patients pay themselves usually include medical indigent patient (ie, uninsured and patients inadequately) and others with off-grid insurance. The number of patients who pay themselves increasing, driven by the slowdown in the economy and the increasing number of patients with health savings (HSA) and health plans high deductibles. In November 2009, the study of Healthcare Financial Management Association (AMF) has indicated that from 2008 to 2009, 97% of hospitals saw an increase in the number of accounts receivable selfpay cases and 35% of these increased by 10% or more by paying themselves patients. In response to the growing number of self-pay patients and in the absence of a policy imposing a ceiling on fees for services rendered to them, hospitals have gradually increased the levying of this group patients. 2007 Article published in the Ministry of Health, found that hospitals charged self-pay patients, 307% above eligible costs and health insurance at about 2.5 times more than what most private health and public insurance companies are paying. Today, most physicians are participating with the insurance so the insurance never allow 100% as they are contracted to accept what the insurance allow.Now to earn generate more revenue they use to bill three times the real burden of the cost of Medicare insurance allowed fee Schedule.Now if the patient has a high deductible plan 80% of the amount of charge will be deductible. Therefore, the patient is overwhelmed by the policy premiums and deductible.
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