Since insurance rates are different than pay out-of-pocket rates who is setting the price for medical procedures?
In: Economics
Health providers. It’s a market economy. Certain insurance systems will only pay X but that doesn’t stop providers from setting the price wherever they think they can get the business. The ones who sort of want the business coming from insured patients set the rates in line with what insurers will reimburse more or less; and professional bodies can set guidelines but I know dentists who accept no insurance specifically so they can charge what they want to charge.
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