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To: lifeisgood who wrote (90568)	9/26/2007 1:51:31 AM
From: Elroy Jetson	Respond to of 306849

Perhaps the difference is in the billed amount. The negotiated rates listed below include both the insurance company payment plus any patient co-pay if any. My Doctor in Beverly Hills bills $160 for an extended office visit, say 25 minute-ish. Blue Shield of California's allowed amount, aka the negotiated rate, is $89.76 for a 44% discount. An annual physical is billed at $240 with a Blue Shield negotiated rate of $127.26 for a 47% discount A national lab charges $125 for a variety of blood chemistry with lipid panel and what not. Blue Shield's negotiated rate is $40.39 for a 66% discount. Blue Cross apparently has even lower negotiated rates. Doctors in Los Angeles who accept the Medicare generally agree that the Medicare allowed amount is roughly only 25% of their billed amount. In Los Angeles the only specialty where a majority of the Doctors seem to have successfully escaped signing contracts with large firms like Blue Shield are anesthesiologists. Hospitals as well get their bill cut by at least 45%, although they often receive additional back-end "facility payments" after completing their annual audit and efficiency reviews with the insurers. Its a different world than when my Grandfather and his pals practiced medicine. .