John has a partially torn rotator cuff and myriad other damage in his left shoulder. Don't really have any good explanation for it happening, but its there and we have to do something about it before it just up and completely tears at the most inopportune time.
We have health insurance, of course, employer provided like all engineers and this really isn't about that political hot potato. But he has called THREE times to ask how much this little do-dad operation is going to cost us out of pocket and we still don't know. THAT is what is so ridiculous. Since the insurance only picks up 80% of this, 100% of that, or 60% of something else all based on the hospitals coding and which doctor/nurse/anesthesiologist/janitor is working that day, we can't just get a x amount of money for which insurance covers y. It is really frustrating. We are still trying to get them to give us a break down before the surgery, seems like its something any customer should have and even your neighborhood plumber can do.
You want to know how bad our medical system is, just try using it.
12 years ago
2 comments:
Get it in writing, if you can! I did that for my sea-urchin removal last year, and it saved us a large bill.
Jen,
There's 3 bills:
1. The facility (St. John's hospital)
2. The doctor
3. Anesthesiologist
I asked the billing person, "how much will I have to pay for everything related to this procedure?". She said that I'd owe $xxxx for the facility. So then I said, "so there won't be any other charges?" to which she replied, "oh, sir you'll get three bills...." (one from each in the list above). So then I got upset and said "ma'am this is the third time I'm calling about billing and I have specifically asked you what the total charges will be". She got flustered and said she'd look into it. It's a big deal because the facility THEY wanted to use is out of my network and only covers me at 60% and has a much higher "maximum out of pocket" premium. The in-network facility "I" want to use covers me at 85% and has a much lower maximum out of pocket premium that I'll have to pay.
The billing person said she didn't know how much the anesthesiologist would cost, and didn't know yet what the doctor was going to charge. I find all of this hard to believe since the doctor said, "I do 8-10 of these each day I'm in surgery" so clearly there's a cost trend that can be referenced here.
So how many people out there have a procedure done....expect to pay XXX dollars, and then get hit with 2-3 more bills for XXX a month or so later??? The whole process is lame.
Supposedly my MRI cost $5500 but the contracted amount with United Health Care (UHC) was only $417 and I was responsible for 15% of that ($63). So, you mean I'd be charged $5500 if I didn't have insurance??? That seems a bit backwards don't you think?
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