Comment by IG_Semmelweiss

For a customer advocate, the pervasiveness of the artificial low rates seems to be an interesting opening.

You should be able to go back to the hospital and say - based on the hospital public fee schedule , total FFS for CPT should be (very low number) . Therefore, my deductible payment is overstated, please reduce my bill dramatically.

A lawsuit would follow, which would make it very interesting. Chief argument:

The customer can clearly say its fraud - he/she looked at the public rate schedule and believed the charges would be based off the public rate schedule.

Ultimately, the disconnect between published rates and the EOB is going to come back to bite hospitals, once people shop around using the data.