After Surgery, Surprise $117,000 Medical Bill From Doctor He Didn’t Know


#1

NY Times:

After Surgery, Surprise $117,000 Medical Bill From Doctor He Didn’t Know

Before his three-hour neck surgery for herniated disks in December, Peter Drier, 37, signed a pile of consent forms. A bank technology manager who had researched his insurance coverage, Mr. Drier was prepared when the bills started arriving: $56,000 from Lenox Hill Hospital in Manhattan, $4,300 from the anesthesiologist and even $133,000 from his orthopedist, who he knew would accept a fraction of that fee.
He was blindsided, though, by a bill of about $117,000 from an “assistant surgeon,” a Queens-based neurosurgeon whom Mr. Drier did not recall meeting.
“I thought I understood the risks,” Mr. Drier, who lives in New York City, said later. “But this was just so wrong — I had no choice and no negotiating power.”

In operating rooms and on hospital wards across the country, physicians and other health providers typically help one another in patient care. But in an increasingly common practice that some medical experts call drive-by doctoring, assistants, consultants and other hospital employees are charging patients or their insurers hefty fees. They may be called in when the need for them is questionable. And patients usually do not realize they have been involved or are charging until the bill arrives.
The practice increases revenue for physicians and other health care workers at a time when insurers are cutting down reimbursement for many services. The surprise charges can be especially significant because, as in Mr. Drier’s case, they may involve out-of-network providers who bill 20 to 40 times the usual local rates and often collect the full amount, or a substantial portion.

That’s just low. Anybody in the hospital or ER is in no position to each & every doctor, nurse, &c if they are in his insurance plan.


#2

I have just come out of the Mater Private Hospital in an Australian city,after a two and a half month stay. I had a heart specialist; an endocrinologist to look after my diabestes; an infectious disease specialist to treat my ulcerated legs; a venous surgeon to assess possible treatments; a lung specialist to treat my pulmonary hypertension and numerous pathology; Cat scans; dopplers; a blood test every day; an arterial blood test every week UGH! and physios coming every day to annoy and get me up for the torture hobble.
Did not pay a cent. However my private health insurance (that cannot go up in premiums due to Community standard Federal laws) probably have a contract out for me as this is my second stint in a 16 week stay within two years.
Australia has a private/publicly funded system that is often vilified but is much cheaper than in America. I don’t know what your poor or unemployed do, but all are covered in our public system. My private insurance costs me $5000 a year. Last cost over $1500 a day for private room and all specialists bulk billed me,(free) as they know me and have grown fond of me over time. (I am just so cute.) .
Weekly nursing care at home costs me $10 a visit.
Also received communion every day and the last rites as it was a Catholic hospital
.Dying but loving it as it is free!


#3

That’s happened to me and many people I know. There’s nothing that can be done about it, though. If your hit by a car, for instance, it’s inevitable that you’re going to wake up owing tens of thousands of dollars to the hospital, doctors, ambulance corporation, etc. A woman I used to work with received a hospital bill for over two hundred thousand dollars from a situation very similar to that, and that was after her health insurance paid the lion’s share of the bill. In many ways ambulances and paramedics are far more dangerous than trigger happy cops or any variety of street criminal.


#4

The NHS may have faults, but I am so happy that in the UK I can go into any state hospital and receive treatment which is free at the point of care delivery. Even here in Italy I have cover for emergency treatment, should I need it, as a European citizen.


#5

I’ve had a similiar experience in Australian hospitals. Over 7 admissions to a private hospital over a 2 year period. As well as day admissions two days a week, every week, over that same period. Except when I was an actually admitted for overnight periods. On average those overnight admissions were 3 weeks each.

There was a mix up on my first admission with my private health insurer, so I saw the bill. I also worked for the insurer at the time, and from my job had a pretty good idea what they were getting charged.

Would have been over $150K. I pay $1300 for my hospital cover a year today. So it was less then as it was 2009 - 2011 and of course we’ve had the annual rate rises in that time.

I love our system. Our health system is one of the reasons I would be very hesitant to move overseas. I know that our combo of private and public works. And when you’ve been that ill, you don’t take it for granted.

I also take some fairly pricey medication - which is completely subsidised by the government. Thankfully, how much I take has dropped to a reasonable level but there was a time it would have been over half my income if I had to pay for it myself. It I lived in the US when I was sick, I don’t doubt that I’d be dead now.

I do feel for Americans. I would be scared to live in the US because of the state of their health system. Heaven forbid if I get sick again.


#6

Similarly in Ireland, although people can chose to pay for private health insurance but it’s neither here nor there, as you’ll get the same treatment anyway.

I have a relative living in the USA and when he lost his job, his healthcare insurance was $48k/yr that he had to pay or not get treatment for his wife who has a chronic illness. One month his health insurance fees were $8k!

The added stress on unemployed people - worried about having no finances to pay for basic living costs, i.e. mortgage/bills/food etc - to then also have to worry about their family’s healthcare, I find unconscionable.


#7

I find it fascinating how much people do not know about the healthcare system in the United States.
And even more fascinating that such ignorance brings snap judgements.


#8

We had a similar problem years ago when my father-in-law was in the hospital. Every morning a foreign doctor would come in to his room, look at his clipboard and leave. When we finally called him out on it he apparently had no real connection to my FIL’s case but was nevertheless submitting a bill for his “services”.


#9

I have had this happen to me. I’m in the US, had surgery, found out several months after the surgery when the bill came how many specialists were billing :open_mouth:

I am still covered under my parents insurance, and it’s really good insurance. Had I been even slightly less covered or lucky, I have no doubt that I’d be under crushing debt.


#10

We had a much milder version of this happen which put me off the PPO approach to health insurance.

When my middle daughter was born we did ALL the stuff the insurance company tells us to. We picked a doctor in the plan and a hospital in the plan. We did a preadmittal review of the care plan with the insurance company.

She went into labor and we did everything by the book.

Then the bill came. The hospital assigns an anesthesiologist and if needed other doctors as they see fit and without consulting you. So we ended up with two specialists “out of plan” that raped us for about $12,000 that our insurance wouldn’t cover.

The willful incompetence of the insurance and health care system in the USA really is as bad as the critics say.

Personally, I’d be fine with a nationalized system that covered pretty much ANYTHING that existed prior to 20 years ago (rolls by year) at fixed costs like the Medicare system establishes. Then if you want access to the current cutting edge technology, buy insurance for that or pay cash. Best of both worlds: Good basic care for everybody and still plenty of financial motivation to innovate and create new treatments and cures.


#11

This may be legit or it may not be.

If it is legit, than it shows, tip of the iceberg I would say, how “sick” our health care situation is in the US.

If it is not legit, it shows that there are many “doctors” who look at charts and send in their bill/s and hope to receive something.


#12

I think I would refuse to pay!


#13

rollseyes

Often, doctors (and anyone else who bills insurance) get literally pennies on the dollar for what they bill.


#14

Are you referring to the author of the news article or to the comments in this thread?


#15

I can’t comment on the US system, all I know about it is what I see on the TV.

I know that I ended up in the hospital with 5 life-threatening conditions, had three surgeons as my main case workers (overseeing my orthopedic surgeon, pain specialist, physiotherapist, diabetic specialist and nutritionist), three surgical procedures, moved from ER to ICU to Orthopedic to Acute Care to rehab/in-patient physio, started with 12 IV’s, finally weaned down to four a day over the course of 2 months. Plus all my drugs and meals.

My out-of-pocket cost? $75 for the ambulance ride in.

I have no idea what the total bill would be, but my “chart” was over 12" thick.

Although I like to think I earned a bit of my keep – I let them use me as a test case to train student doctors (one learned how to take my pulse in my foot, and two others learned how to interview a patient to get their medical history).


#16

Thank God you live in Canada!:slight_smile: Had that happened south of the border I can’t even imagine how much you would have owed. Two months in a hospital here would be just insanely expensive. That co-worker I mentioned was only in the hospital for about two weeks, or maybe less. The only thing free in the US is hospice care!


#17

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