Re: Medical billing is whack

On Sat, 3 May 2008 13:06:51 -0500, "Anny Middon"
<AnnyMiddon@[EMAIL PROTECTED]
> wrote:

>Earlier this year I had a bout of kidney stones.  Luckily I'm insured. 
BCBS 
>sends out these Explanation of Benefits ("This is not a bill") sheets
which 
>show what the what the billing entity charged, what we will owe that
entity, 
>what BCBS will pay, and what just goes away -- BCBS like I guess just
about 
>every insurer has agreements with the providers in the PPO which limit
what 
>will actually be paid for services.
>
>I thought it might be intersting to see what people here would guess the 
>charges were, how much will actually be paid, and how much goes away.
>
>Here are the services I received (I think this is everything):
>
>5 visits to the doctors' (both my primary care doc and the urologist) 
>offices (includes procedure to remove the stent)
>1 ER visit (includes pain meds (4) and IV)
>2 days in the hospital (including various meds -- IVs, antibiotics, pain 
>meds)
>4 visits from the docs (2 by each doc) while I was hospitalized
>1 surgery as an inpatient to insert a stent
>Urologist and anesthesiologist (they twilighted me for this one) charges
for 
>the above surgery
>1 surgery as an outpatient to remove stent, laser the remaining stones
and 
>insert a new stent
>Urologist and anesthesiologist (general anesthetic) charges for the above

>surgery
>1 CT scan (with immediate reading/interpretation -- I'm pretty sure there

>was an extra charge for this)
>4 x-rays (1 chest x-ray, 3 KUB [2 exposures])
>1 stress test
>4 blood tests
>4 urinalysis tests
>1 analysis of stool specimen
>Professional charges to interpret the above tests
>Various charges from Walgreen's for meds -- I'm not going to count up the

>meds I purchased, so since prices can vary greatly, I'll tell you that
total 
>charges here were $210.00.
>
>We will end up paying for both our deductible and co-pays exactly
$2,000.00 
>for all of the above.
>
>So what's your guess on what the totals billed are?
>
>Total amount paid by BCBS?
>
>Total amount that disappears because of arrangements between BCBS and the

>providers?
>
>Obviously this last amount is the difference between what was billed and
the 
>total that will be paid, including the $2000 we'll pay.
>
>Anny
>
>
Total charges somewhere between $100 and $125 grand. BCBS paid around
a quarter of that. Your payments are irrelevant to either side.

Boron