I should say at the outset - I am paying my yearly deductible of $8200 and then insurance pays 100% of the balance of the medical bills.
I just received the bill from the hospital for my 48 hour stay. $81,046.86!!!
This bill is just for the hospital - it doesn't count the doctor bill, all the associated people's bills, anesthesiologist, etc. Just the bed, the hourly check-ins, and the crappy food.
Is it just me or is there something a bit tilted here with runaway medical costs? This 2 day stay, not counting the fees of the people that actually did the work, costs more than most people make in a year.
Doesn't seem right.....
I hear ya. I had 5 days in the joint, $113k but they cut it down to the "health insurance contracted rate" by $97k.....what??? I give up. Why not just charge what it really is rather than monkey around with the numbers so that the contracted rates get paid. Something is very screwy with Health Insurance. But then you get in to the arguments of malpractice insurance, runaway juries, ambulance chasers and everything else. I know I met my deductible, but then my hubby has not met his deductible yet and then there's the 80/20 co-insurance/out of pocket max that's waaaay up there and so it goes. Hub's MRI/MRA will cost us another couple bills. And my surgery was in Jan and the insurance is still messing around with the dr's office with the Phys Asst's bill. I got a $2,000 'bill' saying it was denied by the insurance and when I called the dr office, she'd resubmitted (again) and it should be ok now ???? in the meantime I'm losing more sleep over the costs I thought I'd covered/thought about prior to going down this road.
Anyone going in to this, be sure to really - really - really talk to the dr office, the hospital, your insurance company and get them to tell you costs and what's covered or not. I work in Insurance (Specialty Markets/claims/fraud investigator) and I am still in shock from this whole thing. health insurance is it's own beast
Of course trying to ascertain what things are going to cost ahead of time carries its own frustration, because everybody hedges and nobody gives you a straight answer.
We were laughing yesterday because Blue Cross sent us an update to our policy, and hospitals are now broken down into "preferred participating," participating," "non-participating," and "non-contracted."
They forgot "kinda participating," "really would like to participating," "mega participating," "seriously participating," and "really would participate but we went broke hiring lawyers to figure out WTF you are talking about."
As a die hard libertarian for some 40 years it really pains me to say this but there is something fundamentally wrong with having the finest health care on the planet, and having your access to that health care permitted by entities whose job (and profits) are determined by denying you coverage for your health care. Talk about the fox guarding the hen house.....
I guess I got a real bargain (bahgan in this neck of the woods). My left hip was $47k, the right $53k. I paid $400 total, so to me it's monopoly money, but for the actual fee...????. To me, its like athletes salaries, astronomical, but not within the reach of what I can consider and deal with.
Hello Stephen!
I presume your procedure took place where I had mine...California Pacific Medical Center!? My stay in October 2011 was about three HOURS longer than yours and my total came to $97,000 and change.
And I seem to recall reading that they are a "not for profit hospital"! Could be as I've still not seen an actual bill, just "explanation of benefits" forms.
Bruce
Hospital for Joint Disease, NYC, 3 days on surgical floor and 6 days on rehaba floor: $187,000
That's just the hospital, not the doctors.
I'm not sure how much the insurance paid but I only paid $20.00; nice!
Damn. I thought I had the record for the lowest percentage paid. You just completely trumped me. :'(
Bill came to nothing ,not a thing BUT I had to wait 3 months to see the Hip Doc then 6 months to have op then 2 days be4 op had it cancelled and had to wait 3 more weeks to have it done.Then 10 weeks before I went and had to see my GP to get him to sort out phizo... 6 months for my 2nd hip op bad treatment from nurse's really bad food BUT IT WAS FREE :)
Stephen,
That is double what my stay was for each hip, also about 48 hours, here in Ohio.
Cost even here seem high. The injections in my hips before the surgery, outpatient, 1 hour max, 8k. ER visit for a lacerated cornea 2 years ago, less than 5 min with doc, 2k.
Dan
Quote from: Woodstock Hippy on April 26, 2012, 11:03:32 AM
Hospital for Joint Disease, NYC, 3 days on surgical floor and 6 days on rehaba floor: $187,000
Wow, pretty impressive! So far I'm at about $57,000, have not seen the doctor bill yet. I've paid $1,500.
Woody got em both done at one time, which explains some of his costs.
It must have been the 2 for 1 special at NYC prices. That $20 was some fee that they snuck in for my pre-op testing. The insurance didn't cover it and I couldn't get them to wave it. I'm glad I have good insurance, I wouldn't have to pay that bill, the $20 wasa bad enough!
This topic came up before and I believe many of us were in the 40k to 60k range. I think both of mine were about 55k with me paying about $1500 total. I guess I got a deal.
The original deductible was $1000 for the year, but between surgeries and within the same plan year, they changed the cost to account for the "questionable medical value" of HR. That was right after the FDA asked for more data on MoM HR last spring. So I had to give them another $500 to persuade them that I needed new hips and 4 other surgeons said that I needed new hips and that HR was a perfectly good solution. Actually three of the surgeons said that HR would be better for me than a THR, due to my age and activity level. In short I was happy to pay $1500, but the principle seemed a little goofed up.
We (wife and I) spent lots of time trying to work out how much this would cost - Doctor will not tell you - "talk to insurance"; insurance does not know "talk to doctor". In the end it was about $80K - cut down by insurance and we ended up paying my annual deductable of $5K.
We used the Cleveland Clinic -
I have 3 different account numbers that come on the same letter head - doctor, hospital, anesthesiology, plus other "walk ins". I have spoken with them - "it is like getting an oil change and being charged for the technician and then getting a charge for the facility.
The residents that come in bill separately - I spoke to the clinic about that also "we did not hire them the clinic did - you should add them to your bill"
Got a bill from a doctor I did not see "he is the resident that read you x-ray at the remote facility - that is why I did not know the address"
100's of hours trying to figure it out
Talk about unbelievable costs...
Look at the contracts signed between hospitals and device makers like Smith & Nephew, Cormet, and Biomet. And I say "look at the contracts" figuratively, because you can't find that info anywhere. Neither the manufacturers nor the hospitals want you to know. While it took me a while to get the number, the paper price of a BHR device at Swedish Orthopedic is $29,000. In other words, that is the price the hospital and S&N have agreed upon as the asking price. Each insurance company negotiates a different price and cash payers are given a discount. Still, my insurance company paid $17,500 just for the implant. That's more than surgery costs in some places overseas!
mine was 58,000 but beings hospital was in the "GROUP" cost them 12,000, me 5,000 then 2 weeks at home a insurance increase on premiums of 20%. its all a big scam but what would we do with out, i believe this might be one of those got ya over a barrel things. now we are stuck with the pre existing thing. i know its(pre exist conditions) suppose to go away in 2014 we will see!
Quote from: WTW15 on April 25, 2012, 08:55:19 PM
I hear ya. I had 5 days in the joint, $113k but they cut it down to the "health insurance contracted rate" by $97k.....what??? I give up. Why not just charge what it really is rather than monkey around with the numbers so that the contracted rates get paid. Something is very screwy with Health Insurance. But then you get in to the arguments of malpractice insurance, runaway juries, ambulance chasers and everything else. I know I met my deductible, but then my hubby has not met his deductible yet and then there's the 80/20 co-insurance/out of pocket max that's waaaay up there and so it goes. Hub's MRI/MRA will cost us another couple bills. And my surgery was in Jan and the insurance is still messing around with the dr's office with the Phys Asst's bill. I got a $2,000 'bill' saying it was denied by the insurance and when I called the dr office, she'd resubmitted (again) and it should be ok now ???? in the meantime I'm losing more sleep over the costs I thought I'd covered/thought about prior to going down this road.
Anyone going in to this, be sure to really - really - really talk to the dr office, the hospital, your insurance company and get them to tell you costs and what's covered or not. I work in Insurance (Specialty Markets/claims/fraud investigator) and I am still in shock from this whole thing. health insurance is it's own beast
I had my surgery with Dr. Gross who also uses a physicians assistant. Blue cross blue sheild doesn't cover it under my plan, hope they do under yours.