I've always wanted to add a clause to those consent forms stating that my consent is conditional to the provider being in-network for the insurance information I provided the hospital. It is their responsibility to make that determination before they start treatment. If they provide treatment and find that they're not in network, then they forgo the right to bill for that service.
A great alternative strategy is to structure your finances so that it's impossible for creditors to seize your assets - that way, your practical liability is limited to the up-front costs. Which, by being up-front, you can actually reason about and make informed decisions on.
This is less difficult than it sounds. Move to Texas, and keep all your assets in retirement accounts, home equity in your primary residence, and possibly annuities if you've made too much money for that all to hold everything. Note that this should be done before possibly incurring debts.
I wouldn't describe that strategy as great. Having a desired effect, sure, but the tradeoffs are pretty nasty. And doesn't it create potential situations where you require a lawyer? And what if the laws in Texas change, what then?
Wouldn't it be easier instead for healthcare billing not to contain so many gotchas?
>And doesn't it create potential situations where you require a lawyer?
Sure, but improving your BATNA helps your negotiations even if you don't need to exercise it. The bill gets handled with opening a dispute and sending a "give me documentation for an implied regulatory complaint" letter. If things devolve into a lawsuit or threat thereof, I tell them my financial situation and what they can expect from a lawsuit and offer to settle for a nominal amount.
>Wouldn't it be easier instead for healthcare billing not to contain so many gotchas?
Well yeah, but I can't change the healthcare billing system, while I can change how my finances are structured.
What’s special about Texas? And how can you put everything in retirement account?? 401k is 19k/year and IRA is 5k? What do you do with the rest of your money? Do you setup and LLC or trust? Can you elaborate?
Debt collection follows a combination of state and federal law, and Texas state law is unusually favorable to debtors. Specific important pieces:
1. Your primary residence is protected from forced sale to satisfy general creditors, up to 10 acres (urban) or 100 acres (rural).
2. Garnishment of wages is limited to certain special circumstances, such as nonpayment of taxes or child support.
3. IRAs have unlimited protection from creditors (other states have a cap).
>And how can you put everything in retirement account?? 401k is 19k/year and IRA is 5k? What do you do with the rest of your money?
Home equity is a very significant part of this. If you borrow $300k to buy a $400k home, the $100k you have tied up in your house is protected from creditors. If you have an extra $50k you want to save, you pay down your mortgage more aggressively and creditors can no longer come after it.
Oh, also, from reading into things, it looks like if you buy a 2 to 4 unit house, then even the non-owner-occupied units remain protected. So you can extend things somewhat that way by having a more expensive home that cashflows.
>Do you setup and LLC or trust?
LLCs are more for business-related liabilities, and trusts are weird and expensive enough that I haven't looked into them. Besides which, there's a perfectly reasonable alternative to a trust - annuity and insurance products. Both their value and payments to you are exempt from attachment and seizure in Texas, again with the exception of child support payments and "fraudulent transfers" made after incurring the debt. So essentially, if an insurance company is holding your money and giving it back to you in a structured way, creditors have a really hard time getting at it.
You can likely actually swing it between accessing IRA funds, having a paid-off duplex/triplex/quadplex, and purchasing an annuity or the like. Wouldn't lose all that much efficiency, depending on things.
> A great alternative strategy is to structure your finances so that it's impossible for creditors to seize your assets
It is absolute insanity that this is even a thing to consider.
The funniest thing about it is that if you do this, you are effectively socializing your personal losses and letting everyone else insured through your provider bear the cost for your healthcare. If that's not an argument for actually socializing healthcare costs for everyone, I don't know what is.
If I could cap my downside risk from medical events through insurance, I would do that instead. And this is not a replacement for insurance, since many medical providers will refuse to provide non-emergency care if they didn't expect that they could bill my insurance for services rendered.
But, unfortunately, it's currently impossible to set a maximum price you could wind up owing due to receiving medical care. Any provider you go to could end up incurring out-of-network charges and wind up balance billing you. The only fix is to cap the actual damage of creditor judgements in general.
> But, unfortunately, it's currently impossible to set a maximum price you could wind up owing due to receiving medical care.
Of course, because demand for healthcare is infinite, so you could wind up costing the insurance company an infinite amount of money. And if their expenses are uncapped, they're not going to cap how much you can pay them.
And if they cap their expenses on your behalf, it's not really insurance, it's just a shitty payment plan.
I misspoke a little: it's impossible to set a maximum price that the 95th percentile household can afford. A single medical event can bankrupt households but not the state of California.
imgabe just said in network not that the claim gets accepted. There's been a couple cases where not everyone administering as part of the procedure was in network so there's a surprise bill for one part [0]. You can do all the right homework to make sure the principal people involved are in network and still get screwed!
If the procedure is not covered it doesn't matter if its in-network. You will face the same issue: the provider doesn't know if he will get paid from insurance until at least 3 weeks later.
