She billed me $902 for a two-second X-ray. The insurer pays $78.

In this episode of Broken Healthcare, Ray Kober sits down with Dr. Dana Mincer DO - physician, Direct Primary Care founder, and certified yoga instructor - to break down what really happens when a doctor becomes a patient and gets the bill.

Dana slipped on the ice on New Year's Eve, fractured her elbow, spent an hour in the ER, saw a PA for 7 minutes, and never met a physician. The bill? Over $3,300. She brought slides.

In this episode:

→ The itemized bill from Sentara Health - and what insurers actually pay for the same procedures

→ Why a physician was billed who never walked into the room - and what happened when Dana called to dispute it

→ How CPT billing codes work and why hospitals always bill at the highest possible level

→ Why the chargemaster means the same procedure has hundreds of different prices at the same hospital

→ Why most US hospital systems are for-profit organizations operating under nonprofit status

→ How auto-adjudication works - and why insurance companies are blindly paying claims nobody is reviewing

→ Why self-funded employers using United, Cigna or Aetna as their TPA are paying full retail. Always.

→ What PREVENT Consent is and why you should know it before you ever need an ER

→ How to cite EMTALA - and why it immediately changes the conversation with hospital administrators

→ Why by 2035 healthcare premiums could exceed 50% of annual household income

→ What Direct Primary Care actually looks like - same day appointments, your doctor's cell phone, no insurance billing

→ Why Ray is now 3 months alcohol-free - and what Dana thinks about it as a physician who ran an addiction medicine center

Plus: less than 400 food additives are approved in Europe. The US has over 10,000. They get into that too.

If you're an employer, a CFO, an HR Director, a patient, or just someone who has ever been shocked by a medical bill - this episode was made for you.

🔗 Love Health DPC: LoveHealthDPC.com

📱 Dana's Instagram: @drdanalovehealth

🎙️ Subscribe to Broken Healthcare: youtube.com/@BrokenHealthcarePodcast

Timestamps:

0:00 Introduction & How Ray and Dana Met

4:37 Ray's Magic Mushroom Experience & Sobriety

9:06 Dana's Response as a Physician & Addiction Medicine

13:56 The Vibroacoustic Table & Teaching the Body Calm

22:06 Hospital Consolidation & Energy Medicine in Practice

26:00 The Broker Problem & How Insurance Incentives Work

30:11 Nonprofit Hospitals Masquerading as For-Profits

33:00 Food Additives, Glyphosate & RFK Jr.

50:35 Dana's New Year's Eve ER Visit - The Story Begins

1:01:00 The Bill Arrives - What She Expected vs Reality

1:07:00 CPT Codes Explained & How Hospitals Maximize Billing

1:17:10 What Insurers Actually Pay vs What You're Billed

1:23:01 The Sentara Numbers Revealed - The Real Data

1:30:00 How Self-Funded Employers Pay Full Retail

1:37:00 How to Challenge Your Bills & Independent Auditing

1:44:00 PREVENT Consent, EMTALA & Your Patient Rights

1:57:00 Direct Primary Care Explained - The Alternative

2:03:50 Love Health DPC & How to Find Dana

#BrokenHealthcare #DrDanaMincer #HospitalBills #HealthcareBilling #MedicalDebt #HealthcareTransparency #DirectPrimaryCare #DPC #HealthSharing #EMTALA #HealthcareCosts #CFO #EmployerHealthcare #NonprofitHospitals #PriceTransparency #Podcast

Hosted on Acast. See acast.com/privacy for more information.

Yeah, this one's different.

No guests. No healthcare policy. No claims data. Just me, sitting down and talking about something I've never talked about publicly before.

For years, a couple of drinks at the end of the day was just part of life. Business dinners, networking, winding down. A few glasses of Don Julio. Nothing dramatic - just a quiet daily habit that, somewhere along the way, became more than I wanted it to be.

A guided psilocybin journey changed that. And I haven't had a drink in over two months.

I'm not a doctor. I'm not here to tell anyone what to do. This is just my story - and I'm sharing it because I think too many people, especially in business, are carrying things they don't talk about. The shame around that needs to stop.

In this episode I talk about the months of preparation before the journey, what the experience actually felt like, the memories that surfaced - including seeing my dad, who passed away when I was two years old, and reliving the hardest conversation I ever had with my kids, but this time through their eyes. I talk about what changed after. The calm. The presence. The fact that I just... stopped thinking about drinking.

I also talk about what my doctor said when I told him. That part stuck with me.

This isn't a healthcare episode. It's a human one. If it helps one person feel less alone - that's why I recorded it.

⚠️ Not medical advice. Psilocybin can be dangerous for people with certain mental health histories or on specific medications - please speak to a medical professional before considering anything like this, and check the legal status in your area.

brokenhealthcarepodcast.com

youtube.com/@BrokenHealthcarePodcast

linkedin.com/in/raykober/

#BrokenHealthcare #Psilocybin #MagicMushrooms #MentalHealth #PsychedelicTherapy #Sobriety #PersonalGrowth #RayKober #MensHealth #Healing

Hosted on Acast. See acast.com/privacy for more information.

Your healthcare claims have an error rate of 8 to 12%. Most employers have no idea.

In this episode of Broken Healthcare, Ray Kober sits down with Stephen Carrabba - CEO and Co-Founder of Claim Informatics - to break down what's really happening behind the scenes in healthcare claims, payment integrity, and fiduciary oversight.

Stephen's team recently found $7.4 million in improperly paid claims for a single client. In two months. At a 10.9% error rate.

And the fix isn't complicated. It just requires someone with no conflicts of interest to actually look.

In this episode:

→ Why 8-12% of healthcare claims are paid incorrectly

→ The "sub $15,000" TPA story that should make every CFO furious

→ Why the shared savings model creates perverse incentives and what Claim Informatics does differently

→ How AI is being used to analyze 15,000 pages of contracts and find violations hiding in plain sight

→ Why combining two clauses on page 1 and page 111 of your ASO can legally authorize spread pricing — and nobody catches it

→ The fiduciary exposure every plan sponsor is carrying right now

→ Why post-payment recovery gets harder over time and why prepayment is the smarter play

→ What Marilyn Bartlett found when Montana finally just asked some simple questions ($113 million, as it turns out)

→ Why "garbage in, garbage out" applies to AI - and why building a real system took 8 months

If you're an employer, CFO, HR leader, broker, TPA, or benefits consultant.. this episode will change how you think about every claim your plan has ever paid.

🔗 Claim Informatics: claiminformatics.com

📊 Independent assessment for employers: benefixa.com/#consult

🎙️ Subscribe to Broken Healthcare: youtube.com/@BrokenHealthcarePodcast

Timestamps:

0:00 Why Healthcare Claims Feel Broken

2:12 How Stephen Got Into the Space

5:10 From Pharma Audits to Claim Informatics

8:20 Why Medical Claims Are More Complex

11:35 The Broker and TPA Problem

14:20 What Changed After the CAA

17:10 Why Data Access Matters

20:20 How Claims Are Audited

23:35 Prepayment vs Post-Payment

27:00 Real Savings at Scale

30:15 How Their Fee Model Works

33:20 Why Shared Savings Creates Conflicts

36:40 Independent Oversight and Fiduciary Risk

40:05 Why Recovery Gets Harder Over Time

43:10 How Much Money Gets Missed

46:20 Why Contracts Matter

49:30 The AI Layer

53:05 What Employers Should Demand

57:00 Final Thoughts

#BrokenHealthcare #HealthcareClaims #ClaimInformatics #StephenCarrabba #PaymentIntegrity #ERISA #CAA #FiduciaryDuty #HealthcareTransparency #AIinHealthcare #EmployerBenefits #HealthcareCosts #TPA #SelfFundedHealthcare #Podcast

Hosted on Acast. See acast.com/privacy for more information.