Hospital overnight = $38,257

fhicat

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On Aug 14th I went to the hospital for an orbital surgery to place an implant in my left eye. This procedure is long overdue, and the surgeon said I should get it done before bad things happen 10 years down the road.

So I went in, and after the surgery the doctor wanted to place me in observation overnight, even though I felt fine enough to recover at home on my own. It was supposed to be an outpatient thing, but the surgical team felt better if they could monitor me for a night. Went home the next day at 10am with a bunch of medicine.

A month after the surgery, the bill came. It was $8,000+, and insurance covered some of it, leaving me with $2,500 out of pocket. Okay. Not too bad. I was told before I agreed to be operated on, that the procedure would cost around 8-9k. 

Yesterday, an "updated" bill came. This time, all of a sudden the total is now $38,247, and my responsibility after insurance is $22,511. And this is the same bill - no additional hospital visits. The itemized bill was a bunch of gibberish and medical codes, so I couldn't tell from the bill if I had a colonoscopy or if I had birthed a child.

I can't afford $22,511. I might as well drop out of school. How did 8k estimated become more than 4 times the amount? I talked to the billing department today, but they couldn't explain what my bill was until they "talk to my surgeon", who won't be in till Monday. "We'll note your concerns, have a nice day."

My insurance said they're "generous" to cover as much as they did, because they think it's a "cosmetic" thing. I explained to them it's a medical necessity, but they said they're going off what was on the claim that was sent to them. The problem isn't so much the insurance, it's the bill itself.

Will I go to jail?
 
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peaches08

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So sorry that you're going through this; it sounds like someone really dropped the ball on explaining what the surgery would cost you or there was a mistake in coding.

You won't go to jail, but the bill can follow you and cause problems. My advice is to make sure everything is handled via insurance as best as you can. Then contact the hospital, doctor, anesthesia, and anyone else and file for indigent status and work out a payment plan. I've had hospital bills wiped out 100% due to my indigent status and following up with them in a timely manner.
 

barbh

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I won't get into my opinion about health insurance or medical care gets me hot under the collar :argh: :stomp: First I would get an explantion of what the charges are, it is possible that the first bill was just the surgery, the second could be including the overnight hospitalization. Once you get an explanation of what you are being charged for I would review the information for your insurance. Once your deductiable is met, what do they cover? Where you in network or out of network. If your doctor was out of network did you get a referral from your doctor? Once you have made sure that you are being charged properly for the services that you recieved and your insurance is covering what they are suppose to, the next thing to do is to contact billing to set up an arrangement for a payment plan. If you are limitec on what you can pay, tell them what you can pay per paycheck or month. A coworker if mine who had to have some extensive surgery done and had wracked up quite a medical bill had told me that if you are making an effort to pay that they can not send your bill to collections. I am not sure how accurate this is, but definitly check into it. If you do not make any attempt to pay, after 90 days they can send your bill to collections. From there they will try to collect, usually they will offer you a lower settlement if you pay in full. Once in collections I have not heard of any cases being taken to court, but it will affect your credit rating. It is also possible that they could have a certain percentage of money taken out of your paycheck.
 

natalie_ca

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So I went in, and after the surgery the doctor wanted to place me in observation overnight, even though I felt fine enough to recover at home on my own. It was supposed to be an outpatient thing, but the surgical team felt better if they could monitor me for a night.
I live in Canada and we don't get hospital bills because of our socialized healthcare.

However, in addition to what Peaches has told you, I would certainly play up the part of your post that I quoted above.

It was supposed to be a day surgery procedure which is what you were quoted the 8 or 9 grand for.  The rest of the bill seems to have come from the overnight observation, which the surgeons seemed to insist that you required, for their own peace of mind.

I would certainly keep harping on the fact that it was a day procedure, that you felt fine and wanted to go home, but the surgeons insisted that you needed to stay overnight for observation.  That cost is through no fault of your own.

I would tell them that you will pay the amount agreed upon for a day surgery procedure, but it was your surgeons who insisted on the overnight stay, which added to the cost.
 

catsallaround

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I was pregnant and started bleeding.  It got worse adn some pain figured I should go and confirm it.  came to little under 10,000.  Bloodwork, belly ultrasound and internal ultrasound.  No meds of any kind no fluids.  Still trying to get medicaid set up to cover.  filled out all the papers I needed to and then had more come to sign.  So sick of it at this point.  

I understand things take money to run but still...
 
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fhicat

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It was supposed to be a day surgery procedure which is what you were quoted the 8 or 9 grand for.  The rest of the bill seems to have come from the overnight observation, which the surgeons seemed to insist that you required, for their own peace of mind.

I would certainly keep harping on the fact that it was a day procedure, that you felt fine and wanted to go home, but the surgeons insisted that you needed to stay overnight for observation.  That cost is through no fault of your own.

I would tell them that you will pay the amount agreed upon for a day surgery procedure, but it was your surgeons who insisted on the overnight stay, which added to the cost.
 

MoochNNoodles

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Something is way off there.  Was the proceedure pre-authorized?  I know elective hospital admissions are supposed to be preauthorized.  If it was; your doctor should have already sent documentation that the procedure was medically necessary.  Either way; I'd be raising a lot of noise and keep on top of it!  Document EVERYTHING.  Dates and times of phone calls with the billing departments, who you spoke to, calls with your doctor and his staff with dates and times, etc.  Document document document!  
  This is why I don' t miss working.  (I did billing for the last doctor I worked for before my kids were born.)  
 
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happybird

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Oh my gosh :(
I agree with MoochNNoodles, something is waaay off here. Hopefully, it is simply a billing error that can be easily rectified.

My husband broke his leg badly, had surgery to insert plates to mend the break and was in the hospital for two days, all with no insurance. The total cost was about $40,000 - that's what makes me think there has been an error in your bill. Prices vary from place to place, but it can't possibly be that huge of a difference, I would think (and hope). Plus, we lived in a very affluent area at the time, so they probably charged us top dollar.

I am very curious about those coded charges... I wonder what all you have been charged for? Is there any way to look them up online or do different hospitals use different codes?
 
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starryeyedtiger

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I just had an emergency gallbladder removal two weeks ago; I'm dreading the day that bill comes in the mail! | They can not send you to jail for your medical bills, but it can affect your credit. I would contact them and mention what you told us. [emoji]10084[/emoji]️
 

sugarsandz

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My advice is to keep on the hospital and the insurance company and get a copy of your conversations over the phone as proof. I went to the Dr. once because I don't menstruate and need some tests done to find out what was going on, the Dr. also mentioned my weight as a side subject. Turned out she coded all of my tests as needed because of my weight and not a gyno issue so my insurance covered nothing! I was so livid because the tests ran so high, I called and talked to my Drs office and got it straightened out.

If there is any chance that someone put your info in wrong or in such a way to make it more expensive then I would be on them daily since they seem to take forever figuring out who is to blame. I really hope there was indeed an error and your cost goes down as this seems inflated. I wish you the best of luck!
 
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fhicat

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After enough noise from me and a little help from my surgeon, they reduced it to $3,200 - well within the quoted cost! I don't have to drop out of school anymore! 
 

kookycats

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After enough noise from me and a little help from my surgeon, they reduced it to $3,200 - well within the quoted cost! I don't have to drop out of school anymore! :clap:
Glad you were able to acomplish something. Just unbelievable how they try to scam you. Shows you just have to stick with it.
 

mamabirdy

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So glad we don't have to pay for health care here in the UK. Do you pay much for health insurance? Do you have to pay just to visit the doctors, say for a cold? Glad they managed to sort out your bill and it wasn't as much as you thought.
 
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laralove

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So glad that worked out for you. I can't imagine the stress. I had to have a surgery a couple of years ago. They quoted me $1,000. I'd paid $200 at the time of the surgery. and I was to have a payment plan to pay the rest ($800) over the course of a year. I'd chosen this option over another that cost only $850 but had to be paid all up front. 

When the bill came, it was $4,300. Sorry, what? There was no way I could afford that. I had no insurance and I was a full-time student. I called and they told me the problem was some films or plates or something that they normally have but they'd run out. They had to buy them from a local clinic at $800 each and that was added to my bill. I flipped the hell out. They're poor ordering was not my problem. That they got fleeced on last minute materials is on them. I told them there was no way that I was either able or willing to pay that after I'd been quoted $1,000. She said, "That's just an estimate." No, I told her, that's called "a scam" when you charge 430% more, and that many thousands of dollars is enough for an attorney's retainer. 

I don't know if it ended up being a mistake or if it was my legal threat, but my bill went away. I ended up paying the $200 and the rest was "forgiven" under their "charity" program. 
 

laralove

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Oh, also. A couple of years before that I had to go to the ER for an abscess on my leg from a spider bite. That cost $1,006. I had no insurance then either, but I paid it all over time. The thing that really chaps my bum, though, is that when I got the itemized bill, they'd charged me $60 for a bottle of saline. I found that EXACT bottle online for $2.25. I imagine that an enormous university hospital orders in massive quantities at a dramatically reduced cost. So I don't even know what the mark up percentage was. Something staggering. I guess that's how they fund their "charity" program.
 

happybird

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Fantastic news! I have been wondering how this turned out for you and am so glad to hear it got worked out to your satisfaction :)
 

sillywabbit

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Glad things worked out. I have a family member in the medical field who saw me reading your post and the first thing she said was, "that person needs to get the surgeons notes. maybe something happened during surgery that they're not owning up to and that's why they insisted she stay for observation."
 
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