$51,746 Forest Park Hospital Bill for 2 nights stay and NO COMPLICATIONS

[former_vbg 198]

Interesting information on the government kickbacks.

On my claims, Aetna paid my surgeon within 10 days of them submitting a bill. Most of the claims (not just for this surgery), they usually pay within 10 to 15 days. But, I'm sure that may not be the case for everyone, like you stated in yours.

A good part of the high book rates for these medical bills are courtesy of you favorite federal government. Nobody pays those rates (though they do try to charge them to uninsured emergency patients...) but Uncle does have some reimbursements worked into their system that will pay a small fraction of the "written off" discount back to the hospitals - the higher the "discount" (book rate) the higher the gov kickback they get.

Aetna is real slow about paying the surgeons for some reason - I'm over three months out and they still haven't paid the surgeon's fee, though they have paid everyone else.

[Janese58 11]

Health insurance is such a racket. I cant even start on it......I have Kaiser and pay $306. a month for it with a $3500.00 deductible. I pay $70. just to walk in my doctors office to say "I need a refill on my medicine". Then I pay $100.00 for my Wellburtin. I went to Mexico for my surgery I didnt even deal with Kaiser. UGH!

[SouthernSleever 228]

I'm sure you already know this but what is bill is not what insurance pays. Say you are billed for 10k the insurance will usually only pay 20-40% of that. It's kinda like a sticker price but it's always on sale.

[Suzannesh 376]

First, thank GOD I had insurance and was pre-approved, but I am appalled at what they charged. Forest Park actually sent a bill to Aetna for more than $83,000 and then it was reduced to the contract rate. They have billed on top of that several thousand more for things like the anesthesia, blood work, and some other charges I can't tell what they were for.

What bewilders me is I know someone who had the EXACT same procedure, same day, same length of stay, no complications, same location and was a self-pay. She paid around $11,000 which INCLUDED the surgeon's fee. Yes, I know self-payers get a discount- as they should but the disparity between the two actually angers me because the cost of insurance keeps going up. The hospitals and doctors bill for sometimes double or triple what they KNOW they are contracted to be paid so they can write it off on their taxes. I sure wish I could do something like that on my taxes. Yeah, I didn't choose that profession, but nonetheless.

Part of me wonders how much my doc gets of that hospital bill since he is one of the owners of that Dr. owned facility. Sure, it's no skin off my nose in theory, but it's the bigger picture that bothers me I guess.

Hi,

Oh I so agree with you--this is a crime and they are allowed to do it. Maybe just maybe this is why people can NOT afford Health Insurance. Who gives them the right to be able to charge this amount of $$$$$$$$$$? It is time that someone (and I wish I knew who) puts some guide lines on what hospitals can charge. I also feel the same about the price they charge for medications. And what is a person to do? Thanks for taking the time to post this. It is skin off your nose because eventually you have to pay or your employer pays the insurance premium. And if your employer is paying it and it keeps going up--they have less money to give your a raise or you will have to start paying more for you part of the insurance. NOTHING is free in this world.

Hugs,

Suzanne

[Martie 0]

It's almost a racket how much they charge for the "going" rate. I had an MRI a couple years ago and the base rate was $3000, but the contract rate for my insurance was only $300. Really? Why not just charge everyone that? You know you're not getting $3000 out of someone who has no insurance! Why bother charging that much???

One night stay in the hospital was $40k JUST for the room (not including ANYTHING else). I coudn't believe it. The contract rate for insurance was only $4000. And I think I ended up paying $1000 of that.

My Doctor billed the insurence $40,000 and the hospital billed about 30,000. I had my surgery at Baylor at Trophy Club and it is also a surgery center not a hospital. I've only seen my Doctor twice. Once for the intial Consultation 6 months ago and once right before my surgery. This is pretty standard I think for these types of Doctors. All of my follow ups will be with the PA. I am okay with this, As long as I don't have any complications. I'm good with not seeing him again.

[former_vbg 198]

Yes. My post stated that Forest Park BILLED Aetna for more than $83,000 and were paid the $51,746.

I'm sure you already know this but what is bill is not what insurance pays. Say you are billed for 10k the insurance will usually only pay 20-40% of that. It's kinda like a sticker price but it's always on sale.

[wannasleeve 10]

I agree too, they complain that people without health insurance cause the problems, but so does over charging that sounds like Highway Robbery to me!

First, thank GOD I had insurance and was pre-approved, but I am appauled at what they charged. Forest Park actually sent a bill to Aetna for more than $83,000 and then it was reduced to the contract rate. They have billed on top of that several thousand more for things like the anesthesia, blood work, and some other charges I can't tell what they were for.

What bewilders me is I know someone who had the EXACT same procedure, same day, same length of stay, no complications, same location and was a self-pay. She paid around $11,000 which INCLUDED the surgeon's fee. Yes, I know self-payers get a discount- as they should but the disparity between the two actually angers me because the cost of insurance keeps going up. The hospitals and doctors bill for sometimes double or triple what they KNOW they are contracted to be paid so they can write it off on their taxes. I sure wish I could do something like that on my taxes. Yeah, I didn't choose that profession, but nonetheless.

Part of me wonders how much my doc gets of that hospital bill since he is one of the owners of that Dr. owned facility. Sure, it's no skin off my nose in theory, but it's the bigger picture that bothers me I guess.

[minniekitty 44]

My family's health insurance won't pay for my dad's chemotherapy, at $300 bucks a day. I guess they've gotten sick of covering the hospital bills since he was diagnosed with brain cancer. I'm sure they'd love to find a way to drop us.

It all comes down to the $$$.

[sungbyrd 1]

I have blue cross/blue shield under federal government program. My bill was around 60,000, which they reduced to about 20,000, and my part was $250.00 it is all a racket! They keepbilling my insrance co these outrageous bill and they always get reduced. I had my surgery at Doctors Hospital @ White Rock.

[LVikingFan 14]

My bill was $75,000 for the hospital with an overnight stay. I haven't seen what the insurance is paying, but they made me pay $1,900.00 the morning of the surgery. I had to pay my doctor $1,250.00 and the anesthesiologist $300, all up front. I just got a bill today for my pre-op lab work (that I thought was included in the hospital bill) for $250. But I think my life is worth whatever the price is.

[mamamckinzie 92]

I agree with everyone how much of a racket health insurance is. Having said that, it still baffles me why this country went into (and still is) when someone tries to correct the system. Anytime someone tries to change our health care system or help families or individuals get coverage all we hear about is "our system is the best system in world". Well look at your bill and you tell me if there is not room for improvement.

[smkeller 3]

This was explained to me something like this. The hospitals get tax breaks and other government support (yes, corporate welfare) based on what they get versus what they needed to get; hence it is not uncommon for the charges to be eight to ten times higher than they actually are. I believe that the new health care law addresses this. We will see.

First, thank GOD I had insurance and was pre-approved, but I am appauled at what they charged. Forest Park actually sent a bill to Aetna for more than $83,000 and then it was reduced to the contract rate. They have billed on top of that several thousand more for things like the anesthesia, blood work, and some other charges I can't tell what they were for.

What bewilders me is I know someone who had the EXACT same procedure, same day, same length of stay, no complications, same location and was a self-pay. She paid around $11,000 which INCLUDED the surgeon's fee. Yes, I know self-payers get a discount- as they should but the disparity between the two actually angers me because the cost of insurance keeps going up. The hospitals and doctors bill for sometimes double or triple what they KNOW they are contracted to be paid so they can write it off on their taxes. I sure wish I could do something like that on my taxes. Yeah, I didn't choose that profession, but nonetheless.

Part of me wonders how much my doc gets of that hospital bill since he is one of the owners of that Dr. owned facility. Sure, it's no skin off my nose in theory, but it's the bigger picture that bothers me I guess.

[former_vbg 198]

That's interesting. So, that makes me wonder even more. If they "NEEDED" the $83,000 when they got paid $51,000, how is they could "afford" to accept TENS of THOUSANDS less by self-payers. The staff used to process the insurance claims are not paid tens of thousands per patient.

I'm not disagreeing with you, but it just makes the situation even more glaring to me.

This was explained to me something like this. The hospitals get tax breaks and other government support (yes, corporate welfare) based on what they get versus what they needed to get; hence it is not uncommon for the charges to be eight to ten times higher than they actually are. I believe that the new health care law addresses this. We will see.

[ouroborous 519]

The fact that we do not have single-payer is what causes this; the loop between the billers (hospitals, mostly) and insurers causes rates to soar. The fact that for the most part, insurance "just handles it" causes most of us to not notice -- until the first time you need medical care when you're uninsured. Then all of a sudden, a relatively routine medical treatment can bankrupt you (medical costs are still the number one cause of personal bankruptcy, and will be until we fix our crazy patchwork of for-profit, insurance-based medicine). And all of this is because all of the billing and payment goes through a web of middlemen, each extracting their cut.

The same situation can be seen in all industries where there is "mandatory" (or effectively mandatory) insurance. Just look at how expensive it is to get bodywork done on your car; this is the same situation where most people never get the sticker shock because if they're insured, insurance "just handles it." Thus there is no popular anger, and no consumer search for competition forcing the prices down (you know, how capitalism is supposed to work, when the politicians watching the henhouse aren't bought and sold by the very people they're regulating). Did you notice that one of the parts of the health care reform law that the insurance companies fought so very hard (and very successfully) to keep out was the simple provision that revoked their anti-trust exemption? In theory, why should they get this exemption -- if we're going to have anti-trust laws, everyone should be governed by them, right? It's only fair play. And yet, for some reason, insurers are allowed to monopolize local markets, with the predictable result that there are very frequently only one or two (colluding) insurers in any given market, and consumers have no real choices... no way to hop to a different insurer when the extortion of Aetna or Cigna or BCBS gets too horrible (of course, the insurers have also colluded to make changing insurance outside of a job change very difficult... they basically game the system any way they can).

And if people could see just how much potential salary they're giving up, just so their employers can pay their outrageous insurance premiums, there'd be a revolution. I've seen estimates that say that up to 20-40% of the cost of keeping an employee is benefits, with most of that being health insurance premiums. Just think what you could do with another 20% of your salary in your pocket...

Of course, the moral problem with health insurance is that we're effectively making it unavailable to the poor and uninsured (often the same group) with our broken system. Until we stop screaming "socialism! socialism!" and running away whenever someone mentions single-payer medicine, this will just keep getting worse. Single-payer systems aren't perfect by any means, but they are more humane and a LOT more affordable (both to the individual and to the nation) than our current for-greed system.

And before someone starts talking about the poor, harassed doctors, that's a red herring. Most of the money in our scam-based system does NOT go to the doctor; most of the money goes to CEO's and stock shareholders in whatever corporations manage to squeeze out the most competition. The doctors these days, after paying off the ridiculous graft malpractice insurance rates, are lucky to get by. Have you noticed how private practices for NON-lucrative specialties (lucrative: plastic surgery, weight loss surgery; non-lucrative: pediatrics) are disappearing? That's why; doctors are NOT getting rich off our current system. If they were, we'd have more medical school graduates and fewer business school graduates; instead, we're getting frighteningly near to a serious "doctor shortage" in the US. No, the only people getting rich are the execs and shareholders of Aetna, Blue Cross, Cigna, and so on.

Yes, OP, the system is broken and disgusting, and anybody who's paying attention SHOULD be feeling the same anger you felt when they see just how much of a scam it is, especially when you consider the fact that people are dying because of it.

[lkcraig316 4]

Ouroborous, I'm glad you pointed out that the doctors are really not getting rich like they used to. I never worked in the healthcare field until I was hired as administrative assistant for a joint replacement practice. It blew me away how little of the money that is charged actually goes to the doctors. Our oldest surgeon is in his late 50s and has made a great deal of money. He also has patents and speaks and makes money from that. Our newest surgeon just started practicing medicine two years ago. He is struggling to make a living while he builds up his patient base. He takes as many nights of ER call and office call as he can to supplement his income. I do blame this partly on the insurance industry and partly on the litigiousness of our country. Malpractice rates are absolutely ridiculous, but you can't afford to practice medicine without it. For four surgeons and 6 mid-level providers (nurse practitioners and physician assistants) we pay around about $10,000 per month.

Private insurance companies base their reimbursement rates on Medicare. If Medicare lowers what they will pay for a certain procedure, private insurance will follow suit. Dealing with Medicare is so frustrating for doctors' offices. I have been working on getting our physical address changed in their system since we moved to another office in 2007. I just got the approval notice from Medicare two weeks ago. The amount of tax money wasted by that branch of the government alone is astounding. So I don't think a single-payer system is the answer either. The government is incapable of running a business.