Got the bill for Chris's catheterization

[cherylchapa]

All I can say is TGFI (Thank GOD For Insurance). The total was $26,000! We paid $50. I showed it to Chris because he knows that hospitals are expensive and I don't want him to think that we have to pay it all. I wanted him to see how little we have to pay so he would have less to worry about. Anyway, when I showed him, his eyes just about bugged out of his head. Then I told him that even if we had to pay it all, he was worth every penny. I got a hug.

Now I'm starting to worry about him getting health insurance as an adult. What if he can't?? One more thing for me to worry about I guess. That one'll have to go on the back burner. I've got more than enough right now thank you very much.

 

[catwoman]

Cheryl:

Was that $26,000 as an outpatient? Did anything unusual occur?

Don't remember that John's heart cath cost anywhere near that much two years ago.

 

[cherylchapa]

That was outpatient with no complications other than taking 3 hours in the cath lab. That is what they billed the insurance. I'm fairly certain they won't get that much. But our part was only$50!

 

[sue943]

I am never going to be able to understand the amounts you get charged for your medical treatment. Until this past year I had private health insurance so had private treatment all the way and no treatment ever came near to what you get billed, even if you do only pay part. My catheterization cost £750 four years ago which is about $1240 US.

 

[kerri73]

That's amazing... my cath last fall might have cost in the $3,000 area (I'd have to look), but my total bill was over $30k, however that also included 6 days in the hospital for coumadin management... so I can't imagine an outpatient procedure costing near that much. It definitely makes you wonder about health facilities and their billing procedures these days.

 

[skeptic49]

Cheryl, I can understand your concern about getting health insurance for Chris later on. Hopefully, we will see health care reform that makes it possible for everyone with pre-existing conditions to be insured. That is my hope for Chris and for us all.

Jim

 

[kerri73]

Oh, and on the insurance... when I came of age and got my first job, I had no problems getting insurance through my employer, even with all my pre-existing heart stuff. I had a waiting period before I could make any claims regarding the heart condition, but that was it. If I'd had no lapse in coverage, it would have been a non-issue. Hopefully that puts you a little more at ease about that.

 

[ponytaila1a]

Cheryl, I can understand your concern about getting health insurance for Chris later on. Hopefully, we will see health care reform that makes it possible for everyone with pre-existing conditions to be insured. That is my hope for Chris and for us all.

Jim

My fear with healthcare reform is that there will be no choice of doctors or facilities. I had my repair done now just so that I knew I would be able to choose. Also, I am getting to the age where the "gate keeper" will most likely feel I am too old to "waste money on treatment"!!
Good for you Cheryl...only $ 50 out-of-pocket. I owed nearly $ 1,000 ....for routine under one hour cath.......making payments, of course!!! LOL!!!

 

[ALCapshaw2]

Cheryl,

It may be interesting to ask the Hospital Billing Department to send you an ITEMIZED accounting for that bill, just to see how they divide it up.

'AL Capshaw'

 

[cherylchapa]

Cheryl,

It may be interesting to ask the Hospital Billing Department to send you an ITEMIZED accounting for that bill, just to see how they divide it up.

'AL Capshaw'

I did get an itemized bill. About 2/3 of it was for the cath, supplies, and meds. Then there was the recovery room, short stay room, cardiologist, labs, anesthesiologist, etc., etc. When I get home tonight, I'll try to remember to post it in detail.

I think part of the reason it is so high (aside from money-grubbing hospitals) is because he's a child and took so long in the cath lab.

 

[wcasey5]

My fear with healthcare reform is that there will be no choice of doctors or facilities. I had my repair done now just so that I knew I would be able to choose. Also, I am getting to the age where the "gate keeper" will most likely feel I am too old to "waste money on treatment"!!

Since I moved to the U.S., people keep saying this with no basis in facts. Its weird that nothing like this is being proposed, nothing even close to this exists in countries who have socialized medicine, like the U.K., or non socialized, publicly financed, privately delivered, health car like Canada. The people who are currently profiting from the status Quo are really effective in their fear mongering. What a shame.

I also find it strange that choice is a major concern here in the U.S., since I find the plans I see as tremendiously restrictive compared to what I had in Canada. The only choice seems to be in health insurance providers, which really has very little to do with a persons health, and serves as a filter/ration of health care for individuals, and a subsidy for the health care industry. doubly weird.

On the bright side, to get out of a cath by paying only $50 is fantastic! I wound up paying close to $800, on a $4000 bill. I also got numerious bills from the hospital, the cardio, and lab work. Which were sent all separate.

 

[cherylchapa]

On the bright side, to get out of a cath by paying only $50 is fantastic! I wound up paying close to $800, on a $4000 bill. I also got numerious bills from the hospital, the cardio, and lab work. Which were sent all separate.

We may still receive more bills once the HMO pays what they pay. But the way I understand our policy is that everything related to the cath is covered at 100% with no limit and $50 co-pay. Everything related to the surgery will be covered the same way with a $100 per day co-pay for the hospital stay. So barring any unforseen circumstances, we are looking at $500-700 total. ANd I don't really worry about choice either because our HMO is accepted just about everywhere except UC hospitals (which I don't mind anyway).

 

[bahlvarun]

This is for me..Love Answering US Healthcare

This is for me..Love Answering US Healthcare

So we have lots of issues on healthcare...

I deal in US healthcare and eat up all you healthcare money, just to give stupid advice...


Well, let me say it all starts at a lot of points I'll put it down here to just make it easier for you to understand

1. Doc's pay a lot to get specialized and thus wanna charge more, I guess who wouldn't
2. Same for attendent and Other specialist like pathologist, radiologist, anasthesiologist, they also bill the hospital
3. Hospitals invest a lot to maintain high quality of services for you
4. Ofcourse then there is administration, Legal(this one is not everywhere) that is also high cost resources
5. Infrastructure Management
6. Medical Instruments
7. Expensive Drugs( Cost more due to drug research, innovation costs, marketing costs etc. etc.)
8. Finally, hospital would want to maintain its margin of profits.

Now your insurance actually helps in reducing the costs by making bulk deals with the providers.

Do you know there is actual cost of service and then there is negotiated costs, thus provider negotiated cost, which is far less.

Think about it, how difficult it would have been had it not been for the health Insurance.

I know the current set up is bad, but there are various theories being floated around, I do have mine too . you can find that at

http://my2centsonushealthcare.blogspot.com

Do have a look at that, I feel that is the best deal keeping in mind the real healthcare scenario in US

 

[wcasey5]

We may still receive more bills once the HMO pays what they pay. But the way I understand our policy is that everything related to the cath is covered at 100% with no limit and $50 co-pay. Everything related to the surgery will be covered the same way with a $100 per day co-pay for the hospital stay. So barring any unforseen circumstances, we are looking at $500-700 total. ANd I don't really worry about choice either because our HMO is accepted just about everywhere except UC hospitals (which I don't mind anyway).

The $50 is great! well, the $700 bill coming your way, not so much.

As far as the choice goes, you are exactly right. Once you have health insurance, as long as it is a main stream insurance, its accepted pretty much anywhere. If a doctor wants to make money, as long as its legit and not too much a PITA, they accept many different plans, including any public option. I have seen offices that do not accept certian companies plans, and when I inquired they said it was because hastles in paper work, and very late payments.

Which means the actual choice here in the U.S., is which company to go with (if that is even offered, in my case it is not), which has very little to do with your actual health care, and the real choices to have in health care, which is between a doctor and patient.

 

[RI Mom]

Cheryl,

I share your concern about insurability as an adult. When I totalled up all of the bills with Idrees' last OHS, it was over $250,000. Fortunately we have a catastrophic limit on our insurance of $6,000 out of pocket expenses minus pharmaceuticals so once we hit the magic #, everything is covered 100% afterwards so we will definitely hit it in July this year. It really is insane. The surgeons alone were around $14,000. Of course any amount of money is worth the life of your child but if you are uninsured or under insured you may have to sell your home in order to pay this amount.

 

[ponytaila1a]

1. Doc's pay a lot to get specialized and thus wanna charge more, I guess who wouldn't
2. Same for attendent and Other specialist like pathologist, radiologist, anasthesiologist,

When I worked in healthcare finance the hospitals would "bid" on docs coming out of training....at the VERY MINIMUM hospitals picked up the bills for medical education......( of the nearly 40 docs recruited during that time NOT ONE PAID EVEN ONE DOLLAR FOR THEIR OWN EDUCATION) setting up an office including equipment, medical supplies and equipment, computers, etc, etc.....guaranteed the new doc an income of around $ 12,00 per month (take home) based on the negotional skills of the "agent"......low cost loans for homes and autos...........these were not hospital employees but were "recruited" with these financial packages.....in return the doc would agree to stay in the area for usually five years. All of these recruiting costs were added to bills for commercial insurance (as government reimbursement is fixed).....and of course as stated above the hospital was not about to cut into their profit margin as the CEO bonus was based on profit!!!!

 

[cherylchapa]

Here's the itemized bill for your entertainment...

Here's the itemized bill for your entertainment...

Pharmacy - $466.40
IV Solutions - $226.98
Sterile Supply - $921.24
Supply/Implants - $406.80
Supply/Other - $6134.40
Laboratory - $622.00
Lab/Chemistry - $761.00
OR/Minor - $205.00
Cardiac Cath Lab - $13016.00
Drigs/Detail Code - $162.00
Recovery Room - $1480.50
Observation Rm - $2000.00
Patient Payment - Thank You! - $(50.00)

Total Charges This Stmt - $26402.32

Payments & Adjustments - $26352.32

Total Pending Insurance - $26352.32

Total Patient Responsibility - $0.00 (Yay!)

I'm pretty sure the hospital will write off about 80% of this. Can you imagine what the surgery bill will look like? That ought to get a laugh!

ETA - And regarding insurance as an adult, what if he doesn't want to be an employee on the company health plan? What if he wants to own a small business or be self-employed? Then what? I never thought national healthcare was a good idea but now that my sone may need it, I'm rethinking my position. What does that say about me? LOL!

 

[ruthienc1]

Jennifer- I wonder if what you describe about doctors coming out of medical school not having paid anything for their education is commonplace. Maybe some places, but not here! We hear instead of new docs emerging from training with crushing debt. My husband, who is a cardio and is retiring next Tuesday after 29 years in practice, loves his patients but can't stand the thought of dealing with the ever-increasing load of government intervention and paperwork. Time to enjoy the grandbabies ! Doctors are not all the money-grubbing folks some make them out to be. When I went by the office today to drop something off, his nurse told me the phone had been ringing off the hook with patients distraught at his retirement. He had been telling folks he was leaving as he saw them, but then sent individual letters to the rest. Guess this is the wrong place for me to vent.....sorry.........I've wandered off topic!

 

[Lisa in Katy]

No, Ruthie, Jennifer's scenario is not normal, at least not in Texas or Louisiana. There are docs that get set up in areas of high need and get their loans forgiven - usually areas with lots of poverty, prisons, or other non-desireable locations. Hospitals might give docs free office space for a short period of time, but that's about it. Probably one of the highest costs they have is malpractice insurance, and that's because the US doesn't have enough controls over frivolous suits. However, I'd freely choose our system over any other.

As far as this bill goes, I wouldn't expect it to get much more than 25% reimbursement depending on your insurance. No more than $5000 for a Cath, generally.

Cheryl, if Chris decides to be self-employed, he better make sure he lives in a state with a high risk pool and that he never lets his insurance lapse, or marries someone who has good coverage.

 

[Jessie316]

wow

wow

I had my cath on 5/29 and with all docs and a few complications and insurance I had nothing out of pocket but my insurance was billed almost 16,000 dollars. I was done outpatient also.