What’s behind that bill for the doctor’s visit?

Milwaukee Journal Sentinel, January 9, 2008

A highly trained team of insurance experts is sequestered behind locked doors. They are fed and watered twice a day to keep them lean and mean. They are the real power brokers behind what gets paid vs. what gets denied. They determine, through a detailed mathematical equation that would stump Sir Isaac Newton, that due to their specialty, demographics and other physicians in the same ZIP code, your doctor should get paid a certain amount. More than likely it's about one-third of his original bill. Physicians have no control over this system; they either accept what is paid or they are dropped from the insurance plan. Most feel what they have lost on a per-patient basis they can make up for in volume.