First Medical Bill

11/28/2008

Well I was greeted by my first medical bill for my emergency room visit: $800 hospital and physician costs.

Wow!!! I wish I had know about this site back then I would have avoided the emergency room and just gone to see an orthopedist. Especially since the Or-tho removed the splint that the emergency room put on and put their own on.

I am curious though did anyone else have a problem of getting an estimate of how much the surgery will cost, prior to the surgery? 

1st week back at work and I can’t lie I am whipped!! Always thought I was in relatively good shape but the NWB me has some work to do.

Ordered the IWalkFree and got a chance to talk to the inventor today. I am excited about the prospect of getting the use of my arms back, should have it by Wednesday!! One more weekend on crutches.

Have a great weekend!!!

6 Responses to “First Medical Bill”

  1. sgtmo Says:

    Hey Surfingpilot,
    I suppose it depends on your insurance company. I myself have United Health Care and I don’t have a set co-pay. I have a percentage instead (20 percent.) All in all between the Urgent Care visit, the Ortho visit and the surgery itself (facility fee, ortho fee, anesthesiologist, MRI etc etc) my share was about $1200. Not bad considering. . .
    What I’m curious about is I get a bill for $3500 for the surgery and my insurance pays $1200 of it, then I get billed $90. What happens to the remaining $2210?

  2. Smish Says:

    Surfingpilot: I don’t think they want to give an estimate of what surgery will cost because there are so many variables that can make the price go up. If you don’t have insurance, you can most definately get them to give you the “self pay” price. It is a lot lower than the cost if you have insurance. I bet you can even negotiate your $800 ER bill down as well. A lot of hospitals will take 20-40 percent off the bill if you will pay it all at once too. I have Kaiser insurance. My surgery cost me $100 for the MRI and $100 for the actual surgery. Kaiser doctors are hit or miss but I got blessed and found one of the best doctors in the city, Kaiser or not.

    Sgtmo: What happens to the remaining $2210 is it gets written off. Doctors agree to do that to be in a coverage plan for certain insurance groups. I guess they figure they will get a lot of referral business so it works in their favor.

  3. MarilynRD Says:

    Hi All,
    Checking in and hope everyone had a Great Thanksgiving. I love these insurance questions. I asked before my surgery what the billing codes were specifically and it is your right to know them. You go to the insurance with these codes and get an “estimate” and obviously if you have a complication, it may change. Get the “preauth” in writing and it will save you a headache later. My Doctor gave me his usual codes (he performs these at least once a week) and told me my portion was $135~!! WOW, I was so thrilled because I had pain and it was worsening for the past 3yrs. Amazing and honestly, after the surgery he was TRUE TO HIS WORD!! :))))))))) It is actually what my portion really was. Ask if the bill includes the facility fee, the anesthesia, and supplies too! The insurance covered everything…thank goodness! Ask about the fee for the boot and mri and follow up rehab. I had an elective surgery to repair my achilles, debride the bone, and lengthen the tendon. No ER visit. It makes a huge difference if you ask “Do you take my insurance” vs “are you under contract with my insurance”. I am getting sick of Doc’s who don’t take my insurance…..I know they are not getting what they think they should be paid, but frankly, no one is in this economy and sometimes I feel that they are “all about money!”. My DOC was amazing…not a complaint about the fee….and was very skilled, and under contract with the insurance. His complication rate seemed very low!!! The PT was a problem, as I wrote in other posts.

    Smish is right—they write off a portion of the fee that is above the “reasonable and customary” for your area sometimes, IF they are under contract with your insurance. I was walking in a boot at week 4. I am not sure my Doc is a “risk taker” but I think he has data to support early mobility =early recovery. I am sure that he individualizes care but for the most part has a “usual” protocol. NO ATR is an emergency as we are finding out, so check all your resources! In the end, the longer protocols are more about YOU—your situation evaluated by the Doc and research does indicate early mobility is better with whatever injury your dealing with usually. If you can return to work earlier, it is better, right?! One thing to consider which I have never done before is checking into Chiropractors ! I have an appt with one this week for the first time in my life. I didn’t check with insurance but willing to self pay and may fine out that they take it—decisions to be determined. I hope this post was helpful and sorry for the long winded answer to a simple question! Ask your doctor what codes he usually bills for with this procedure—very typical standard of practice. Ask about the boot cost, PT cost, anesthesia, facility…..contract vs 80/20 coverage.. GOOD LUCK!

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