Posted on 06/23/2008 8:34:39 AM PDT by vimto
My lad is in America waiting for a visa to live there and marry a lovely American lass. He was taken ill and went to hospital where an appendectomy was performed. The bill is $28,000 minimum. We think he has medical cover but we don't know the datils ...is ths figure about right? Anyone out there with any advice?
The first thing he needs to do is go in and tell them that he doesn’t have insurance and a lot of times they will cut the bill. Same with the Dr. and then they will take payments.
I had my gallbladder taken out last year. It was an emergency removal. (Went through the ER and was scheduled to have it removed within 12 hours. I spent 1 night in the hospital and this was a rural hospital)
Total was around $16,000 (what my insurance company was billed)
Now let me tell you a secret...
If your son or you can payoff any balance in full, then ask the hospital to discount the final amount due. Most hospitals will knock off an instant 10% or more if you pay the balance in full. You have to ask the hospital for the price break. Almost every hospital in the USA will give this 10% or more discount if you pay the balance due in full. Most hospitals will only give a 10% or more discount if the amount owed it $100 or more.
Don't ask for this discount unless you plan to pay the full balance due.
You simply say...
If I pay this balance due in full will you give me a discount?
If they say yes... then ask them how much they will know off the balance due.
This is not BS (most people do not know about this because the hospital is not allowed to tell you about it.)
The reason I know about it is I know someone that works in billing at a major hospital and they told me about it.
Everyone I have told who has had a hospital stay or hospital charges have asked the hospitals for this discount and every time they got discount.
I also got the discount at my rural hospital after getting my gallbladder removed last year.
Good luck and I hope your son is feeling better soon.
(just like others have told you)
Oops...
“know off” should be “knock off”
Hospitals inflate their bills terribly to those without insurance, but if you are firm and resolute they will negotiate.
Of course this can work in reverse. I know of a case where lap band weight loss surgery was performed. The fee was $18,000 for someone who paid cash, without going through the insurance company. But in this case, the insurance company paid. And the bill? Over $70,000. I was amazed at the difference and a person in the medical office confirmed to me that it was true.
So the hospital has a lot of leeway to bargain, in either direction.
>>>Thailand?
I don’t know what that joke is all about.
Sounds about right. Ten years ago mine cost $11,000. It was a real kick in the crotch.
I’ve chosen not to buy HI and instead spent the money on RE. So far it has worked out very nicely.
Depending on your son’s employment status, many states have coverage for those with “low incomes”, often up to 45K annually or more US. You probably want to check on coverage through the home country plan first. The hospital billing office will know about many of these programs and if immigrants are eligible in that state.
Health coverage in the US is a messy patchwork of federal and state programs. You might try this non-profit for more information: http://www.coverageforall.org/
They have an email and US toll free line as well. Ernie is the manager of the unit and has the best information. I suggest working the hospital financing office first, and then using these folks get additional info on state and federal insurance coverage, if available.
Tell him not to get married. The best advice anyone can give.
It is a highly inflated statement in which they claim is a bill is $28,000. They send that to an insurance company which will not even pay even 30% of that amount.
If there is no insurance company, they will bill the patient 50% of the inflated statement or $14,000. If you can't afford that, they will continue to reduce the amount to something you can afford.
I am so sorry to read about your son’s emergency - and hope all the great advice you received here will give you some tips on getting him out of a financial jam before he gets married.
Meanwhile I hope he is on the mend and looking forward to fewer problems in the next year.
You are great father for doing some research for him with the membership here. The advice is valuable.
Best wishes to your son and his bride to be too!
As an aside - the U.S. prides itself on doing complicated conjoined twin separation surgeries or going abroad with medical teams annually to perform birth defect surgeries in other nations - but we can’t seem to get it right for our own people right here at home.
Is that upside down or what?
It's not a misnomer, it is a fact! Last year I had simple outpatient procedure (in and out in less than 2 hours) for which the hospital sent a totally ridiculous bill of $2,500 to the insurance company. This did not include any of the doctors fees, anesthesia, pathology, etc. That was all billed seperatly. The $2,500 was for the use of a room, a set of sheets and I suppose the glass of juice they gave me afterwords.
The insurance company initially rejected payment because the idiots at the hospital put the wrong procedure number on the the bill. After the rejection, the hospital then sent me a bill for $1,250 at a 50% discounted "uninsured" rate.
After many months back and forth with the clinically brain dead hospital billing personnel, they finally resubmitted the entire $2,500 bill to the insurance company with the proper billing code and the insurance company promptly paid them a grand total of $850 which they accepted as payment in full. End of story.
Now here we have three pricing levels for a simple hospital visit.
1. The $2,500 List Price or Rack Rate which they NEVER get.
2. The 'Retail' price of $1,250 they will attempt to collect from the uninsured.
3. The 'Wholesale' price of $850 that is pre negotiated with the insurance company.
Last year I went through three days of tests at one of the hospitals in Philly; all was covered by my insurance, but I didn't get the bill. I did have access to the insurance co.'s online system through my employer, and pulled the records showing procedure/amount billed/amount paid. I noticed that there were about 25% of the line-items that were denied, due to Not Applicable, or as Included in Other Payouts. Of the balance, any MD or other qualified medical individual's bill was cut to 55% or less; Drugs and Durable Medical Equipment charges were cut to 35% or less. My insurance paid out less than $14K on the original $40+K bill.
I too believe that the hospital in your case should submit the bill to Britain's NHS and get their refusal in writing before your son makes any arrangements with them. As a visitor here on a valid visa, he should be covered at least in part, if not in whole due to it being emergency surgery.
No, it is outrageous. The entire hospital bill for my birth in 1950 was less than $25 which was about 8% of a normal working man’s monthly pay and the average american only spent $197 per year on healthcare as a whole. Today if the average young guy is making about 3-4K per month a normal uncomplicated hospital delivery will run around $16,000 to 20,000 which is at least 4 times the monthly pay, so yes the costs have gone up a great deal. Shoot, in 1955 the average cost for one day in the hospital was $35 and adjusting for inflation you don’t even get close to that amount today.
If people wanted to be treated using the same methods, equipment, and training they had in 1950, I’m sure costs would be a lot cheaper.
“Last year I went through three days of tests at one of the hospitals in Philly; all was covered by my insurance, but I didn’t get the bill. I did have access to the insurance co.’s online system through my employer, and pulled the records showing procedure/amount billed/amount paid. I noticed that there were about 25% of the line-items that were denied, due to Not Applicable, or as Included in Other Payouts. Of the balance, any MD or other qualified medical individual’s bill was cut to 55% or less; Drugs and Durable Medical Equipment charges were cut to 35% or less. My insurance paid out less than $14K on the original $40+K bill.”
Your description is typical of many people that I know. It’s a game, or at least it looks like that from where I’m at.
Oh, it's turned into a game, alright.
Noticed the others comments above; one thing I recall is back when I was a kid and had appendicitis and we had no insurance, was that while costs were lower, they weren't as egregious as they seem today. You went to the Doc's office and paid his bill -- $15 or $20 plus $3-5 for the shots or pills. The insurances were for catastrophic care, hospitalisation and surgical care. Any radiology/pharmacy/etc. was billed under the hospital charges, instead of multiple bills from a dozen different entities.
Of course, back then we didn't have the feds mandating coverages the way they do now; I believe that Medicare/Medicaid is the driving force to the over-pricing and over-billing across the board. No; I don't have an answer as to how to fix it.
You mean way back then when nurses really did nursing, cleaning people really cleaned, and even a patient who was totally out of it would have their sheets changed as many times a day as necessary and would be bathed daily.
Today, if you have a loved one who can't speak for himself in the hospital, you better be there to speak for him or he will be ignored. Technology aside, hospital care today is pitiful compared to the past.
Actually the methods and equipment and training to do an appendectomy have not changed all that much. The real problem is insurance coverage and lawsuits by ambulance chasers and the way in which these have encouraged hospitals and doctors to charge whatever the market will bear. If your garbage collectors are assured that the fees they charge you are covered by someone else then they will quickly figure out that it is in their best interest to raise rates because there is no more competitive pressure from customers because the customers never directly pay the bill.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.