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The New Coffee Room

  1. TNCR
  2. General Discussion
  3. Pretty soon you're talking about real money

Pretty soon you're talking about real money

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  • 89th8 Offline
    89th8 Offline
    89th
    wrote on last edited by
    #56

    Ah I see, kind of like dental insurance on special procedures (like an implant) but way bigger bills.

    1 Reply Last reply
    • HoraceH Horace

      That was just for the surgery center facility. There is another bill for the surgeon, another for the anesthesiologist. Those are all covered directly by my health insurance but there's always a portion I am responsible for, even after the deductible is covered. I figure the whole thumb thing will cost me about 10-15k out of pocket when it's all done.

      JollyJ Offline
      JollyJ Offline
      Jolly
      wrote on last edited by
      #57

      @Horace said in Pretty soon you're talking about real money:

      That was just for the surgery center facility. There is another bill for the surgeon, another for the anesthesiologist. Those are all covered directly by my health insurance but there's always a portion I am responsible for, even after the deductible is covered. I figure the whole thumb thing will cost me about 10-15k out of pocket when it's all done.

      If they are in network, that would seem to be a bit high for your part. Have you received your EOB's on their services?

      “Cry havoc and let slip the DOGE of war!”

      Those who cheered as J-6 American prisoners were locked in solitary for 18 months without trial, now suddenly fight tooth and nail for foreign terrorists’ "due process". — Buck Sexton

      1 Reply Last reply
      • HoraceH Offline
        HoraceH Offline
        Horace
        wrote on last edited by
        #58

        I mean across all three surgeries and including all doctor visits, physical therapy, etc.

        Education is extremely important.

        1 Reply Last reply
        • taiwan_girlT Offline
          taiwan_girlT Offline
          taiwan_girl
          wrote on last edited by
          #59

          @jon-nyc Dont know if you would be willing to share, but what was the gross cost for your medical procedure?

          1 Reply Last reply
          • jon-nycJ Online
            jon-nycJ Online
            jon-nyc
            wrote on last edited by jon-nyc
            #60

            Around 900k.

            But that’s everything, all the visits before and after, special tests (a heart cath can be 10-15k and I’ve had 4 of them), rehab and ‘prehab’, surgery, ICU time, hospital time, etc.

            Only non-witches get due process.

            • Cotton Mather, Salem Massachusetts, 1692
            1 Reply Last reply
            • jon-nycJ Online
              jon-nycJ Online
              jon-nyc
              wrote on last edited by jon-nyc
              #61

              I don’t know what I spent, it was probably capped at a few grand per year for co-pays.

              We even had some reimbursement for relocation, but I was listed long enough that we burned through it. So I probably spent 20-30k of my own money (over, say, 2014-16) if I had to guess.

              Most of it didn’t feel like medical bills. Like buying a home oxygen concentrator or paying rent or renting furniture.

              Only non-witches get due process.

              • Cotton Mather, Salem Massachusetts, 1692
              1 Reply Last reply
              • 89th8 Offline
                89th8 Offline
                89th
                wrote on last edited by
                #62

                @Horace I require 1x update plz

                HoraceH 1 Reply Last reply
                • 89th8 89th

                  @Horace I require 1x update plz

                  HoraceH Offline
                  HoraceH Offline
                  Horace
                  wrote on last edited by
                  #63

                  @89th I paid the $1433 and am now hoping the 98k bill just magically disappears. I received no receipt of payment, though the woman on the phone said she'd send me one. Nor have I ever received a bill. The only bill received so far is the one sent to my insurance company. So basically the process is that this surgery center sends a huge out of network bill to the insurer, gets pennies on the dollar for it, and accepts some other "small" amount from the patient. I have to trust the system that the balance of the 98k bill is not legally passed on to me. Having seen no paper yet, I really don't know.

                  Education is extremely important.

                  1 Reply Last reply
                  • RainmanR Offline
                    RainmanR Offline
                    Rainman
                    wrote on last edited by
                    #64

                    Horace said, "I have to trust the system..."

                    No kidding. He actually said that. Look at his post!
                    It looks like his typing, far as I can tell.

                    Scary, might be Covid-20 or something.
                    Too much sun? Bad water. Drunk on Jon. Found religion.

                    Ax, help him help him!! Soon he'll be drowning in trust, and then, blam! No return from utopia.

                    1 Reply Last reply
                    • Doctor PhibesD Online
                      Doctor PhibesD Online
                      Doctor Phibes
                      wrote on last edited by
                      #65

                      You either trust the system or you move to Canada.

                      I was only joking

                      1 Reply Last reply
                      • 89th8 Offline
                        89th8 Offline
                        89th
                        wrote on last edited by
                        #66

                        Thanks @Horace what an almost unbelievable lack of paper records given the amounts you’re talking about.

                        1 Reply Last reply
                        • Doctor PhibesD Online
                          Doctor PhibesD Online
                          Doctor Phibes
                          wrote on last edited by
                          #67

                          It's unbelievable that we have to live with this shit.

                          You get a bill for $100K, and are told 'not to worry, it's an administrative error'.

                          Yeah, that just fills me with confidence. I really hope the same people doing the accounting aren't the same ones wielding the scalpels.

                          I was only joking

                          Catseye3C 1 Reply Last reply
                          • Doctor PhibesD Doctor Phibes

                            It's unbelievable that we have to live with this shit.

                            You get a bill for $100K, and are told 'not to worry, it's an administrative error'.

                            Yeah, that just fills me with confidence. I really hope the same people doing the accounting aren't the same ones wielding the scalpels.

                            Catseye3C Offline
                            Catseye3C Offline
                            Catseye3
                            wrote on last edited by
                            #68

                            @Doctor-Phibes said in Pretty soon you're talking about real money:

                            I really hope the same people doing the accounting aren't the same ones wielding the scalpels.

                            OR SURGEON to nurse: "Remind me again, which side is the appendix on? Left or right?"

                            (With apologies to Bach. 😬 )

                            Success is measured by your discipline and inner peace. – Mike Ditka

                            RainmanR 1 Reply Last reply
                            • Catseye3C Catseye3

                              @Doctor-Phibes said in Pretty soon you're talking about real money:

                              I really hope the same people doing the accounting aren't the same ones wielding the scalpels.

                              OR SURGEON to nurse: "Remind me again, which side is the appendix on? Left or right?"

                              (With apologies to Bach. 😬 )

                              RainmanR Offline
                              RainmanR Offline
                              Rainman
                              wrote on last edited by
                              #69

                              @Catseye3 said in Pretty soon you're talking about real money:

                              @Doctor-Phibes said in Pretty soon you're talking about real money:

                              I really hope the same people doing the accounting aren't the same ones wielding the scalpels.

                              OR SURGEON to nurse: "Remind me again, which side is the appendix on? Left or right?"

                              (With apologies to Bach. 😬 )

                              Why are you apologizing to Bach?
                              Don't tell me he did it again!

                              1 Reply Last reply
                              • bachophileB Offline
                                bachophileB Offline
                                bachophile
                                wrote on last edited by
                                #70

                                Situs inversus.

                                Look it up

                                George KG 1 Reply Last reply
                                • bachophileB bachophile

                                  Situs inversus.

                                  Look it up

                                  George KG Offline
                                  George KG Offline
                                  George K
                                  wrote on last edited by
                                  #71

                                  @bachophile said in Pretty soon you're talking about real money:

                                  Situs inversus.

                                  Look it up

                                  Ever seen it? We had one for a CABG - really screwy from what I understand (I wasn't the gas passer on that one).

                                  "Now look here, you Baltic gas passer... " - Mik, 6/14/08

                                  The saying, "Lite is just one damn thing after another," is a gross understatement. The damn things overlap.

                                  1 Reply Last reply
                                  • HoraceH Offline
                                    HoraceH Offline
                                    Horace
                                    wrote on last edited by
                                    #72

                                    Yesterday I had a followup appt with the doctor, but ended up only seeing his physician's assistant. We got to discussing the next surgery and I asked where it would be done, and mentioned my issues with the previous place. He was pretty shocked to hear of the 98k bill my insurer received. As always, nobody on that side of the issue ever knows about the money issues. (One of the many symptoms of the total lack of market forces in these transactions.) Apparently what I told him got back to the surgeon, who then apparently called the surgery center and gave them a dressing down. The surgery center then called me to try to smooth out any issues I may have had. This doctor and his group is an important customer of theirs and they can't afford to be pissing him off, so all of a sudden it became priority to make sure I'm happy. The surgery center told me that even though they're out of network, they check with the insurer and only charge the patient what the in-network charge would have been. Since I was allegedly below my out of pocket limit for the year, they charged me 1400. I asked whether that 1400 contributes to my out of pocket total, since that payment was made without my insurer's awareness, and she said yes but maybe she'd double check anyway. I let her know that the whole system of billing as out of network and charging the patient separately as if they had paid in-network, did not fill me with confidence that my expenses were being properly tracked and accounted for. Today she called back and told me that I had been overcharged for my previous surgery, and that my out-of-pocket actually had been met, so sorry, so she'll be giving me my 1400 back. My next surgery will be at this same place, and I am to disregard any bills I may see on my insurer's website, because for some reason my insurer lets me know whenever a provider bills them for services provided to me. Imagine that.

                                    My wife sometimes asks me how the insurance system works for health care in America. I try to convey that it's a chaotic mess that must be negotiated anew every time you need medical services, and if you don't pay attention, you get screwed.

                                    Education is extremely important.

                                    1 Reply Last reply
                                    • JollyJ Offline
                                      JollyJ Offline
                                      Jolly
                                      wrote on last edited by
                                      #73

                                      I once paid for a high-deductible Blue Cross policy on my son. Not because he would probably need it, since 20-somethings don't usually meet $10k deductibles.

                                      It's because even if you haven't met your deductible, you pay the network negotiated price.

                                      “Cry havoc and let slip the DOGE of war!”

                                      Those who cheered as J-6 American prisoners were locked in solitary for 18 months without trial, now suddenly fight tooth and nail for foreign terrorists’ "due process". — Buck Sexton

                                      1 Reply Last reply
                                      • HoraceH Offline
                                        HoraceH Offline
                                        Horace
                                        wrote on last edited by
                                        #74

                                        If your provider is in-network. Otherwise you're subject to the whims of the billing department of the provider.

                                        Education is extremely important.

                                        1 Reply Last reply
                                        • 89th8 Offline
                                          89th8 Offline
                                          89th
                                          wrote on last edited by
                                          #75

                                          Thanks for the update @Horace !

                                          1 Reply Last reply
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