Omg Have You Seen The Bills Sent To The Insurance Company.

[TinkerToyz 45]

I had an email today from UHC inviting me to view my statements online. So I logged in to my insurance account and was SHOCKED. A bill for over $80,000 from the hospital was submitted. This does not include the surgeon's bill, radiology, pathology or anesthesia.

The hospital has been paid per plan contract slightly over $28,000. Other bills are still pending.

Either hospitals are taking a beating on self-pays, or subsidizing them with what insured patients are paying.

All totalled, this process has been billed to my insurance at somewhere close to $130,000.

[Mz_Elle 23]

This it too funny....I just got my eob notification from myuhc. I was flabbergasted too. So far I've paid about $950 out of pocket. My hospital bill for the 2 day inpatient stay was 73K! Not to mention the pathology, anesthesiology, and radiology fees that are mounting. I think I'll be in the 125K range after all is said and done. Also my out of pocket is increasing per the EOB to about $3500 for which I'm now VERY GRATEFUL.

[Sparky79 41]

Wow. I should be getting mine from UHC shortly. I went to a surgeon that is out of network but they honor the in network rates. I'll be interested to see how much UHC actually pays. I only had to pay what I had remaining of my out of packet max which was about $1300.

[Mz_Elle 23]

Well I had my surgery on 07/03 and UHC has paid 59K to the hospital as of today. That's a pretty quick turn around and a pretty darn good reimbursement rate. I know the facility is a Center of Excellence hospital for my plan, so that may explain the quick turnaround and high reimbursement rate. I can only give thanks to my doctor's staff for ensuring everything was precerted timely and covered. They really did an awesome job. I even got to keep my DME equipment for my leg compression machine that was to assist with reducing my chance of blood clots in my legs.

[Star1221 270]

Wow... Mine was only 18,000 lol. Pocket change compared to you guys lol. Only 1000 out of pocket

[Sparky79 41]

I was told that UHC covers all when you go through a "Center of Excellence" but I wanted to be more local and I had heard really good things about the surgeon I went to. Thankfully, they also deal with all of the insurance stuff so I did not have to stress too much about it.

[Shelli_d 38]

I'm still pre-op jumping thru my insurance hoops ( 3 months in..half way there!!) and so far my out of pocket has been my co-pays which as of now is $390..when the 6 months are over it will be $540..but i went on line and checked what the bloodwork costs and O M G the one set of tests was $888! i was like Thank God my insurance pays that b/c that is INSANE!!!

[mufasas-mom 170]

I have UHC as well and checked this morning as I also received an e-mail asking me to check online for the recent claim paid. WOW - the psycho doctor charged UHC $1300 for one visit - but they only paid her $395. I still don't see any billings for all my visits (5 of them so far, last one is next Wed, Aug. 1) with Nutritionist and such - but I guess True Results bills at the end. So far this year I've reached my OOP Max of $2500, so this surgery will not cost me anything..yahoo. I did not have any co-pays with my UHC plan. I should get pre-op instructions and surgery date next week....yahoo. already purchased Protein mixes - need to get some Isopure and heating pad for recovery. Also, have told my boss and HR and they suggested that once I get the surgery date to call our Short Term Disability company and file the claim NOW, so I won't have to worry about not getting paid on time and such, the STD folks have screwed me over many times - this year with pnumonia i was home for 6 weeks and didn't receive a paycheck the entire time - thank god I have a 401K that i was able to tap into for mortgage, car payment and such.

good luck guys.....hope to see you on the losing side soon!

[Laceyloveland 21]

I'm a Dr. & I would just like to remind u that what gets billed is NOT the same as what gets paid to the hospital/surgeon. There is usually a huge difference, and the physician & facility must accept the contracted rate. It's frustrating for patients and care providers both!

[mufasas-mom 170]

I figured that the doctors and such know the insurance game and probably 'fluff' up the initial bill knowing that the contracted rate that they receive is much lower. But honestly, it is shocking to see that someone billed $1300 for one hour of their time, actually it was 30 min with her and 30 min taking the 500+ psych eval test.....

[Laceyloveland 21]

I understand & agree with u on that. I do a lot is charity medical care for people w very low paying or poor insurance. It is my choice to do so, but it can be frustratung when the cost if providing the care is more than the reimbursement, or ur only real choice is to give something away if it is critical to patients care. Again, I don't mean to complain because it is my choice to accept some of those patients and it has its own rewards. But sometimes I feel patients rarely see that side of things. But I agree about ur particular charges.

[TinkerToyz 45]

I totally realize that what is billed and what is paid is as different as night and day. Mine was billed at over $80,000 and the payment to the hospital was slightly over $28,000. Self pay at this same hospital is approximately half what the insured reimbursment ended up being. Insured people subsidize the self payers and the NO payers.

[O.T.R. sleever 3,386]

The amazing thing is that most hospitals run on a 3%+- profit margin. So many people don realize that so many people get treatment & never pay for it also a ton of Medicare & Medicaid treatments are done at a loss. Constantly defending frivolous lawsuits cost hospitals a ton of money, even if hey win them all. There are so many things we could do to reduce the cost of healthcare. But that would mean allowing a doctor to make decisions & recommendations without having to worry about getting sued for doing his job.

No way that could work... Letting people that invested years into learning how to help people actually just help people. How stupid of an idea is that?

[Willow216 91]

I work for Workers Comp insurance as a case manager and I pay medical/hospital billing and the hospital can bill whatever they like but there is a fee schedule for every medical procedure there is and that is what they actually get paid they never get paid what they bill, in fact a self paying patient can demand that they pay as per Medicaid fee schedule and the hospital has to accept it.

[O.T.R. sleever 3,386]

n fact a self paying patient can demand that they pay as per Medicaid fee schedule and the hospital has to accept it.

Really? You don't by chance happen to have that documented anywhere do you. I know several propel that this would help signifigantly.