"Hospitals can do math. Combating a clear, prompt, and defensible payment requires staff time, letters, appeals, and sometimes legal counsel.... If your plan pays a transparent multiple of Medicare, if your language is precise, if your appeals correspondence is professional, and if your member advocacy is proactive, the hospital's marginal ROI on fighting you is poor. They often accept ... because you act like a payer with a system, and the effort isn't worth the benefit."  MORE >>