CancerNetwork Members: Login | Register
Become a fan on  Facebook  Add us on  Google Plus Follow us on  Twitter Join us on LinkedIn Sign up for our Newsletters Subscribe to our RSS Feed

 

CancerNetwork SearchMedica Medline Drugs

Powered by SearchMedica

 
PUBLICATIONS
NEWS
PODCASTS
TOPICS
BLOGS
NURSES
PATIENTS
JOBS
CONFERENCES
CME
SUPPLEMENTS
 

Home » Practice Management

 

Hernias and High-Deductibles: Byzantine Bills Prove Hard to Decipher

By Bryan R. Fine, MD, MPH | April 9, 2012

There is as lingering discomfort in the "down there" area. But I’m optimistic that will continue to improve, and I’ve even starting jogging — with doctor’s clearance, of course.

The scars are healing nicely, so my summer beach aspirations aren’t destroyed.

(MORE: Healthcare Policy: From Washington, D.C., to Your Practice)

Probably, I could roll this story on for quite a while.

I still haven’t received a bill from the anesthesia team. I suppose it’s possible it’s rolled into the hospital bill for services, but since the EOB wasn’t truly itemized I can’t say for certain. I doubt it, though. It is rare that physicians and hospital bill together. Even physicians employed by hospitals often live in separate physician practice group that bills — and advocates — as a distinct entity.

So, as of this moment, I have received the surgeon’s professional fees explanation of benefits and the hospital explanation of benefits, the former of which arrived at approximately $7,000 in charges (I was asked to pay about $1,000), and the latter — hospital "fees" — came in at nearly $20,000.

Immediately after my last post, nearly three weeks ago, I had my follow-up visit. Upon arrival and check-in, the woman at the desk asked me how I would like to settle my bill (for physician’s fees). I politely explained to her that the one bill I had received — $297 for the initial assessment, of which I was asked to pay $294 — I had promptly paid. The remainder of charges, which she had on a paper in front of her, I hadn’t even been billed for yet. I explained that I’d received the EOB from the insurance company — but I understand that "This Is Not a Bill." She assured me she’d get on it.

No doctor’s bill yet.

My hospital EOB also arrived. Conveniently, it is impossible for me to recognize what I have been charged for. The itemized list of services and widgets, which together add up to a total bill of $19,285 for my two-hour visit to an outpatient center in Virginia Beach, is in fact a simple repeated "Medical_Care." Yes, I apparently received 24 units of "Medical_Care," which varied in price from $0.15 to $8,433. You would think distinguishing these units would be important to a consumer who is trying to make educated choices, yes?

As well, I haven’t received an actual bill from the hospital. My insurance company got to me first.

I did receive a customer satisfaction survey rather promptly, which I filled out and have returned. My grading was across the board quite good, as I have been happy with the outcome, I felt the nurses and physicians were quite knowledgeable, and the hospital itself was clean and bright.

There were no questions on the survey about costs of care. I’m assuming that is because patient’s don’t usually worry about those sort of things, and if ever there was an indictment that costs aren’t being equate or tied into patient satisfaction, the absence of appropriate questions on the patient satisfaction survey — the Holy Grail to hospital administrators — is profound.

I continue to be amazed by the complexity and layering of the medical bills associated with my short, elective, outpatient procedure.

Multiplying this by a chronic condition, with a less knowledgeable consumer and an unexpected occurrence, for someone who may be in a lesser position to afford the bills — you can easily see how out-of-control the processing becomes.

As of now, I have eaten up the entirety of my deductible in my high-deductible health care plan. I’m glad this has happened by April, as I’m now — in theory — rather incentivized to get my health check-ups, and pursue the needed labs and preventive care, all of which will be covered 100 percent. One moral is that elective surgeries for people in high-deductible plans should always be done in January.

I’ve been through this before, written about this before. I’m interested to see how it plays out, where the responsibility is expected to lay for teasing through all the information. In the past, this has gotten me phone calls from hospital financial offices and collections agencies. Not because I am unwilling or unable to pay, but rather because I’m holding "the system" accountable to provide accurate information, closely reviewing the services rendered in my care, and expecting exceptional customer service.

Find out more about Bryan Fine and our other Practice Notes bloggers.

 

Join the Conversation

Want to join the conversation? If you're a healthcare professional, we'd like to hear your comments. Just sign in or register today to become part of our growing, online community.

More from Bryan R. Fine

Making Public Health Policy and Economics a Priority

Identifying the Distance between Healthcare Cost and Patient Care

Debate over Healthcare Economics Nothing New

Hernias and High-Deductibles: Byzantine Bills Prove Hard to Decipher

Hernias and High-Deductibles: Unclear EOBs and Unknown Providers

Hernias and High-Deductibles: The Quest for Costs Continues

Hernias and High-Deductibles: A Healthcare Costs Discussion

‘Bending the Curve’ in Healthcare Spending

Transparency in U.S. Healthcare: Has It Gone to the Dogs?

Where is Healthcare in the Election Discussion?

Price Transparency in Healthcare: Why All the Secrecy?

Medicaid vs. Private Insurance: Which is Better?

Redefining ‘Uninsured’ When Examining Patient Care

Healthcare Costs Actually Matter for Patients Paying Out of Pocket

Is ‘Profit’ a Nasty Word in Healthcare?

An Uninsured Discussion

Healthcare Policy: From Washington, D.C., to Your Practice






 
TOPIC INDEX

Cancer Types

 
  • Breast
  • Breast (HER2+)
  • Breast (Triple-Negative)
  • CML
  • Colorectal
  • Gastrointestinal
  • GIST
  • Genitourinary
  • Gynecologic
  • Head & Neck
  • Hematology
  • Kidney (Renal Cell)
  • Leukemia
  • Lung
  • Lymphoma
  • Melanoma
  • Multiple Myeloma
  • Ovarian
  • Prostate
  • Sarcoma

Supportive Care

More Topics

  • Bone Metastases
  • End-of-Life Care
  • Palliative Care
  • Ethics in Oncology
  • Practice Management
  • Practice & Policy


All Topics 


 
MOST POPULAR
  • Most Popular
  • Most Emailed
  • Most Recent
  • Papillary Thyroid Carcinoma
  • Robotic-Assisted Radical Prostatectomy: Who Is Benefiting?
  • ASCO: Long-Term Tamoxifen Benefit for Breast Cancer Confirmed
  • A 48-Year-Old Woman With Irregular Vaginal Bleeding
  • Dermatologic Adverse Events Associated With Targeted Therapies
  • Cannabis Linked to Decreased Bladder Cancer Risk
  • Breast Cancer Screening, Risk, and Options for High-Risk Women
  • Rising PSA Level in a 46-Year-Old Man
  • ASCO: Long-Term Tamoxifen Benefit for Breast Cancer Confirmed
  • Recurrent Epithelial Ovarian Cancer: An Update on Treatment
  • Soluble HER2 Levels Prognostic Factor in HER2+ Breast Cancer
  • ASCO: PD-L1 Antibody Elicits Durable Response in RCC
  • RECORD-3: Sunitinib Still Standard First-Line Treatment in Metastatic RCC
  • ASCO: Dabrafenib Shows Activity in BRAF-Mutated NSCLC Patients
  • Preventing Burnout in Oncology
Click here to subscribe to our newsletter
 
COMMENTS
  • Most Commented
  • Most Recent
  • 50 Shades of Pink—And Why It Helps to Know the Difference
  • Preventing Exposure to Hazardous Drugs
  • ASCO: Vinegar Screening Significantly Reduces Cervical Cancer Mortality
  • ASCO: Sulforaphane in Prostate Cancer Found Worthy of Further Investigation
  • Study: Recurrent Heartburn Ups Risk for Throat Cancer
  • Radiation-Induced Enteritis: Incidence, Mechanisms, and Management
  • HER2-Directed Therapy for Metastatic Breast Cancer
  • Accelerated Partial-Breast Irradiation: The Current State of Our Knowledge
  • It’s Time for Clinicians to Reconsider Their Proscription Against the Use of Soyfoods by Breast Cancer Patients
  • 50 Shades of Pink—And Why It Helps to Know the Difference
Click here to subscribe to our newsletter


 
SearchMedica Search Result

Find peer-reviewed literature and websites for practicing medical professionals

CME on Practice Management
Evidence on Practice Management
Guidelines on Practice Management
Patient Education on Practice Management
Clinical Trials on Practice Management
Practical Articles on Practice Management
Research and Reviews on Practice Management
All "Practice Management" results

CancerNetwork on Facebook

CancerNetwork | ConsultantLive | Diagnostic Imaging | Musculoskeletal Network | OBGYN.net | PediatricsConsultantLive |
Physicians Practice | Psychiatric Times | SearchMedica | Medical Resources

© 1996 - 2013 UBM Medica LLC, a UBM company
Privacy Statement - Terms of Service - Advertising Information - Editorial Policy Statement - UBM Medica Network Privacy Policy