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Thu May 25, 2023, 04:48 AM

This company made billions by surprise-billing helpless ER patients. Then justice arrived

Some businesses deserve sympathy when they land in bankruptcy. Then there's Envision.

The Tennessee company prospered as a provider of medical staff to hospitals around the country. It concentrated on emergency physicians, anesthesiologists and radiologists for a simple reason: Their patients typically had no ability to pick and choose among these doctors when they need care.

Waiting to be seen at the emergency room or already laid out on an operating table, the patients weren't in a position to ask whether the doctor was in their insurance plan's network.

These higher payment rates [are] caused not by supply or demand, but rather by the ability to "ambush" the patient."
Zack Cooper et al, Yale University
They might not even know they were seen by out-of-network doctors until they received a bill for their services ó a surprise invoice for hundreds or even thousands of dollars.

Envision's "secret sauce was to pile medical debt on people with emergencies," says Eileen Appelbaum, co-director of the Center for Economic and Policy Research, a nonprofit Washington think tank. "That was purely taking advantage of people at their most vulnerable time."

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The No Surprises Act blew a sizable hole in Envision's profit-and-loss statement ó part of "a whiplash-inducing onslaught of obstacles and complications" facing the firm's management, its bankruptcy filing stated.

https://www.msn.com/en-us/money/companies/column-this-company-made-billions-by-surprise-billing-helpless-er-patients-then-justice-arrived/ar-AA1bCv1Q

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Reply This company made billions by surprise-billing helpless ER patients. Then justice arrived (Original post)
BlueWaveNeverEnd Thursday OP
Lonestarblue Thursday #1
Hermit-The-Prog Thursday #4
2naSalit Thursday #7
Jerry2144 Thursday #15
Bernardo de La Paz Thursday #5
Hortensis Thursday #17
ExWhoDoesntCare Thursday #19
Lonestarblue Thursday #20
DFW Thursday #2
rampartc Thursday #14
Deminpenn Thursday #3
Joinfortmill Thursday #13
Deminpenn Yesterday #22
uponit7771 Thursday #21
hatrack Thursday #6
Takket Thursday #8
OldBaldy1701E Thursday #11
dalton99a Thursday #9
Renew Deal Thursday #10
Joinfortmill Thursday #12
marble falls Thursday #16
Ritabert Thursday #18

Response to BlueWaveNeverEnd (Original post)

Thu May 25, 2023, 06:05 AM

1. One more reason we need Medicare for All.

Far too much of the money spent for medical care in the US goes to excessive profits for insurance companies like Envision. Eliminating the special networks that insurance companies create to enhance their profits for out-of-network care does nothing for quality healthcare.

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Response to Lonestarblue (Reply #1)

Thu May 25, 2023, 06:33 AM

4. But how, then, will they afford the skyscrapers, corporate jets, and resorts?

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Response to Hermit-The-Prog (Reply #4)

Thu May 25, 2023, 07:25 AM

7. ...and politicians.

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Response to 2naSalit (Reply #7)

Thu May 25, 2023, 08:22 AM

15. Or SCOTUS (in)Justices?

Yet another grain of sand on the beach of reasons why we need Medicare for All or some version of Socialized non-profit, Government run medical coverage

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Response to Lonestarblue (Reply #1)

Thu May 25, 2023, 06:51 AM

5. Had an operation in Canada, +3 dr appointments. Never saw a bill, not a penny out of pocket. nt

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Response to Lonestarblue (Reply #1)

Thu May 25, 2023, 09:00 AM

17. MfA would be another FOR-PROFIT, capitalism-based plan.

Frankly, I doubt even Bernie was behind it. It would also need a "No Surprises" provision to protect from predatory surprise billing, which we now have. This is also hardly the only way MfA providers would seek to increase their profits.

With the collusion of Republicans in government who would be involved in creating and passing MfA and in regulating it to benefit business forever after whenever they get majorities.

If they didn't manage to defeat it entirely before passage -- a huge possibility. They're still working on making ALL federal government plans unconstitutional.

I'm extremely glad of what we've been able to accomplish so far, proud of what we did here, and worried about what the RW extremist SCOTUS majority is going to do. Poof and national insurance is GONE.

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Response to Lonestarblue (Reply #1)

Thu May 25, 2023, 03:58 PM

19. Only someone who has never dealt with Medicare

Could or would say that.

Most people have nothing but problems with using it. The drug coverages are a joke--ask any Medicare recipient about the dreaded "donut hole." You need supplemental policies to cover the co-pays and all the long list of services that Medicare doesn't.

We've done the cost-analysis for when I'm eligible. It's cheaper to stay on my husband's private insurance, and I'll have far--far--better coverage than Medicare offers.

Medicare is better than nothing. But only a little.

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Response to ExWhoDoesntCare (Reply #19)

Thu May 25, 2023, 05:34 PM

20. I've been on original Medicare for over 8 years and have no issues with it.

The cost of my supplemental insurance is no greater than I was paying for my employerís insurance when I was working. I rarely pay anything out of pocket beyond my Medigap and drug policies and the cost of any drugs. When I need to see a specialist, Iím easily able to do so because I do not need a referral to do so. My employerís insurance provided no better care than I receive under Medicare and Iím not limited to the doctors within an insurerís network. I have absolutely no complaints about original Medicare.

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Response to BlueWaveNeverEnd (Original post)

Thu May 25, 2023, 06:07 AM

2. I bet I know which firm represented Envision

Hyena & Vulture LLC

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Response to DFW (Reply #2)

Thu May 25, 2023, 07:58 AM

14. dewey, screwem, and howe llc

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Response to BlueWaveNeverEnd (Original post)

Thu May 25, 2023, 06:08 AM

3. After a recent ER visit,

I was astounded by the charges listed in the explanation of benefits letters. Had I not had insurance, the out of pocket expenses would have been in the low 5 figures rather than less than 1/10th of that. It was easy to imagine how quickly medical debt could pile up.

While helping to manage care for a relative, got regular letters from a doctor's office demanding payment for services from my relative. On the advice of the relative's health insurance provider, I ignored them. After the relative died, another bill from the office arrived. When I informed them the relative was dead, their reply was "Okay". They never made a claim for payment against the estate. It was clear the doctors were just sending out a bill hoping to dupe the patient into paying it.

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Response to Deminpenn (Reply #3)

Thu May 25, 2023, 07:54 AM

13. Evil

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Response to Joinfortmill (Reply #13)

Fri May 26, 2023, 06:49 AM

22. Wouldn't go that far, but

it's clear that hospitals and doctors are trying every way possible to get paid as much as possible from anyone or anywhere.

Our health care delivery system is a real mess. Years ago Kucinich pointed out that the US could have national, gov't run health care for the same amount of money we are paying now for the mish mash of public, private hospitals and doctors.

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Response to Deminpenn (Reply #3)

Thu May 25, 2023, 05:54 PM

21. "just sending out a bill hoping to dupe the patient " Just damn, they stop at nothing

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Response to BlueWaveNeverEnd (Original post)

Thu May 25, 2023, 07:22 AM

6. Shocked, shocked: the lampreys and hookworms of private equity doing their thing

EDIT

It's worthwhile, then, to take a closer look at what this firm and its owner, the private equity firm Kohlberg Kravis Roberts & Co., have been up to, and why we should celebrate the modest change in the American healthcare system represented by the act. (TeamHealth is owned by another private equity firm, Blackstone.)

Private equity firms acquire businesses typically through leveraged buyouts, in which the acquisition is financed largely through borrowings to be paid back out of the acquired business' revenues. Generally, their goal is to cash out by selling the business or taking it public within about five years.

EDIT

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Response to BlueWaveNeverEnd (Original post)

Thu May 25, 2023, 07:28 AM

8. Seems like a terrible business model actually.

Why ambush patients to hit them with out of network bills when you have no idea if they can ever pay you? You canít get blood from a rock. It is far less risky to just be honest and work with insurance companies to be in network.

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Response to Takket (Reply #8)

Thu May 25, 2023, 07:50 AM

11. Because there is a twofold idea behind this.

They do not want anyone who will be going to the hospital for other than a minor injury that will not detract from your life of making them richer. If you are infirm, or older, or suffered a debilitating injury, they do not want you to be around taking any pennies that they might be able to get their hands on. They would prefer you just die and get out of the way for someone who is healthier and more willing to work themselves to death for the oligarchy.

Secondly, they do not want anyone who is going to be unable to pay their outrageous fees to the last cent, so they make sure that you cannot afford to do anything after your bill arrives. Between the legal actions from their lawyers, and the collections and the late fees and so on, they will get their pound of flesh even if it ruins you forever. Our healthcare system is just another get rich quick scheme these days and I am still stunned that we are letting this continue. (Actually, not really. Nothing the human race does stuns me anymore.)

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Response to BlueWaveNeverEnd (Original post)

Thu May 25, 2023, 07:42 AM

9. These leeches deserve the deepest depth of hell.

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Response to BlueWaveNeverEnd (Original post)

Thu May 25, 2023, 07:45 AM

10. I don't understand how you can walk into a business and then

Someone tells you that one person doesnít work for them and is a lot more expensive to see. They are basically defrauding patients and insurance companies.

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Response to BlueWaveNeverEnd (Original post)

Thu May 25, 2023, 07:50 AM

12. WTHF? Capitalism at it's unholy greediest - phucking ill people. Now that's really sick.

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Response to BlueWaveNeverEnd (Original post)

Thu May 25, 2023, 08:46 AM

16. Amazing what an effective, enforced, well targeted law can do. How'd they get it past the GOP?

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Response to BlueWaveNeverEnd (Original post)

Thu May 25, 2023, 09:33 AM

18. Just encountered this when my husband needed emergency surgery

The whole ER crew were independent contractors working for a company with a billing address in Maine. They also hound you by email until you tell them to stop. So far they've only billed the Medicare deductible but if they try to bill me more I'll send them a copy of the No Surprises Act.

By the way doctors have filed suit against the No Surprises Act because they're not able to bilk unsuspecting patients with impunity.

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