$700 Bill!!!!!!!!!!!!!! Help me understand

[Tiggerlover91]

That's MY part of the procedure that my Gynecologist wants me to have done. I had to have misunderstood what the lady said over the phone. I thought she said it would be no more than $1000...I thought she meant the WHOLE bill...obviously, she just meant MY part! You know I could have handled 25% of 1000....$250, but if my part is $700....we HAVE to be talking nearly $7000!!! OH MY!! DH and I DO NOT have that type of money to put out right now, so I'm calling tomorrow to cancel my appointment. I'm sorry, but she'll have to wait and get this test next year. It's NOT life threatening and I'm in no immediate danger...as a matter of fact, I'm in NO danger AT ALL.

For those of you who are curious and men, stop reading now if you wish, I was having an IVP done, it was to check for an enlarged uterus. As we know, mine seems to be fine right now, but with my fibroids, things can change. Also my old OB/GYN's notes are a little hard to understand. One notation says one thing and another something else about the SAME situation! I just can't do it right now gang...DH and I can't. We just moved into a new place and we haven't truly established a budget yet. I know I can pay the bill off monthly, but $700....I'd rather not if you please. Thank the Father my mammogram will be free as my insurance covers all of it once a year as it's preventative maintenance.

Just wanted to vent a little. I don't know how hospitals do it, how they charge so much. I understand they have to maintain their bills, keep their equipment running, and pay their staff...but HEAVENS!! Those who don't have insurance, bless their hearts, no wonder so many people go untreated for so long...you can't afford it. Even with my insurance that hurt my feelings today!

Okay, I'm done being a baby now. Can anyone help me understand why hospitals charge so much....anyone???

Blessings all,

Denise

 

[Dizz(n)ey]

What most don't understand is when you see a hospital bill, the insurance company is NOT paying that price.

They do this in order for the CO-PAY, or "your % of the bill" to be higher...

Example: My grandmother was recently in the hospital....Her bill for 4 days was $27,000....She had to pay $2000 out of pocket as "her share"...

The insurance company only pays the hospital $14,202.00 out of that bill!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
When you see the hospital bill to pay your % you are paying a % of "retail" value, not the actual value the insurance company pays out to the hospital

It's one of the biggest jokes

If the hospital only charged her the % of what they pay ($14,202.00 in my example) they would get only almost HALF of what they are getting by charging her off the total retail price.

 

[Tiggerlover91]

Wow, that's pretty sad.

 

[hercamore]

What?

That cost doesn't seem right. This is to check your uterus size?

I have all sorts of gyne proecudures done this past year, including a hyst.

I also had fibroid problems. They don't go away easily and can cause anemia (and that can be life threatening).

I waited too long to do somehting about my fibroiids and that was a mistake.

herc.

 

[4greatboys]

That cost doesnt seem right to me either. Back when I was amoung the working I worked at an Imaging facility and IVP's were no where near $700. Why not call the drs office for a CPT code (the code the bill the procedure under), call the place its being do to check on the price then call your ins company and verify what the benefits are for that procedure.
Maybe you are sch for more than 1 test. $700 for an IVP is a lot.

 

[Maleficent13]

What most don't understand is when you see a hospital bill, the insurance company is NOT paying that price.

They do this in order for the CO-PAY, or "your % of the bill" to be higher...

Example: My grandmother was recently in the hospital....Her bill for 4 days was $27,000....She had to pay $2000 out of pocket as "her share"...

The insurance company only pays the hospital $14,202.00 out of that bill!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
When you see the hospital bill to pay your % you are paying a % of "retail" value, not the actual value the insurance company pays out to the hospital

It's one of the biggest jokes

If the hospital only charged her the % of what they pay ($14,202.00 in my example) they would get only almost HALF of what they are getting by charging her off the total retail price.

This isn't the case. I work in healthcare, and have for many years. The % you pay is always taken from the adjusted amount, not the gross amount. In my experience, the gross amount is large because most companies are setting their charges per their market research of similar companies. Plus, the lower your published rate, the lower your insurance reimbursement adjustment.

If your grandmother was charged the % based on published rate, I would seriously see about contesting that with the hospital. Although $2,000 is roughly 15% of $14,200, which is a pretty standard out-of-pocket precentage. It doesn't sound all that unreasonable to me.

 

[HoneyPooh]

Providers are not allowed to charge you your percentage on anything other than the "allowed" amount as specified by your insurance carrier as per their contracts. For example if a procedure costs $1000.00 total and your insurance carrier says they allow $600 for that procedure and they pay 80% of that, you can not be charged more than $120.00 (20% of $600.). If you are charged for a % of the non-allowed amount, question it. The provider can lose their contract with that insurance carrier if they bill you for non-allowed amounts. The only other variables are for deductibles etc. but these are within the allowed amount. Definitely check with your insurance carrier with the appropriate CPT code. Providers are obligated to write off the difference between the actual charges and the allowed amount. I've been doing medical billing to long.

 

[Christine]

I think YOU need to do some more checking.

I recently had a lump removed from my breast. When I arrived at the hospital for the procedure, the clerk said "You must pay our portion right now." I didn't know this. She told me that I owed her $493 right then and there. I said "$493 dollars!!" I had to pay it. She told me that they had already checked with my insurance company, they had a contract with them, and they KNEW that this amount would be my portion of the build. Well, fortunately I had a credit card and I paid it. Two months later, I get a $290 refund check from the hospital. So, you see, my portion really was not that much. I think the total bill was around $5,000 and I had to pay $290. This is not the first time they have misquoted what my amount would be. I think they are probably going off the "gross" cost and not the after insurance cost. I would call the insurance company myself. I bet they are incorrect.

 

[Tiggerlover91]

I will be calling Cigna in the AM. I called the hospital once again and the girl still told me after Cigna pays their part, I'm responsible for $700. This procedure is $2400??!! WOW! Upfront I have to pay $150, which I had no problem doing, but I just don't understand where all this comes from. I've never had any procedure done where I've had to come that much out of my pocket....NEVER! I'll call Cigna since they are the ones who will know for sure what's going on.