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4532 | Healthcare providers overbilling so they can write it off as a loss? |
My health insurance company negotiates the fees with my healthcare providers so that we pay a set rate for services. I noticed however that when my doctor would submit a claim, it would be for a far greater amount than the negoitate fee. Then the insurance would pay and the doctor's office would adjust my account by crediting back the overcharge. I asked "if you know how much the insurance will pay to begin with why not just bill that amount? Why overbill?" I found out it is because they can write off the overage as a loss on their taxes! Does anyone else find it crazy that they are allowed to overbill so they can get a tax break? |
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Mathew
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If I correctly understand what you are suggesting they should not get any sort of tax break for this "over-billing". It appears that you are suggesting that they are claiming this as uncollectable debt. For that to be a deduction they would have had to had the ability to have collected it in the first place. In the case you site they have agreed to the lesser charge. It would be interesting to learn how they are getting any legitimate tax break from such an "over-billing" practice. |
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Steve C
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I have been a tax accountant for 27 years. Your information is wrong: no one can write off income they have not received. Doctors routinely overbill so they can keep the pressure on for higher fees. |
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bull_rooster_aardvark
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That doesn't make sense I mean you can't write off money you never receive. If I loan you $100 with the agreement you will pay me back $200 next week. Then you pay me back $100 next week then there is no taxable event. I can't say I lost $100 - I broke even (if you had paid me back $200 I'd have to say I made money and pay taxes on that - but thats not the case).
I always thought the ridiculous costs were for people who didn't have insurance and because the doctor probably doesn't really know how much the insurance will pay so they overbill figuring the insurance will then reduce the amount (ie if the doctor billed $100 and the insurance allowed a cost of $120 then the insurance would still just pay $100 but if the doctor bills $150 they get the full allowed cost of $120 - really its in their best interests to overbill) |
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PepsiLime
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They aren't getting a tax break. They are also having to declare the income from the overbill. It still works out the same, but it's just so that they end up with getting paid a higher % of what they expect to get paid. If your bill should be $1,000 and they will only get $500, they either have to recognize the $500 in income, or recognize the $1,000 in income and a $500 write-off. Either way, they only end up with $500. If they make the bill be $2,000 and have to write off $1,000 of the bill they end up getting the full $1,000, but now they either have to recognize $1,000 of income, or $2,000 of income and $1,000 of a write-off. Now, either way their income is $1,000. By inflating the bill they end up with more cash, but end up with more income as well, and are taxed on the higher income. |
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John D
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There is no tax benefit because the write off is the exact same amount as what the difference in revenue is. You would calculate the tax on the net. For example, if you bill $100 but write off $50 then you would be taxed on the $50. But if you only billed the $50 then you are taxed on the $50.
The reason for billing at a higher rate is that: 1) not all insurers reimburse at the same rate. If you set your rate too low the an insurer that pays more might not reimburse for the entire charge. 2) Insurers calculate some reimbursement rates based on a percentage of the prevailing rate charged in the area. By upping what they charge they increase what they receive. 3) People without insurance don't have the negotiated rates and have to pay the entire bill, so the doctor gets more from them. |
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kellbelle21
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that is not true! healthcare providers do not get tax breaks on the amounts "overbilled" to insurance, the reason the amounts are different is because the software that providers use has amounts uploaded and all providers will bill over the allowed amount, then they just have to write it off. as a loss. period, never to see it again..... |
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PJ
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Ahhhh no. It is not a negotiated fee. The fee is dictated. And every insurance company has a different amount they pay. They should be able to charge what they want. If the patients don't like it they can go somewhere else. Free market all teh way! |
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mom of 3
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yes, it is very unfair
thus the saying: "the rich get richer and the poor get poorer" |
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