ATR Recovery: A Full Accounting (USD)
Well, now that I have all my doctor and PT visits in the rear-view mirror, I did an accounting of the expense of my ATR recovery. I know this is only tangentially related to the purpose of this site, but I thought someone might find this interesting and/or useful. As this was the largest medical expense I’ve ever incurred, I found it very illuminating.
The grand total billed amount for my ATR (ER visit, pre-op care, surgery, and post-op care) was $22,833. My health insurance company negotiated that amount down by 33.5%* to $15,192. Of this paid amount, $1,263 (or 8.3%) can be attributed to pre-op care, $6,247 (or 41.1%) can be attributed to my surgery, and $7,681 (or 50.6%) can be attributed to post-op care, mainly PT. After hitting my health insurance policy’s maximum out-of-pocket expenses shortly after surgery, I did not skimp on my PT as it was all covered. If it were my money, I wouldn’t have consumed as much (professional) PT as I did.
Clearly, another advantage of pursuing the non-op ATR recovery route is the expense. Over 40% of my ATR recovery expense came from my surgery–and 75% of that was for the surgical center and the anesthesiologist. The more I learn, the more attractive the non-op recovery route appears to me.
As an interesting aside, the day before my surgery my OS’ billing office called and offered me a 20% discount if I paid in cash tomorrow (i.e. before my surgery). I have a high-deductible health insurance plan and at first I thought what a great deal! However, after thinking about it further, I decided against their generous offer. I knew my out-of-pocket expenses as a result of this injury would be my annual deductible, so why pay anything any sooner than necessary. Also, I was curious about what my health insurance company would be able to negotiate–and at a 23%* discount, they did slightly better.
In the end, I’m very happy with my recovery outcome, but if I had to do it over again (I sincerely hope not!) I’m nearly certain I would go non-op–less risk, less expense, and very possibly the same or better outcome.
*33.5% was the dollar-weighted average negotiated discount for all of my ATR care, with a range of individually billed items discounted anywhere from 10% to 77%.
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6 Responses to “ATR Recovery: A Full Accounting (USD)”
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Interesting stuff! Good luck skipping the second one!
Very interesting! Makes you wonder just how inflated these numbers are… I stopped in my medical center’s accounting office to pay my bill the other day and it initially didn’t even occur to me to ask for a discount — until the receptionist asked me “how much would you like to pay today?”
I responded that I would pay 80% that day if it meant we could close out the account, and they accepted. I thought I got a good deal but it looks like I left another 10% on the table!
davidk - this is fascinating to someone like me who comes from a country where we never get a medical bill ever. We moan about our healthcare system (and believe me, depending on where you are/what you need, it does have shortcomings) but stressing about how to pay or whether the insurance company will cover the costs never comes into the equation (unless for some reason, you decide your care is so woeful, you will go privately). I’ve actually already booked my first PT session privately, which will start at week 4 after my injury (non-operative route) because I don’t trust the NHS system to give me an appointment until way after that. However the cost of that appointment is only about $75, so I think I can handle 2-3 of these and then hopefully the NHS ones will kick in. I did pay about $100 to hire a knee scooter, but so far only a few days in, that seems to be worth the money.
If you don’t have any objection I will keep this costing for future reference: I’m a medical journalist and once I get more recovered am hoping to write an article on the whole surgery versus non-operative recovery controversy. I agree that given the huge cost of surgey, this is only another reason not to pursue this avenue!
That is a staggeringly high cost and the discounting process is a little bewildering!
Heeling, I have no objection to you saving my figures for future reference. I was curious about the cost since I have no reference points myself. If some others share their own recovery expenses, it would be interesting to compare.
Herewegoagain, I agree completely! Although totally different, this experience does remind me a little of airline seat pricing. When traveling on a plane (alone), if you were to ask the people sitting on your immediate left and right what they paid for their ticket, you would likely end up with three (including your own) different prices for essentially the same good.
Hi David, I haven’t been on A-blog much the past few months. Was curious how some of the “class of early 2014″, so to speak, was Doing. I like your accounting post… Will try to find my receipts and add it up. Should be a good comparison because we got injured within a few short weeks of each other. Best.-Jon