Everyone gather ‘round, because it’s time for another episode of How Much Will We Pay?, the show that attempts to guess how much our insurance company is going to bill us for our healthcare services.
It’s always a bit of a mystery, isn’t it? Sure, we sometimes know whether certain things are covered or not, but the actual dollar amount that’s charged versus what our insurance will cover versus what we’ll get billed for? That’s anyone’s guess.
Or...is it? As it turns out, there is a method to the medical billing madness, and it’s called “usual, customary, and reasonable fees,” or “UCR fees,” if we’re the cool kids. Which we are. The UCR philosophy is applied to consultation fees, procedure fees, prescription costs, equipment costs...all of it. “UCR fees” are how much we’re going to be asked to pay after our insurance covers what it will cover, and they’re determined using this incredibly complex calculation that isn’t vague at all: “How much are other doctors in the area charging for this same service when it’s necessary for the patient?”
That’s it. That’s how UCR fees are determined. So if every oral surgeon in the Pittsburgh metro area is charging $1,200 for necessary root canals and we go to a dentist who’s charging $2,500 for the same procedure, there’s a good chance our insurance isn’t going to cover the whole $2,500. But they’ll probably cover $1,200, because $1,200 is usual (other dentists charge this amount every day all over town), it’s customary (very few dentists dare deviate from the accepted root canal cost), and it’s reasonable (it’s the going rate for a root canal, and it would be hard to find a decent dentist who would do one cheaper).
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Finance: What is Compensation: Advisory ...2 Views
Finance a la shmoop what are advisory fee limits? well they're basically a
price ceiling above which financial advisors can't go yeah I can't go they [Financial advisors in an elevator and hit price ceiling]
can't touch that ceiling you know like hammer time, can't touch this...
so when you invest in a mutual fund you pay two fees there's a commission
and there's an annual management fee usually based on the assets you have
with them under management like maybe it's one percent on the first hundred [Asset rises]
grand that you have and then half a percent above a million or whatever
but there is a third and insidious fee element in the world called advisory
fees like how do you choose which fund to buy well if you have a financial
advisor they'll walk you through the lists of mutual funds out there and [Ice cream flavors appear]
index funds and all other set of funds as well well they're like a gazillion of
them and then that advisor will charge you for their time in some form right
someone's got to pay for their beach house well if you start adding up all
the fees you're paying for arguably no better performance than had you just [Itemized list of fees appear]
logged onto schwab.com or fidelity.com and bought an index fund hmm
well then you're gonna start to pause here it starts to be a big number in
those fees that eat meaningfully into your investment returns most buyers of [Pacman fees eating up money]
mutual funds are not financial gurus yeah not like that they're doctors and
lawyers and plumbing parts distributors and they really don't have a
sophisticated understanding of just how badly they could get taken by
unscrupulous financial advisors so the industry placed a series of structured
limits to keep the non gurus safe from the financial predators when it comes to
compensation and fee limits you know on advisory services and predators like [Tiger walking by]
this guy
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A redemption charge is a charge applied when you redeem shares of a mutual fund in a deferred commission purchase structure.