People in the US are used to this sort of thing but I wanted give everyone a peek into the way healthcare is billed:
The price charged to insurance for OR use and three days of babysitting for a ruptured appendix was $42,500. No ICU. This does not include the surgeon’s fee or the anesthesiologist’s bill or the pathologist’s examinationof the removed offending organ.
The amount actually paid by insurance was $8,950 with an additional $680 of patient responsibility (what the patient has to pay).
The other over $30,000 was “adjustment”, money that will never be paid by anyone.
The games we play.
After the birth of my child, I received a bill from the hospital for my care… over $2,000. There were also bills for the OB, anesthesia, pediatrician, the NICU stay, etc.
I expected the bills to be high. My baby was worth any price but I still wanted to know what my money was paying for. Being on the physician side of medicine, I don’t often get to see the $ side from the standpoint of a patient so I decided to dig.
What I found most annoying was that the bill was not broken down into anything meaningful, so I requested an itemized bill so I could see the details.
When I reviewed the several pages of information that came a few weeks later, I found several charges for questionable lab tests as well as medications that I was fairly certain I had never received. Propofol, a sedation medication commonly used in ICU… the one that killed Micheal Jackson. Dopamine, a vasopressor that is used in the ICU to keep your blood pressure up. There were a couple of obscure infectious disease tests that there was no reason for me to be tested for. I called the billing number and listed my concerns to the woman who answered.
“So are you requesting a review of the charges?” She sounded astonished.
“Yes. Yes, I am.”
A week or two passed and I received a call that said that over $700 of the charges had been removed but there were still two items that I was disputing, the lab tests that should have never been done, that they were not going to budge on.
“Well, I would like to see proof that they were done and I would like to know why because they do not make any kind of sense.”
“I cannot provide that.”
“Then I would like to request a copy of my records.”
“Ma’am you are more than welcome to request a copy of your medical record. The charge is $4 per page.”
“How big is my record?”
“I don’t know but I expect probably over 40 pages.”
(Was it really $4/page? Maybe it was less. Were there only 40 pages to the record? Probably there was more. Much more. It was a few years ago, and I don’t remember the details exactly but suffice it to say, the cost was going to be quite high.)
“Can I come by and just review my record?”
I did some quick math and figured that the disputed charges were less than the cost of the copy of my medical records and I ended up just paying the dang bill as it was.