Laparoscopic appendectomy cost questions on recent surgery

olegeezer · Aug 10, 2013

About a week ago, I woke up at 3am with abdominal pain extending to my right side. I immediately thought it could be my appendix. By 7am after googling the symptoms, I decided to go to an ER and get it checked out. It was an inflamed (no rupture) appendix after they did a CAT scan. About 12 hours after the initial pain, the appendix was out and I was on the recovery road to the sun. I was discharged after a one night stay. It all went well and I was well satisfied with the medical help I received. I do not have medical insurance but I will be responsible for my surgery costs. I understand that hospitals and doctors are not in business to break even. I am searching for advice on how to determine what "usual and customary" fees are for the services I received. After a little research on the internet, the costs for these services vary considerably and I just want to find out how to get the best possible "bang for my medical buck".
At the moment I feel like I just went in to a car dealership, signed a blank contract and they have all the cost info.
I got my anesthesia bill yesterday for $1050 and I know I have several more statements coming. I think the hospital has labeled me as a "true self-payer", after a very brief conversation with a billing rep.
So any suggestions on negotiating costs with my providers would be appreciated. [IMGL][/IMGL]

Uncle Phil · Aug 10, 2013

If you can find it, find what the BCBS rates or UHC rates are. Maybe they will agree to drop down toward what the insurance company pays instead of sticking you for the full rate.

olegeezer · Aug 10, 2013

fnmag said:
Can't help with the costs, but am glad that you caught it in time and had access to good health care. It could have been worse if you were, say.....in Thailand.

Yes, I was glad I wasn't far from help!!
Timing is everything here and the docs consider it emergency surgery as it 's a real mess if it ruptures. (Bob Donald knows).

Thanks Uncle Phil, I may need an insider to get those BCBS UCR rates?? Regardless of the charges, it feels real good to be amoungST the living.....

TOS · Aug 10, 2013

You mentioned a car.
You can negotiate a cash price, just like you do when buying a car or motorcycle.
I would guess your hospital cost from $20-50K and you all ready mentioned the anesthesia cost. Negotiate both of these with cash. I would start at 30% of the total for each bill.
You will also receive a bill for radiologist (reading the CT) and a bill from pathologist for exam of the specimen (appendix) . You probably can't negotiate these bills of approximately $300-500 each.
Stand fast on your offer! It may take months and several phone calls etc. but, can save you thousands!
Important, don't waste your time talking with people that can't accept your offers i.e. talking to the manager instead of the salesperson when buying a car.
I would also ask for a itemized statement of the billing. Make certain you received everything on it! This also makes them know that you are serious about your charges vs. cost.
Hope this helps you some.
Tim

George · Aug 10, 2013

Not only is the US the highest cost provider on average, [-]butt[/-] (Oh, wait, that's a different procedure) but we also have the widest raaaaaaaaaaaaange of charges, high to low. Recent reports document this, do a search. And, how can ya cll yurself OL' Geezer if ya ain't olde enuff yet for Medicare? :rofl1:

olegeezer · Aug 10, 2013

Just the kind of stuff I'm looking for Tim, thanks.
The anesthesia statement only gives the total charge and says "This is the only statement you will receive". I had a CRNA administer the knock out juice and that's all I remember. I will ask for an itemized list anyway.
George, I'm just an Olegeezer poser I suppose. But, at my age, I can't bare to wish to be medicare age. The older I get the faster it goes, whether it be money or time.

The Dan · Aug 10, 2013

olegeezer said:
Just the kind of stuff I'm looking for Tim

What Tim said... I got a outrageous bill form a clinic when I was a self pay and I went in in person and talked to there billing head who cut 60% off the bill if I paid it that day. I just told them if you turn it in for collection you are out 40% for the agency to collect it.

v8-7 · Aug 10, 2013

There is something called the https://www.healthcarebluebook.com/

"The Healthcare Blue Book is a free consumer guide to help you determine fair prices in your area for healthcare services. If you pay for your own healthcare, have a high deductible or need a service your insurance does not fully cover, we can help. The Blue Book will help you find fair prices for surgery, hospital stays, doctor visits, medical tests and much more. "

I don't know how accurate it is, but the prices I looked up were way cheaper than what I was charged .

v8-7 · Aug 10, 2013

https://www.healthcarebluebook.com/page_Results.aspx?id=43&dataset=hosp&g=Appendectomy

olegeezer · Aug 10, 2013

v8-7 said:
There is something called the https://www.healthcarebluebook.com/

.

Thanks Stan, I have it bookmarked! And just yesterday I was well enough to install those LED mirror signals you shipped to me! (shameless plug, I like em, but only tested with the covers off). I gotta be West Virginias worst for leaving my signal on long after the turn.
My ST is pretty naked since pre-appendectomy I had it down for some almost serious preventive maintenance. Now it seems I have some spare time to finish the job as long as I don't lift more than 5 pounds........ I guess if I don't mess with the tars or the gas tank I will be in compliance.

Ronn · Aug 10, 2013

olegeezer said:
do not have medical insurance but I will be responsible for my surgery costs. I understand that hospitals and doctors are not in business to break even. I am searching for advice on how to determine what "usual and customary" fees are for the services I received. After a little research on the internet, the costs for these services vary considerably and I just want to find out how to get the best possible "bang for my medical buck".

You may find useful information here:

Fairhealthconsumer.org

TOS · Aug 11, 2013

olegeezer said:
Just the kind of stuff I'm looking for Tim, thanks.
The anesthesia statement only gives the total charge and says "This is the only statement you will receive". I had a CRNA administer the knock out juice and that's all I remember. I will ask for an itemized list anyway.

The anesthesia billing is more like, "fee for service". They usually charge "per unit", which is usually 15 minutes. All the supplies and medications that the CRNA used will be on your hospital bill. But, you can still negotiate a cash price for the service.

Good Luck,
Tim

Papa · Aug 12, 2013

I too was self pay and my first hospital visit was 19k, the second was 26k. Afterwards my attorney advised me that they would have settled for 60%. I did argue an ER visit from 1800 to 1200. I now have insurance. Good luck.

olegeezer · Sep 5, 2013

Well, the numbers are in (I think?). There may be a couple of more coming, but the majors are in.

$20256 Hospital, includes ER, EKG, Catt Skan, xRay, room, drugs, tools and supplies, OR, recovery room, CRNA fee, plus various other incidentals

$1748 Surgeon fee for laparoscopic appendectomy

$1050 Anesthesiologist

$ 434 Radiologist

$ 68 Surgical Pathology

$23,556 Total before any deals were offered for prompt payment with no insurance involved.

Is there a surgeon in the house? Better yet, are any medical billing people in the house? Or, does anyone have an opinion as to whether these charges are (UCR, Usual, Customary and Reasonable) for a very uncomplicated appendectomy, a one night sleep over and a total elapsed stay of 25 hours from check in to check out?
The follow-up Doc said it would be OK to ride as long as I didn't crash in a Catt-aSTrophic manner...

fubartes · Sep 5, 2013

...had mine burst in the OR table. Not fun! Glad all you have to worry about is the payment of services.

Mcubed45 · Sep 5, 2013

I wonder if it wouldn't hurt to talk to an attorney, to help you with the negotiation. But then, there goes even more money.

olegeezer · Sep 5, 2013

fubartes said:
...had mine burst in the OR table. Not fun! Glad all you have to worry about is the payment of services.[/QUOTE
Yes, my dad died from a ruptured appendix in "59" when I was 8 years old. I know this is the reason I got my belly to the ER as quickly as I did. I was having very mild pain when I got to the ER.

Mcubed45 said:

I wonder if it wouldn't hurt to talk to an attorney, to help you with the negotiation. But then, there goes even more money.

Click to expand...

I rank attorneys and insurance salesmen in the same "last resort" category. There are times when you have to use them. I don't think this will be one of those times.
I do highly respect my surgeon and his team for their expertise and good work!

Mark · Sep 5, 2013

You can still go into the hospital and ask them about 'self pay discount'.
I really don't know if any of the other crew members will offer; but, it wouldn't hurt to ask.

Good luck!

TPadden · Sep 5, 2013

My only advice is never pay the first bill, or the second, or the third, ...... or........

No negotiation necessary: every bill I got from my last hospital adventure was less than the previous bill right up until the second time they mentioned collection agency. Then paid and everyone was happy.

drrod · Sep 5, 2013

You might want to find the Time magazine article written by Steven Brill, back in the winter. It dealt with the costs of health care.
Here is an interview with Charlie Rose regarding it. It is in 2 parts.
Rod

https://www.youtube.com/watch?v=pvhlERCfui0

https://www.youtube.com/watch?v=fdO8reLFk5A

Laparoscopic appendectomy cost questions on recent surgery

olegeezer

Uncle Phil

olegeezer

TOS

George

olegeezer

The Dan

The Dude Abides

v8-7

v8-7

olegeezer

Ronn

TOS

Papa

R.I.P. - 2020/02/10

olegeezer

fubartes

Mcubed45

olegeezer

Mark

Gotta make tracks

TPadden

Tom Padden

drrod