Wow...and people wonder why health care is so outta control

[JennCH 19]

So I had a VSG on Monday 1/14. Absolutely no complications. NO additional tests, out in 24 hours.

Got the claim summary today. The hospital charged BCBS AL 35K and BCBS allowed 6K. Wow. No wonder people with insurance can't afford to get sick because us with insurance get huge discounts.

Kinda disgusting if you ask me.

Jenn

[mrchris 98]

The hospitals would argue that they need to charge 35k to get the 6k and if they charged less, they would get less. I dunno who's right, I do know cash prices tend be a lot less for those paying cash.

[NurseGrace 509]

In the states I think the going rate for a sleeve is about 10-12k around where I live.

[Traci J. 207]

My bill was 42k for everything, and my was done with the robot...BCBS allowed 26k. Luckily I only had to pay the rest of my OOP expense. It's extremely outrageous. I work in healthcare, and all hospitals/doctors charge huge fees then the insurance companies all have their own limits on what they will allow. Wouldn't it just be easier to actually bill out what they know the insurance companies will pay them back for??? After all, they can't go after anything above the allowable amount from the patient's anyway. And for people that don't have insurance, they can usually get their charges cut down to what they would normally get back from an insurance company if the patient is wiling to make a few phone calls. My friend had hip surgery and for some reason her insurance didn't pay for it due to referrals or being out of network or something, but anyway, she called the insurance to see how much they would've allowed if it was covered and then haggled with the hospital to get it lowered to that price. Saved her more than 1/2 the cost.

[Kapoorvilla 117]

In the states I think the going rate for a sleeve is about 10-12k around where I live.

Remember 10-12k will not be the total of your bill. We are told 10k here in NC but you entire hospital bill is more like 50k. With my insurance I winded up paying only 2 to 3k having already met the rest of my out of pocket earlier in the year. Also just because the bill the insurance 50k does not mean they get that amount as the Insurance has set rates they will pay.

[MichiganChic 3,262]

Hospitals can charge whatever they want, based on their cost. They have agreements with insurance companies, and have to accept usual, customary and reasonable amounts. Having said that, individuals can also contact hospitals and negotiate lower rates as well if they are uninsured. Usually if you let them know you are self pay, they will work with you.

[aliandrews 98]

My insurance was also billed 42k and I had to pay 1333 out of pocket. Not fun.

[apricot1119 105]

I was self pay. $20,000.

[Kapoorvilla 117]

I was self pay. 20' date='000.[/quote']

I have hear the 10k quote for self pay but figured it would be more once everything was paid

[Ima Loser 197]

When a hospital or doctor is "in-network" with an insurance company, they agree upon a contracted rate for every procedure... They agree to accept ONLY that amount of money... The Dr can charge $1million for a procedure but if in their contract to be "in-network" they agreed to accept $100 that is ALL they will get NO MATTER WHAT!!! That is why I get so angry when drs complain about how little they are paid... I feel like yelling at them and saying "HELLO you agreed upon these amounts!!!"

-I know this not only from working in Drs offices, but now I working the Health INsurance Industry!