Jupiter Medical Center Complaint - Price Gouging - Hospital Outpatient

Review by limey1 on 2007-04-09
JUPITER, FLORIDA -- I had two operations at Jupiter Medical Center last year. My insurance company paid $8,000.00 for the first one.

My Insurance company would not pay the hospital for the second operation. Jupiter Medical Center billed me $15,000.00 for the second operation.

Both operations were identical in the duration and care involved.

I contacted them to ask why I should pay $7,000.00 more than they billed the insurance company. They said that they gave discounts to insurance companies and not to individuals. What a SCAM!
Comments:6 Replies - Latest reply on 2007-08-12
Posted by rhondam718732 on 2007-04-09:
Did you question why your insurance isn't covering the 2nd one? That sounds strange.
Posted by Cyane on 2007-04-09:
I believe that most hospitals bill like that - discounts to the insurance companies, higher rates to the uninsured.
Posted by N. on 2007-04-09:
It's not a scam. It's a contract. That hospital has a contract with your insurance company that states the price allowed for each service. They didn't write off that first $7000.00 out of kindness. You should be more concerned as to why the insurance denied the second surgery. Sounds like your coverage limited in some way. It is your responsibility to understand your benefits. If the limit was an annual maximum for instance, you may have been able to wait to the next calendar year to have the second procedure done and then it likely would have been paid by the insurance. If the plan is a group plan through your employer talk to the human resources person to see what went wrong.
Posted by Dedicated Reader on 2007-04-10:
Well said, Noneill!
Posted by beachman on 2007-05-08:
I am on both the corporate and foundation boards of the Jupiter Medical Center. You have a problem with insurance company not the hospital. People with no insurance and no money walk in and have rung up thousands of dollars in bills that are never paid. The hospital has contracts with insurance companies not individuals. But they will deal with you if you sit down and show them that you are willing to pay something.
Posted by Amitofou on 2007-08-12:
limey1's posting concerns with the $7000 difference in the two identical operations.

Should the hospital charge the 2 difference prices because one bill was paid by an insurance policy and the other by himself? This is exactly what is wrong with the health care system in the U.S. Hospitals may give you all the reasons for the multi pricing schedules for different patients: such as insurance contracts, uninsured patients. The true reason is that hospitals want to extract as much money as possible from patients. You don't expect them to lose money if a patient is on Medicare. A patient in most circumstances, is a captive consumer and is at the mercy of a hospital. In a way, for most patients, the moment one has walked into a hospital it has a monopoly and can charge him as much as possible. The price tag for any procedure in any hospital is not transparent at all. In addition, a hospital can charge a patient many little things for a procedure.

So what is the solution?

(1) A hospital must make the price list readily available;
(2) One price for one procedure, regardless the source of the payment; some folks don't have insurance and cannot afford of the payment, that is a separate issue.
(3) All supplies used in a hospital must be charged at a fixed margin or a range of margin over the cost. If a patient does not like the price for the supplies, he would be allowed to find his own supply vendor.

Hospitals (mostly non-profit as they would like to calim) are not supposed to make too much profits; if they are in the business to make huge profits, they are in the wrong business. Some of the hospitals that evoke the name of Jesus Christ of Virgin Mary are the worst offenders in price gouging (any surprise after you have read about some sexual crimes?).

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