Echo-cardiogram charge shocker!!!

o2bhealthy

WARNING!!!!  PLEASE use CAUTION when scheduling or allowing medical tests to be scheduled, especially at a different facility.

Yesterday I received a bill for an echo-cardiogram for $2,920.61 (this was AFTER my contractual adjustment by the insurance company).

I have had at least 4 echo-cardiograms done at a local facility over the last 2 ½ years. They were ordered as a follow up to my chemo treatments to insure no permanent damage has been done to my heart. In every instance, my insurance was billed $764 and my out of pocket cost was approximately $300.

The facility I had been using has closed down, so my oncologist’s office scheduled my recent test at the local hospital (small town, not many options).  I blindly went along with everything thinking the costs would be ‘close’ to my previous billings. I even asked the scheduler what I could expect as far as cost and was told approximately $800 which knowing it was a hospital I expected a jump in cost.

Imagine my surprise when the bill came and was almost 10 times higher then my previous bills!!!

PLEASE remember to ask what the estimated cost will be BEFORE confirming and appointment with the FACILITY in question so that you do not have a near heart attack like me…

ibcmets

Maybe you can still negotiate this with the hospital.  I know sometimes chemo is covered in the hospital only for those not insured. Even if you are insured, you should bring this up to hosp admin.

Terri

mrsnjband

Is the new place out of your network?  We have learned the hard way that my insurance does not pay the way it should if you go to an out of network doctor or hospital.  NJ

SeasideMemories

Michelle,



I just hate insurance!! I found out going through rads that there is so much I don't understand.... When I was going through rads I got my bill as expected from the Radiation group.... Well after a few weeks, I started getting another bill from the hospital... What??!



So I called the hospital...As it turns out.. while my rads group is physically located at the hospital, they are not employees of the hospital so they bill for their services and the hospital bills for use of their space and equipment!! I called my insurance company and, while unusual, it is allowed by law to bill this way!! At the time I had met my out of pocket max so it was 100% out of my insurance company's pocket but, should I ever need rads again, I would go elsewhere due to this even though I was happy overall.....



Guess you also need to know who works for who, too!

Kaara

I think you can call and negotiate with the hospital over the bill if you can prove that it is over the reasonable and usual charge for the same service elsewhere.  I would get together copies of your prior echo;s, make copies and send to them agreeing to pay only that amount.  I wouldn't pay the bill until they agreed to it.  I had this same problem with my small town hosp. over a stupid pill they gave me in emergency that Medicare wouldn't cover.  I offered them half...a year later they finally took it!

o2bhealthy

Thank you everyone for posting...

MrsNJ - I live in a rural area so we are limited.  The Cardiac center I used to go to was closed so my oncologists office scheduled me at the only other option, our local hospital.   I knew it would be higher and even asked the scheduler how much I should expect in charges and was told $800- $1,000.  I am just so sad because I thought I did everything right and still got hit with a huge unexpected bill.  I realize it is my fault to trust that my oncologists office had my back and actually checked the the pricing...

My husband and I have written a letter to the hospital board of director since the billing department, although appropriately 'sincere' basically told me it is what it is...my insurance also said that the charges were appropriate based on how they are contracted with the hospital...

I wanted to make sure to put this cautionary tale out there so that hopefully it will protect someone else from getting screwed.

I think I just need a big cry and a stiff drink

o2bhealthy

((((Seaside)))) thank you friend! 

o2bhealthy

Kaara I wish I could find my bills from 2009/2010 but apparently I put them in a 'safe' place before I came out of my chemo fog...I was able to find a spreadsheet from my old insurance carrier with the 2010 charges but there is no brake down and I only know it is a echo because of the Dr. listed (BTW it is the same doctor that now works for the hospital and read my last echo that cost 10x more)

o2bhealthy

Thanks Nancy!  I will talk to the onc's office, however I do not think that the scheduler actually checked the cost but estimated what he 'thought' it should be   If they weren't the only oncologists in my area I would not return...one of the disadvantages of living in a rural area.

SeasideMemories

Michelle,



I was thinking about this post and remembered something our lawyer said when we hit a glitch duing our closing on our house purchase... We were all sitting in his office on a Friday... He called our mortgage company and the person who answered the phone basically said she couldn't help... to which our lawyer replied... We are sitting here at a closing so, go find someone who can help and, the next call here better be from someone authorized to make a decision, so aim high!!



He then hung up the phone... looked at us and said... Never take a NO from someone who was not authorized to give you a YES in the first place! The supervisor called back and we were able to resolve the issue!



Sounds like you and your husband have done the right thing in escalating the issue to someone who would be high enough in the chain to amend this situation rather than just parrot their policy to you!



Hoping you get a fair resolution! Hugs, in the meantime!

peggy_j

PLEASE remember to ask what the estimated cost will be BEFORE confirming and appointment with the FACILITY in question so that you do not have a near heart attack like me...

Sounds like echo-cardiogram part II.

What, what a shocker.  Do you think you'll use this hospital again for any reason? I've heard stories of people who refuse to pay and eventually the provider takes a write off. Er, not that I'm suggesting this...

What a drag. Are there any advocates who can go to bat for you? (maybe newspaper consumer advocate or ??)

AlaskaAngel

o2behealthy,

This is a nightmare for you, and was not of your doing. I share your dilemma as a rural person. Our hospital is the only hospital for hundreds of miles, all by air or ferry, and even though it is affiliated as a nonprofit, it has bloated executive-level employees that make the life of actual practitioners and patients as difficult and expensive as possible. There is no "convenient" alternative available, and no cost control of any kind.

If people think the health care system can continue to operate with these costs that are steeply escalating overnight by passing them on to individual patients, they better think again.

I would make waves about this if I were you, and stick to your guns as much as possible. Thanks for the heads-up. I will be asking the hospital here for a written estimate in advance for procedures. I might even send it to the local newspaper.

A.A.

ptdreamers

O2bhealthy, We too live in a small rural community. I would contact the billing department and ask them if they reduce the bill. Explain that you have had the procedure before and bsed on that you were not expecting such an increase. Also explain that paying the full amount would place a financial burden on you with all the other costs you are incurring with cancer. Often they have the leeway to reduce your bill. Good luck.