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by ChuckMcM 3064 days ago
How do you come to that conclusion? I've seen a number of articles and cases like [1] where a company decides to charge apparently "what ever it wants" and the insurance company said "fine" and paid it. This article[2] talks about the wide range of prices for the exact same procedure within the same area. Is it your understanding that each of those different doctors justified their costs and the insurance company validated them?

[1] https://www.law360.com/articles/940691/fla-compounding-pharm...

[2] https://www.usatoday.com/story/news/politics/2016/04/27/huge...

1 comments

Each doctor offers hundreds of services/procedures. Each one has a different price. The insurance company needs a certain number of doctors in the network to be competitive and they can't really have hard cutoffs for every single item. It's not that surprising that there are outliers.

Additionally, lots of doctors often bill incorrectly on purpose so that a particular services/procedure gets covered, so I am not sure we should keep "justified" and "validated" in these discussions.