Last night I opened a piece of mail from the hospital where I had my gastric banding procedure performed. The notice stated it was not an invoice, but just a statement of charges. OMG, the total charges were $82,000 billed to my insurance company.

Okay, I did have a little issue with my spleen bleeding during the surgery, so I stayed in the hospital for 2.5 days, but OMG, $82,000. I thought self-pay banders were paying around $20K in the USA and around $8K in Mexico.

The implant device was $11K and the OR was $20K and the recovery room was $6K and the semi-private room was $9.5K and the list of charges keeps on going. :sad:

Thank goodness for my insurance.:thumbup:

I think I would have fainted on the spot.

It's amazing how much they charge.

I would be more concerned about why my spleen was bleeding during surgery than how much it cost. Did your surgeon nick the spleen during the procedure? A bleeding spleen quickly becomes an emergency.

I would be more concerned about why my spleen was bleeding during surgery than how much it cost. Did your surgeon nick the spleen during the procedure? A bleeding spleen quickly becomes an emergency.

I am aware of why the spleen bled during surgery and no the doctor did not nick it. It was scar tissue from a previous surgery. :thumbup:

Eeeeeeeeeeeeeeeeeeek!!!

Hope you're share won't be much! That is awful.

Last night I opened a piece of mail from the hospital where I had my gastric banding procedure performed. The notice stated it was not an invoice, but just a statement of charges. OMG, the total charges were $82,000 billed to my insurance company.

Okay, I did have a little issue with my spleen bleeding during the surgery, so I stayed in the hospital for 2.5 days, but OMG, $82,000. I thought self-pay banders were paying around $20K in the USA and around $8K in Mexico.

The implant device was $11K and the OR was $20K and the recovery room was $6K and the semi-private room was $9.5K and the list of charges keeps on going. :sad:

Thank goodness for my insurance.:thumbup:

That doesnt sound right. They are ripping off the insurance company big time! This is what brings up costs to consumers. Fraudulent charges being submitted to your insurance. I would report them. My doctor group sent me an invoice for $5,000 and I was responsibile for $960. I was in recovery for about 6 hours. Thats way too much.

That doesnt sound right. They are ripping off the insurance company big time! This is what brings up costs to consumers. Fraudulent charges being submitted to your insurance. I would report them. My doctor group sent me an invoice for $5,000 and I was responsibile for $960. I was in recovery for about 6 hours. Thats way too much.

Yes, it does sound excessive to me too. I thought maybe because I stayed for 2.5 days in the hospital. Not sure who to report to, but it just sounds like way to much money being charged.

I thought self-pay banders were paying around $20K in the USA and around $8K in Mexico.

i was self pay and it was $15k (dallas, tx). i checked in at 9am, was home by 3pm.

i have no idea what insurance companies bill these days - that bill however does seem excessive....again have no idea. my appendix burst back in 06' and cause complications resulting in my gall bladder being removed 2 days later and that bill was less than 75k for a wk stay in the hospital....(insurance covered).

for someone who had to go self pay because i did not meet my insurance criteria - it's frustrating to see what the billing rates are. this is the highest i've read yet.

I was in the hosp. for about 7 hours. The hosp part of the bill was $54,000. They only got paid $6,000 of it.

. . . and people wonder why the costs of medical insurance go up by double digits every year???

Of course the hospital will never get that much for the surgery . . . insurance only pays certain allowed amounts, the patient pays their portion, and everything else is written off.

However, I think that what they charge is so far out of sync with reality that they should be ashamed for even sending a bill for that much. Is it really any surprise that some people go elsewhere for medical care?

OMG....yeah he's totally trying to rip off your insurance...and even with 2 days at a hospital that does not add up 80,000 + dollars.....Example- my son who was born 2 months premature lived in NICU for 1 MONTH! his statement of charges was 89,000 dollars....thats understandable....a lap band,slight bleeding,2 days in a hospital....I think not.

I have to say the more I deal with doctors the more I have a complete distain for them....dishonest,unethical,Greedy arrogant and the biggest BS'ERS:cursing: The whole lot of them should be taught a lesson...I take nothing a doctor tells me a face value....I defy any doctor to look his nose down on me and expect to roll over and take it as though they were the end all and be all of opinons.

:embaressed_smile:OOPS...didn't mean to go on a rant:embaressed_smile: I would defintly report it what are they gonna do take away your BAND??:thumbup:

I am very thankful my insurance paid 50% of what is allowed. My total out of pocket expense for surgeon, OR, and anethiesia was a little less than $1000. I did however see the bill that was sent to insurance and about fainted myself. Being that I do insurance for a living I knew that insurance NEVER pays the full amount that the provider bills, if they are contracted with the insurance company. The hospital portion itself was $72,000 (give or take) I paid $100 outpatient copay.....insurance paid a little over $22,000 for that part. However, since my insurance policy states this procedure is only payable at 50% of the allowed amount for the surgeon and anethesia, I thought I was going to have to pay around $5,000 to $8,000 out of pocket....but to my surprise NO. The surgeon billed insurance a little over $7,000 which BCBS AL only allowed $1,078 for the banding procedure itself.....I pay $539.00 and insurance paid $539.00. Also, since I had to have a heital hernia repair he billed for that as well around $2,300 and it paid the whole amount for that. My portion of anethesia is $326.00 insurance only paid 50% of that as well.

So all in all I think I came out so much better than I thought....and worth every damn penny. When I saw these statements from the insurance company I was pretty pleased. Like I said I thought I would be coming off a lot more than that. So this was a GREAT Christmas present to myself!

Merry Christmas EVERYONE.....

good luck on your journey and

great food choices during the holiday season.

I work in the medical field. No one is trying to rip anyone off. The bills are routinely way above what is reimbursed. The insurance companies have a contract with the hospital and will get a set amount payed to them based on what has been agreed upon. This will not make sense to you unless you work in the medical industry.

And, remember the bill looks excessive to you but there is also the added cost of paying for those patients that come in for all different reasons with no insurance. The payment for their care has to come from somewhere and you with the insurance help pay for their care! Yes, this increases the cost to everyone. The nurses like to get payed for the work they do just like everyone else.

michelle

Since my procedure was medically necessary for my health, I do not have any co-pays for the hospital stay. At least that is what my insurance told me as I was researching the process/procedure.

There is no way I could ever afford $82K. This is the best and by far most expensive Christmas gift I ever received. I am very thankful for my insurance.

I had my surgery at TLC Edge in Plano, Tx. I was selfpay and my cost was $11,990. I received an itemized invoice for the surgery and also a bill for $290.00.

When I paid the $11,990, I was told that was all I had to pay and when I called to check into the invoice that was sent to me and why I still owed money, they said it was for a diagnostic laparoscopic procedure, which they billed my insurance almost $6,000 for. Lap exploration is part of the surgery anyway, to verify that you can get the band placed.

I was also told, the day of surgery, that they needed my insurance card in case something went wrong and they needed to transfer me to a hospital or I had other needs, but that my insurance would not be billed for any other purposes. I did self pay because I didn't meet insurance requirements for lap band placement. I guess they found a portion they could bill for and did so.

The total bill was for over $80,000. I was told I received the invoice by mistake and it wasn't suppose to come to me. I don't think I should have to pay the co-pay for the remainder though, because I was told everything was covered and now because they found something they could get paid extra for, now they are billing me a co-pay.

OMG....yeah he's totally trying to rip off your insurance...and even with 2 days at a hospital that does not add up 80,000 + dollars.....Example- my son who was born 2 months premature lived in NICU for 1 MONTH! his statement of charges was 89,000 dollars....thats understandable....a lap band,slight bleeding,2 days in a hospital....I think not.

I have to say the more I deal with doctors the more I have a complete distain for them....dishonest,unethical,Greedy arrogant and the biggest BS'ERS:cursing: The whole lot of them should be taught a lesson...I take nothing a doctor tells me a face value....I defy any doctor to look his nose down on me and expect to roll over and take it as though they were the end all and be all of opinons.

:embaressed_smile:OOPS...didn't mean to go on a rant:embaressed_smile: I would defintly report it what are they gonna do take away your BAND??:thumbup:

Oh come on! Not all doctors are "dishonest, unethical, greedy, arrogant, and the biggest BS'ERS" I have been a nurse for 25 years and I can tell you I have dealt with VERY FEW dishonest or unethical doctors. Arrogant and full of BS I can agree with on more than half of them. But honestly.. most doctors I have worked with are great people, mainly family men, and they all worked too hard for their medical licenses to jepordize them by trying to make an extra buck or cheat the system. As far as "greedy" goes.. Do you know what the average "take home pay" for a general practioner in America is today? This is after they pay all their over head.. I recently read that is is $86,000!!! ( this is the average between general practioners all across the US from New York City to small town in Alabama.) Now.. Divide that by their hourly work and they don't make much. I once worked for an Internal Medicine doctor.. Here is an example of his daily schedule. At the hospital by 600am to round on his patients that are there, to the office and see patients from 8-5. Review patient charts, lab results, return calls from 5-7 pm. Go to hospital on lunch break for a comittee meeting, Go back to the hospital after work to discharge patients. Home by 900PM and but "on-call" all night and answer patient phone calls, calls form hospital etc. then do it again the next day.. I don't know why the heck they do it. They could surely make more money doing something else. Must suck to work 24 hours a day for your patients and then run into ungrateful people with crappy attitudes who don't trust a thing you say and think your arrogant, greedy, dishonest, unethical and full of BS and have complete distain for you.

By the way.. the original poster said it was a bill from the HOSPITAL not the DOCTOR. so the doctor is NOT trying to rip her off. Even though the hospital billed that much they will only get payed their contracted rate that the hospital and the insurance company agreed upon when the hospital became a contracted provider.

Edited December 25, 200817 yr by nursekathy2u
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