Medical Bill Rant!!!

[Lulu54]

What's wrong with our system?  Last month I had a cortisone injection done in the big joint of my big toe  (think bunion!) in a local private lab/facility. It was done there where they could use flouroscopy to guide the needle.  The procedure took almost 3 minutes from start to finish - lay on the table, numb the joint with lidocaine and then inject it with the cortisone.  I was in their facility - waiting room and all - for less than one hour.

I just about fell out when I opened the explanation of benefits that I got from BCBS today. I knew this place was associated with a private hospital in their building and out of network. They had said I would not have to pay my copay if I just sign over the insurance check to them. This sounded like a pretty good deal and I  owe nothing.  

But I am shocked beyond words that they billed my insurance $14,600 for this simple procedure.  Or course my insurance is ONLY going to pay them $3,900, but still I am shocked.  My husband's stent put into his heart and a three day stay in the hospital was less  than $14K.

Among the billed items was pharmacy charges for contrast, which I know I definitely did not have. I had licocaine and cortisone. Period.   There were also other charges which make no sense but that was the most expensive one.

I am scheduled to have my other foot done in December, but have serious reservations, now that I have seen this bill.  Can anyone out there give me an explanation as to why something so simple would cost so much? There was nurse, a radiologist and my doctor in their "operating room" which was not a sterile environment. They took my vitals before and after. But that was the extent.  

puzzled and shocked,
Lulu

[Lulu54]

I'm thinking they have coded me for bunion surgery and not just this simple injection.  But someone has to pay for the fancy suite and high-tech equipment, right?

I got the EOB (explanation of benefits) from my insurance company for the doctor, and they paid him $98 which would be reasonable.

This place did stress that I would not be responsible for the copay amount if I turned over the insurance check to them (it was sent to me since they are out of network for my BCBS).  

Waiting for Monday when I can call ,

Lu

[ku111]

My guess is a coding error.  I would ask for an itemized billing and see what they charged you for each item (if you haven't).  I have caught so many errors.  Now, I have called about them and no one seems to care but I still make note when I called and who I spoke with.  It may be a simple oversight or it may not.  The economy has hit everyone. LOL  

[doublevision1]

Whaaattt???!!!   I am literally speechless.

[Lulu54]

Yes, this really did help.  The intense heat/pain that I would feel in that foot after standing/walking for long periods of time is gone.  I could probably match you bunion for bunion.  I hear too many stories of how the surgery doesn't correct the problem and I hesitate to even think about it.  He said it can be done every 6-9 months if needed.

This was my podiatrist, who is a really nice guy.  I can't imagine he even begins to dabble in the billing side of medicine.

Our insurance is so messed up here, that everything is billed at a much greater rate because the insurance is only going to pay a fraction of the costs.  BCBS is paying less than 25% of what was billed.  Go figure.....

[tingletingle]

Oh Lulu,
I nearly fell off my chair at the size of dollars quoted for what sounds so simple and straight forward.

But if anyone can get to the bottom of it I have no doubt you can. I am sorry for all the unnessary stress that this is putting on you.

I think the health system sometimes sees us coming. I visited a new neurologist on Friday for a second opinion. When they phoned to confirm the day before the price mysteriously jumped from $240 to $300. I ended up spending half an hour with him. But this is nothing compared to the gouging you are experiencing.

I hope you can talk some sense into them.

Blessings
Alex

[summerluvr]

Did this "help"?   I have bad bunions, had surgery on both.  First one is doing great, and my foot was operated on with three incicions, two breaks, and one fusion with three screws.  Second one was just shaved down, and broken and aligned by the toe joint and bunion (and pain) came back in under a year!  Could you not get a regular orthopedic surgeon to do this?  I admit I'm in Canada so we do not have private hospitals.  Podiatrists can do minor surgery in their office which is private and you just pay them for the work as it is not covered under OHIP.