I’m Just A Bill
UPDATE: “I’m Just A Bill” has won the bronze medal post award at this week’s Patient Consumer Parade at Six Until Me!
Yes, I actually downloaded “Schoolhouse Rock” from iTunes!
Maybe I should have titled this, “I’m Just A Dork!”
I wasn’t even little when Schoolhouse Rock came out, but to this day I can sing “Conjunction Junction”!
If you think that’s bad, I know all the state capitols from listening to Wakko sing them on “Animaniacs”!
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Well, it’s been three months since John’s gangrenous gallbladder was removed and his diabetes discovered.
He exercises twice as much as ever, runs blood sugars from 103-124 while on 1000mg of Metformin and I dropped about 7-10 more pounds since I stopped buying sugar.
John still is able to drink his wine and he is very good about keeping it at 5 ounces a day. I however, drink Diet Pepsi like it is never going to be produced again.
Hey, no one is perfect!
But now it comes in two new flavors!
What other addictive substance can boast of that?
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For the last three weeks I have been flooded with “EOB”s. For the initiated, it means “Explanation of Benefits”.
In other words, I have found out what we were charged for John’s hospital stay, his doctors, his labs, radiology, etc., and exactly what our insurance will pay.
I nearly fainted, but for reasons you may not suspect.
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For almost two hours, the life of my husband was in the hands of two doctors: his surgeon and his anethesiologist.
For this responsibility, the surgeon charged only $1500 - including all pre-op and post-op visits. Remember, this was a complicated laparoscopic surgery requiring a three day hospital stay, with a Jackson-Pratt drain a foot-and-a-half long into his abdomen for two of those.
For his services and responsibility, the anesthesiologist charged only $1520.
I nearly fainted for two reasons:
- I can’t believe how low these charges were. I honestly expected three times as much as that. And it would have been worth every penny.
- Our insurance paid them 100%. ONE HUNDRED PERCENT! I didn’t think any insurance companies paid doctors what they asked for. Then again, these were specialists. My regular doctor doesn’t get 100% of what each visit is billed for. Even with my co-pay.
But then came the piece de resistance: The Hospital Bill
Inferior Medical Facility charged John FIFTY THOUSAND, FIVE HUNDRED AND FIFTY-FIVE DOLLARS AND NINETY-SIX CENTS.
$50,525.96
I did faint.
Oh, but wait! Inferior Medical Facility is in our “plan” so we got a discount!
$41,816.96
Of which a little less than 80% was paid by our insurance. Which means that in the blink of an eye, in the time it took a gallbladder to go bad, in just 72 hours, we became nearly $9,000 in debt.
It would take me longer to spend that much in Vegas.
Thank god we have insurance. What happens to those who don’t? What if you are poorer than dirt and your gallbladder goes out? How do you pay?
Fifty thousand dollars for a med/surg room.
- A room that for at least 24 hours, he shared with three other patients.
- With approximately every four hour appearances of an RN.
- With 60-90 minute waits for pain medication.
- With blatant JACHO violations.
- Whose motto in the ER is “HIPAA Go To Hell”, but on the floors lab results were guarded like Guantanamo Bay.
- For a man who was totally self care, alert, oriented and ambulatory.
- A man who had to ambulate to the nurse’s station to ask for pain meds because no one was answering his light.
I’m waiting for the itemized hosptial bill to arrive, just to make sure he wasn’t accidentally charged for giving birth to twins.
Here’s how I figure it:
- Assume his nurses make an average of $55.00 per hour (not unusual in CA). That would mean his nursing care would have been approximately $3960.
- Figure his housekeepers made $25.00/hr. Not likely, but for the sake of argument. That is $1800.
- The room, using a moderately priced hotel figure, electricity, water…oh, $125 per day. (Remember, nursing and housekeeping are separate). That is $375.
- Figure fifteen dollars per meal (that would factor in the dietary workers and allow for the fact that some of the meals were clear liquid), even though he was NPO for a couple of them. That would be $120.00
I’m up to $6375.
Let’s be generous and give the Diabetic Educator $250 for her one and only visit to the bedside that lasted 30 minutes.
$6625.00
Let’s really go out on a limb and say $50.00 per fingerstick, four times a day. $600.00
$7225.00
Let’s give $10,000 to the OR team (sans doctors).
$17,225.00
And oh, about $3000 for his forty-five minute use of the recovery room and the fact that the nurse was on call.
$20,225.00
And IV fluids….along with the antibiotic he got twice a day. $25.00 per IV bag…he used maybe six liters. $150. Antibiotics twice a day - let’s give ‘em a BIG price, like $500 per dose, six doses, $3000.
$23, 375.00
Let’s allow $2000 for oxygen.
$25,375.00.
Can somebody tell me where the other $25,125.96 went?
He didn’t use that much pain medicine…..
I can tell you where it didn’t go.
To the doctors.
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By the way, the fourteen hours that John was in the ER cost $4725.
It was in addition to the regular hospital bill charges.
Our co-pay was only $50.00.
And it wasn’t waived when he was admitted.
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When the itemized bill does arrive, I’ll let you know how close I was to my estimates.
I suspect I will be waaaaaaay off…….
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Next: How Many Pelvics Does It Take to Diagnose a Hemorrhaging Ovarian Cyst, Anyway?
Kelly
August 17, 2006 at 2:05 am
OK, but do you know the COUNTRIES song from Animaniacs? That’s a toughy!
“Conjunction Junction, what’s your function?”
Hehehehe!
Kelly
August 17, 2006 at 2:15 am
And on the other side, Michaela had a bill only $5000 over that for 15 days! Not 3!!!
And she had an MRI, vEEG, EKG, Fluoroscopy, a surgery, PT, OT, Speech, a high-dollar formula instead of food, many blood tests, plenty of drugs, AND was seen by at least 5 different specialists!
What in the WORLD are you paying for here?!?!
Is this because you live in Cali?
radtec
August 17, 2006 at 12:11 pm
You’re indeed quite lucky. My insurance wouldn’t have covered anywhere near that much!!
Those without insurance? Well, ‘we’ would pay what we could and walk around a zillion dollars in debt!!
THAT is what YOU are paying for now…the ‘lack’ of payment from those who ‘have not’.
EMT-P JD
August 17, 2006 at 4:18 pm
What to attribute that extra $25,000 to? Well, how about all the care that the hospital gives, but doesn’t get paid for, because some people (who have jobs and insurance available) choose to not get insurance…to cover charity care provided to those who try to work, who want to work, but can’t get a job that provides insurance…to make up for the difference between the cost of care and the amount reimbursed by Medicare and Medicaid…to cover the costs of complying with excessive and foolish regulations that burden healthcare without helping patients…to cover the costs that are required, such as disaster preparedness, but not considered worthy of compensation by the government or payors…Health care in America is a mess, and massive changes are needed. I wonder if we will ever end up with a rational, efficient system.
Notes From a Rockin’ Couch Potato // Emergiblog
August 17, 2006 at 10:05 pm
[...] New post up over at Scared To Health…… [...]
Teresa
August 18, 2006 at 6:34 pm
Our healthcare system is indeed a mess. We have skilled practitioners and great technology but too many special interests that prevent any rational, radical changes in the way healthcare is delivered.
Insured working people routinely file for bankruptcy because of healthcare debt. A 10% or 20% hospital deductable will do that.
My family has been lucky. Out insurance is great. Keeping Richard alive has cost us very little out of pocket.
Teresa
August 18, 2006 at 6:37 pm
Sorry..that’s “our” insurance, not out! And deductible.
Kathleen
August 18, 2006 at 10:56 pm
hospital bills are OUTRAGEOUS. I checked in @ 10am for a cystoscopy, had the surgery and checked out @ 1400. My bill was $9k. I was lucky. Since I’m an Rn I have great medical insurance and didn’t pay a penny.
I bet the majority of the your husband’s bill was the medication. I gave a chemo the other day, a 30mg/1ml injection that cost $4k!
Our hospital doesn’t turn anyone away for lack of funds. However, I do believe the hospital makes up the for that cost in “incidentals” to the paying customers.
We have got to get a national healthcare program!!
Bardiac
August 19, 2006 at 1:23 pm
I didn’t do the math on your labor costs, but remember the employer’s cost is usually about double the actually salary/wage if the worker is getting benefits, social security, and so forth. That still doesn’t add up to the total bill, though. (I’m guessing the itemization will be way up there.)
Yep, hospitalization is expensive. Scary expensive.
I’m confused that you weren’t already really aware of that because you work in one.
NPs Save Lives
August 20, 2006 at 12:26 pm
Kim, It’s AMAZING how much healthcare costs these days. I agree with the above comments about how the ones who don’t pay or the ones with no insurance being the the main reason for the increases. Of course, pure greed from the hospital counts pretty highly.. I hope your husband is doing better!
The Answer Nurse Returns // Emergiblog
August 21, 2006 at 6:45 am
[...] Emergiblog is proud to announce that this post at Scared to Health has won the Bronze Medal post award in this week’s Patient Consumer Parade at Six Until Me [...]
Jenny
August 21, 2006 at 7:36 am
Kim-
My husband is a “pre-diabetic.” He just started Metformin, and is on an anti-hypertensive. If he could just loose 30 or 40lbs, he would be so much better off.
Its partially my fault, I dont know how to get all the sugar and crap out of the house. How frustrating, especially when his dad is IDDM.
Thanks for posting about this experience. I will keep reading, and learning. (just found this today…)
ltaylor
August 21, 2006 at 2:36 pm
Kim - there has to be an error! As you recall my hubby was in the ICU for a couple of weeks and on the floor for a couple more due to an allergic reaction to heparin used in stent procedures. Our hospital bill for that was 40K (we are in Texas). This included some meals for me which we were charged $15.00 but does not include the actual stent procedures and subsequent admits on the telemetry floor for a day or so - those are separate. So we actually added to the bill on our own accord. I have shoe boxes full of bills from the hospital, various doctors, labs, EOB’s and past due statements. So while my debt did take a bit longer than yours, I would still be in Vegas too!!!
I hope you can get it straightened out. I am shocked!! Peace, L
Karen
August 21, 2006 at 5:02 pm
:: struggling to peel myself off the floor ::
I knew that hospitalization was expensive, but holy cow. That’s amazing.
INSTAHEALTH » Archive » Just Bill Me
August 21, 2006 at 6:33 pm
[...] Via PCP6, this is a great post from Scared to Health about the awful complexities and magnitudes of modern healthcare bills. The truth is that medical bills shouldn’t be that high, and they shouldn’t be complex. Part of the whole idea of ‘consumer-driven health care’ is to get hospitals to buy into the idea of price transparency (i.e., they agree to tell us patient-consumers what things cost before they charge us $50,000+!!). Because when hospitals do that, the bills will be more simple and less costly. Why? [...]
Gail Rae Hudson
August 21, 2006 at 6:35 pm
Kim, although it doesn’t look like it from the url, I’m the author of the post “How to Be Where You Are” at which you just left a comment. That site is a sub site of my main site, to which I left the url here. I just got back from being interrupted, by my mother (I’m her full time caregiver), reading posts at the PCParade this morning, yours of which made me reel! My mother is well covered by her insurance but I get the bills, anyway, which detail what insurance is covering. Those, alone, make me shudder. Yours sent me to the altar praying that I will never, ever be ill and I will die in some freak accident, like a meteor hitting our house!
The comments, too, on this post, are extremely informative. You’ve pushed a hot button I’m really glad you pushed!
Anyway, I’m finally back, am writing the comment I intended to leave earlier on your post, and I noticed that you also commented on mine, asking if you could link to it. I looked for an email address around here but couldn’t find one so I’m answering your request here: Absolutely! Link freely to that or anything else you find on my journals that intrigues you.
I’m glad you submitted to PCParade this week. Excellent submission!
Patient-Consumer Parade » Archive » Just Bill Me
August 21, 2006 at 6:35 pm
[...] Via PCP6, this is a great post from Scared to Health about the awful complexities and magnitudes of modern healthcare bills. The truth is that medical bills shouldn’t be that high, and they shouldn’t be complex. Part of the whole idea of ‘consumer-driven health care’ is to get hospitals to buy into the idea of price transparency (i.e., they agree to tell us patient-consumers what things cost before they charge us $50,000+!!). Because when hospitals do that, the bills will be more simple and less costly. Why? [...]
INSTAHEALTH Market » Archive » Just Bill Me
August 21, 2006 at 6:53 pm
[...] Via PCP6, this is a great post from Scared to Health about the awful complexities and magnitudes of modern healthcare bills. The truth is that medical bills shouldn’t be that high, and they shouldn’t be complex. Part of the whole idea of ‘consumer-driven health care’ is to get hospitals to buy into the idea of price transparency (i.e., they agree to tell us patient-consumers what things cost before they charge us $50,000+!!). Because when hospitals do that, the bills will be more simple and less costly. Why? [...]
Mary Lu
August 22, 2006 at 3:22 am
Well here’s where I get to put on my administrator’s hat for a moment… (Please, don’t shoot me because of my previous position folks!) I’ve been though this one myself and here’s how you fight the system…
Kim, first off, write a demand letter and send it certified-return receipt to the hospital, that you want a complete itemized bill for all charges. Once you get the bill, then send another letter, before you faint again, certified-return receipt, notifying the hospital you are disputing the bill and asking for a complete chart review of the charges on their end.
This gets their attention (trust me,) telling them that you’re not some idiot with a checkbook, who’s willing to run to their bank, credit union or worse yet, credit card to pay them off.
Then go through the bill, line by line– check off what you know he got. Question everything else. Also if the pharmacy charges look over the top, email me and I’ll go ask the DOP in my house if the charges are even close.
Armed with all that information, you then set up a little meeting with the hospital administrators/billing department about something called “reasonable and customary” charges. It will widdle down the bill in short order. Do not be afraid to mention each and every darn HIPAA, DHS, Joint Commission violation and nursing error. This becomes your bargaining chips. Also don’t be afraid to talk to your insurance company to see if they’ll help you sort out the bill. Some do– other’s don’t.
Now you should be getting a number close to reality. And finally don’t be afraid to ask if the hospital you’re hubby took up his regal residence and convalesces is a preferred provider of your insurance company. If they are, they will be willing to write off a good portion of the 20%. And finally– check into the discounts the hospitals are giving because they are inflating prices to cash pay patients. I can get you more info on that… just email me. By now you might have enough cash for a quick weekend to Vegas if you stay away from the casinos, to get your blood pressure in to the realm of reality.
Good luck and keep me posted.
amanda
August 14, 2007 at 11:07 pm
sounds like you need to call your insurance company and make them aware of this blatent case of overbilling. insurance companies handle so many hospital charges many over charges or blatent mistakes are accidentally overlooked. Makes one wonder what the REAL cause of inflated insurance premiums are.
Marijke
September 3, 2007 at 6:02 am
55.00 an hour??? WOW! Where do I sign up. Here in Quebec, when I left active nursing at the beginning of the year, after many years of experience, as an RN, I was making a grand total of 26 dollars and change per hour. And losing at least one third of that to taxes.
Sorry about your incredible hospital bill. I know we have our problems with health care here in Canada, but man, the more I read about things like this, the more grateful I am.