So yeah, holy balls! (Medical bill)

[achiro]

I recently had an injury that required a few stitches. It also required an ER because it was on a Sunday. I never saw a doctor, only a PA. I told them I didn't need anything to numb it, just sew it up. I drove 30 miles to get there, walked in on my own, and even wondered if I couldn't just go home and take care of it myself. It was deep enough and because of the location on the front of my shin I knew pressure from walking would be a problem so I decided stitches were needed.

So I get a bill from the hospital for $1600, they did write off just over $500 of it. $1100 for 7 stitches, I figured it ws a bit high but ER so whatever. Then I get a bill from the physicians billing for another $1100!

I call and find out that the hospital has billed it at the level 4, of 4, which they consider the most severe. Now remember, I walked in on my own, the bleeding had pretty much stopped which to me is maybe a 1 or 2.
I call the physicians billing and they tell me it doesn't matter if I see the doctor or not, the doctor on call is still billing full price.

Am I wrong for thinking this is crazy? This has to be Obamas fault.

[KantoSooner]

Not sure if this is Obama's fault, but it's certainly just flat out wrong. And drop dead evidence that we don't have a free market in medical care and, unless we get one, we're going to have to have price controls.

[yermom]

this is the crap that needs to change, not the dumb **** everyone is focused on

[achiro]

this is the crap that needs to change, not the dumb **** everyone is focused on
Yep, I agree. Similar to the argument regarding tuition. As long as someone is paying for it bill it as high as you can.
I recently read an article about an MD that has gone to an all cash membership practice. He has an agreement with a diagnostic lab that gets him a $200 test for 3 bucks and an imaging clinic that gets him and MRI for $600 that would normally cost over 3 grand. The surgery center in OKC had a video floating around not to long ago that had similar stuff. My question has always been, if they can do it for 3 bucks, why in the hell are they getting more just because insurance is paying it.

[badger]

I have heard that hospitals tend to lower ER visit bills if you call them on it. There's also those that keep from going to collections just by paying $1 a month (on thousands of dollars of bills, yes)

I don't think hospitals/doctors/etc getting wealthy off you or your insurance, but rather using those that can pay to cover those that can't.

[rock on sooner]

Naw, ya can't blame Obama...this stuff has been going on since at
least 2000. I know. Had to take my son to an ER when he twisted
an ankle at Show Choir rehearsal. Two hours to wait and $1200 bill..
xray, consultation, wrapped and a pair of crutches...

[Breadburner]

Are you Injun by chance......???

[KantoSooner]

I don't think hospitals/doctors/etc getting wealthy off you or your insurance, but rather using those that can pay to cover those that can't.

I give doctors some credit. Hospitals, on the other hand, especially the so-called 'non-profits' are one of the major drivers of high costs. Massively profitable, with no oversight whatsoever and virtually untaxed, they exist mostly to feather the nests of administrators through titanic salary/benefit packages (Yale Medical Center paid their chief something like $12 mil a year vs. $3 mil for the president of the University. A multi-site primary care hospital in a small/medium city is 4 x harder to run than a university with 30,000 students, umpteen professors with egos to match any doctor, operations in over 100 countries, etc etc.?) and old boy tie-ins to local imaging and specialty med practices.

One potential 'solution' to our health care mess would be to nationalize all hospitals and leave the rest private. (we could compensate the churchs and corporations who own hospitals on the basis of whatever value they claimed on their tax returns. That would be funny to watch. Can you say, 'Squeal like a pig"? Sure you can.)

[FaninAma]

I recently had an injury that required a few stitches. It also required an ER because it was on a Sunday. I never saw a doctor, only a PA. I told them I didn't need anything to numb it, just sew it up. I drove 30 miles to get there, walked in on my own, and even wondered if I couldn't just go home and take care of it myself. It was deep enough and because of the location on the front of my shin I knew pressure from walking would be a problem so I decided stitches were needed.

So I get a bill from the hospital for $1600, they did write off just over $500 of it. $1100 for 7 stitches, I figured it ws a bit high but ER so whatever. Then I get a bill from the physicians billing for another $1100!

I call and find out that the hospital has billed it at the level 4, of 4, which they consider the most severe. Now remember, I walked in on my own, the bleeding had pretty much stopped which to me is maybe a 1 or 2.
I call the physicians billing and they tell me it doesn't matter if I see the doctor or not, the doctor on call is still billing full price.

Am I wrong for thinking this is crazy? This has to be Obamas fault.

Speaking as a physician who works in the ER it is crazy. But what is just as crazy is the fact that a medicaid patient can walk into the same ER for an ear ache even though the charges at an urgent care are less than 1/3 of the ER price and not give a **** because they don't pay a deductible or even a $10 copay. Plus the ER probably gets reimbursed at about 1/10 of what they charge a medicaid patient. So you are making up the difference. And no, it will not get better under Obamacare because there will be more medicaid patients abusing more ER visits.

[badger]

patient can walk into the same ER for an ear ache
I had an ear infection a few weeks ago and was up at 3 in the morning googling if I should go to the ER for it because it hurt that damn much :(

you have my sympathies for ER work. I'm sure the people there think that their ear aches and non-emergencies are emergencies

[Mjcpr]

you have my sympathies for ER work. I'm sure the people there think that their ear aches and non-emergencies are emergencies

Why? He's getting $1,100 whether he sews up somebody's leg or doesn't even show up. Hardly in need of sympathy. Tax shelters, yes....sympathy, no.

[badger]

Why? He's getting $1,100 whether he sews up somebody's leg or doesn't even show up. Hardly in need of sympathy. Tax shelters, yes....sympathy, no.

Aw c'mon man it's not like he owns the ER. It's like not having sympathy for the Lowe's cashier because you're handing them $1,000 for the refrigerator. Yes, customer, you are always right. Yes, customer, I will go as fast as I can. Yes, customer, I know that your time is valuable. Yes, customer, you are my highest priority.

I used to work in retail hell during college summers. I had thick skin, but I also only had to be there a few months of the year. The full time hell workers could be brought to tears by some of the demanding types :(

[sooner_born_1960]

Did you miss the part where the physician billed a separate $1100?

[badger]

Did you miss the part where the physician billed a separate $1100?

i don't think his physician was faninama :)

[FaninAma]

I had an ear infection a few weeks ago and was up at 3 in the morning googling if I should go to the ER for it because it hurt that damn much :(

you have my sympathies for ER work. I'm sure the people there think that their ear aches and non-emergencies are emergencies
Google home remedies for ear aches. BTW, most trivial visitsI see in the ER occur between 8 and 10 am. The urgent care opens at 10:30 but the medicaid patients don't want to wait since there is no financial incentive for them to use the cheaper clinic.

[FaninAma]

i don't think his physician was faninama :)

Most ER physicians work for the hospital. We have no input on billing.

[yermom]

Google home remedies for ear aches. BTW, most trivial visitsI see in the ER occur between 8 and 10 am. The urgent care opens at 10:30 but the medicaid patients don't want to wait since there is no financial incentive for them to use the cheaper clinic.

so maybe they should expand the hours? use a PA instead of a full doctor?

[FaninAma]

so maybe they should expand the hours? use a PA instead of a full doctor?
Using a PA doesn't decrease your costs. The hospital bases charges on how much they need to pay for overhead and not lose money in the department. If they are a for-profit hospital then throw more cost into the equation.

[yermom]

so it's not Obamacare/Medicare, it's a staffing/administration issue

[FaninAma]

Obamacare is exacerbating an already existing problem. Medicaid is woefully underfunded for the number of patients it covers now. Increasing the number of people covered by Medicaid isn't going to help that problem. Medicare will soon end up in the same underfunded mess that medicaid is in....if it hasn't already.

[Soonerjeepman]

Obamacare is exacerbating an already existing problem. Medicaid is woefully underfunded for the number of patients it covers now. Increasing the number of people covered by Medicaid isn't going to help that problem. Medicare will soon end up in the same underfunded mess that medicaid is in....if it hasn't already.

but but now with obamacare they're "legit"....they have a card!!! these folks just don't get it....lol

I, for one, appreciate your first hand knowledge.

[bluedogok]

I almost died last week of biological meningitis of the brain, went to the emergency room on Tuesday the 7th and don't remember anything until I woke up in the ICU at Parker Adventist hospital (Denver area) on Sunday (the the 12th). Spent my 50th birthday in a regular room, now I am in a rehab hospital recovering. Now the bills will come.....

[FaninAma]

I almost died last week of biological meningitis of the brain, went to the emergency room on Tuesday the 7th and don't remember anything until I woke up in the ICU at Parker Adventist hospital (Denver area) on Sunday (the the 12th). Spent my 50th birthday in a regular room, now I am in a rehab hospital recovering. Now the bills will come.....
Wish you all the best for a full recovery.

[yermom]

I think that probably warranted a new thread :)

That sounds effing terrible. Good to see you posting again

[olevetonahill]

I almost died last week of biological meningitis of the brain, went to the emergency room on Tuesday the 7th and don't remember anything until I woke up in the ICU at Parker Adventist hospital (Denver area) on Sunday (the the 12th). Spent my 50th birthday in a regular room, now I am in a rehab hospital recovering. Now the bills will come.....

Hope everything continues to improve Bro. Belated Happy B-Day also.

[Breadburner]

I almost died last week of biological meningitis of the brain, went to the emergency room on Tuesday the 7th and don't remember anything until I woke up in the ICU at Parker Adventist hospital (Denver area) on Sunday (the the 12th). Spent my 50th birthday in a regular room, now I am in a rehab hospital recovering. Now the bills will come.....

Get well soon.....!!!!

[bluedogok]

Got word I'm supposed to be released to the house on Wednesday the 22nd, so things are progressing well.

Thanks for the well wishes.

[Breadburner]

Great news.....!!!!

[Wishboned]

Good to hear you're on the mend Blue. Not a great way to spend a 50th, but after what you went through I'd say the fact that you spent it on this side of the dirt was good enough.

[BigTip]

And that hospital is only charging bluedogok $115 a day for internet access. Cheap!

Get well soon.

[diverdog]

Do you guys have Doc In the Box model out west? They are walk in clinics usually staffed by PA's or Nurse Practitioners and they deliver a really good value for the buck. My kid got 12 stitches to the knee and it was around $300 which was covered by my insurance. The waits are usually short.

[FaninAma]

Do you guys have Doc In the Box model out west? They are walk in clinics usually staffed by PA's or Nurse Practitioners and they deliver a really good value for the buck. My kid got 12 stitches to the knee and it was around $300 which was covered by my insurance. The waits are usually short.

I think they are pretty well estabilshed in most communities with a population above 15,000. In larger cities you can find dedicated pediatric urgent cares. The downside with a lot of these clinics is if you need anything more than CLIA waved lab services or more than very basic diagnostic radiology they aren't likely to be provided in these clinics meaning they will see you, charge you and then if they can't work your problem up appropriately they will refer you somwhere that can which means you may get charged twice.

I will say that urgent cares should be able to address 90% of the medical complaints that use non-private physician clinics for acute issues.

[bluedogok]

Do you guys have Doc In the Box model out west? They are walk in clinics usually staffed by PA's or Nurse Practitioners and they deliver a really good value for the buck. My kid got 12 stitches to the knee and it was around $300 which was covered by my insurance. The waits are usually short.
Yes, my primary care doc is in a combination family practice/urgent care clinic.

[Turd_Ferguson]

Yes, my primary care doc is in a combination family practice/urgent care clinic.

Thoughts and prayer's for ya brother!

[bluedogok]

I have been released to home from the rehab hospital, maybe I can start sleeping well now.

[jkjsooner]

The downside with a lot of these clinics is if you need anything more than CLIA waved lab services or more than very basic diagnostic radiology they aren't likely to be provided in these clinics meaning they will see you, charge you and then if they can't work your problem up appropriately they will refer you somwhere that can which means you may get charged twice.

This reminds me of one problem I've noticed - how little record sharing is done in the medical community. If you don't personally keep track of the tests that have been run on you, when you go from one place to another you'll end up getting the same tests over again.

At least that's my limited experience. It seems like pure waste.

[KantoSooner]

As I understand it, you're supposed to have a primary care doc. And that doc is supposed to do the minor stuff and then refer you on to specialists when necessary. That primary is supposed to be the QB on your team.

The problem is that said primary is very rarely interested enough to do squat. No one shares records and all the specialists feel compelled to alter meds prescribed by other docs and only extremely rarely even check what other meds are being taken. And, of course, expecting any doctor to review meds and terminate those no longer needed is a pipe dream.

We have almost lost my father on six occaisions over the past 3-4 years, all of them due to medication interactions. A recurring potassium situation was caused by two different doctors outthinking one another and ordering conflicting meds (a potassium supplement to treat anticipated potassium shortage caused by diuretic....except that the diuretic was a potassium sparing one), that one was caught by a 28 year old hospitalist and a Kmart pharmacist....after three hospitalizations. More recently, a massive GI bleed was caused by another doc deciding to see if blood thinners and Indocin went well together. Finally got that 'figgered out' after two hospital stays and five units of blood. (short answer is, 'No. they don't work well together."

So, jkj, you're correct in your assumption, but it's worse than you imagine. There is no one in charge of anything. Your primary care doc has no duty nor, likely, any interest in delving into your case. The inmates are the only ones with any interest in running this asylum.

It is up to you to maintain your own medical records (I now demand copies of everything and we keep our own central records at home on our computers). And it is up to you to do your own medical research and to make sure your medical 'professional' does not kill you. And that is only about 5% hyperbole.