver signed to get paid for it in the event insurance says no?
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Old Jul 10th 2014, 1:20 am
  #174  
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Default Re: The NHS 'is the world's best healthcare system'....

Originally Posted by Jsmth321 View Post
Would they still provide you their services if they don't have a waiver signed to get paid for it in the event insurance says no?
I can't answer that. I know the specialist I saw didn't ask me to sign anything along those lines.
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Old Jul 10th 2014, 1:24 am
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Default Re: The NHS 'is the world's best healthcare system'....

Will you be have enough time and focus in this sort of situation?
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Old Jul 10th 2014, 1:26 am
  #176  
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Default Re: The NHS 'is the world's best healthcare system'....

Originally Posted by hungryhorace View Post
I am pleased my insurer bars them from doing so. Here's an extract from my EOB:

"Message Code: 5S
Message Description: This Charge Is Denied. The Plan Considers This Procedure To Be Experimental Or Investigative. Unless The Member Has Executed A Valid Waiver, Prior To Service(S) Rendered, The Member May Not Be Billed."
I suspect if you read the fine print, it will say that the doctor has to get pre-approval for certain procedures and if he doesn't you will be held responsible.

In other words, you can't just go and get a "nose job" or even a "mole" removed if it is not medically necessary. In the case of scans, the insurance company has made a determination that anything beyond a specific number is not medically necessary and probably having a monthly checkup when you aren't sick is also not medially necessary.
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Old Jul 12th 2014, 8:56 am
  #177  
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Default Re: The NHS 'is the world's best healthcare system'....

From the Telegraph.
The NHS - Britain's national religion - doesn’t have a prayer - Telegraph
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Old Jul 12th 2014, 1:23 pm
  #178  
 
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Default Re: The NHS 'is the world's best healthcare system'....

Originally Posted by Beaverstate View Post
For those who don't want to read the whole article, or who have blocked access to telegraph.co.uk, the last three paragraphs are as follows:
[The article foresees some limited charging for services as inevitable] ..... This is part-privatisation, and no doubt where we will end up. Throwing ever greater sums of public money at healthcare is not, and cannot be, the way forward even if the political consensus for it could be found.

Demand is a bottomless pit. If provision is seen to be effectively free at the point of delivery, it can never be sated.

There is no limit to what doctors can, and will, spend attempting to keep people alive. The older society becomes, the more expensive it gets. If a publicly funded NHS is to survive, some way of capping the demands that are put on it, leaving the rest to private provision, has to be found. Ethically, and morally, this is a much bigger challenge than the politically heated debate around largely futile NHS reform. Yet it must eventually be faced.
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Old Jul 12th 2014, 1:40 pm
  #179  
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Default Re: The NHS 'is the world's best healthcare system'....

I suppose this should have a spoiler alert to protect those members who are either a.) very naiive or b.) Under the age of 10.

Spoiler:
If the NHS is our national religon, the article is the equivalent of being told father christmas doesn't actually exist: which may be true, but quite a large cohort of people don't want to know the truth
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Old Jul 12th 2014, 1:52 pm
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Default Re: The NHS 'is the world's best healthcare system'....

Originally Posted by steveq View Post
I suppose this should have a spoiler alert to protect those members who are either a.) very naiive or b.) Under the age of 10.

Spoiler:
If the NHS is our national religon, the article is the equivalent of being told father christmas doesn't actually exist: which may be true, but quite a large cohort of people don't want to know the truth
The government doesn't have an unlimited amount of money to spend on "free" healthcare?
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