The money game

Pumpkin visited a physical therapy six times in August 2012 to rehabilitate her sprained ankle from lacrosse back in April. This therapy charges $75 per hour/visit without insurance. Because of the type of health insurance we have, I paid out of pocket for her sessions, as uninsured, but asked the therapist to file with the school insurance.

  • June 4: Dr. Bregman
  • June 5: MRI
  • July 30: Dr. Michael Schwartz
  • August 1 – 22: physical therapy

Out of all the doctors/facilities we’ve visited for her injured ankle, this therapy office is the most helpful and efficient, because they’re the first one being reimbursed. Dr. Bregman and MRI have sent our accounts to collection, in spite of them saying they’ll take care of it, contact the insurance company, etc. The insurance company is looking for itemized bills but I couldn’t get them to send me.

Anyway, today I contacted the insurance again, the insurance rep said,

“We’ve send out two checks to the therapist, $1,460 and $520.”

I called the therapist, she said: “I haven’t received any checks. The insurance company sent us a discount form on Dec 18, 2012, saying if we accept the reduced amount of $1,900 [their responsibility is $3,200], they will process the matter quicker.”

What’s wrong with my math here? Why does the therapist charge so much more with insurance? Free money or what? I do not think for a minute that they would take a loss to treat my daughter, so $75 must be a fair amount. But when a insurance is involved, they charge $533 instead?

What would the insurance do differently to process the same claim? Obviously $3,200 to $1,900 is a big drop.

The therapist did her job and was paid in full – $75. Now with few paper exchanges, she stands to profit again, rather handsomely. A therapist makes upward $500+ an hour is ironic. The health care system is a joke and I still strongly feel the medical doctors are being ripped off by the MBAs.




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