[thegreenerside]

My wife just received an itemized bill from The Villages Regional Hospital for an emergency room visit a couple of weeks ago (she is doing fine). The doctor ordered a CT Scan of her head and of body non contrast. TVRH is billing our insurance company as follows and wondered if that seemed abit high. I am assuming that these totals do no include the reading of the scan by the doctor or technician.

350 CT Scan 1,327
351 CT Scan/Head 3,414
352 CT Scan/Body 2,172

[duffysmom]

My husband visited the emergency room (VRH) and had several tests which included the same scans and after 8 hours (most of which was waiting) we were handed a bill for over $10,800. His initial complaint was feeling dizzy. We were not given a disagnosis and his dizzieness cleared up that evening. We have since learned that several of our neighbors had the same symptoms and had inner ear infections. By the way, the ER doctor never considered the possibility of an inner ear infection.

[Peachie]

Greenerside, I believe reasonable price and CT scan in the same sentence may be an oxymoron....

[diskman]

my wife had one a month ago in the er $6,000 hmo paid for it

[thegreenerside]

The total bill (hospital) was for $7785 with no diagnoses. She fell and hit her head and was knocked unconscious for a couple of minutes. Symptoms of dizziness, double vision, and unable to keep balance continued for several days after ER visit. She went to see her primary doctor whom ordered an additional CT Scan which still showed no injuries. As of today she is back to "normal", but she is sure the symptoms will reoccur when we receive all the bills even after insurance makes its payments. Of course this is November and we have not had to make any deductible payments this year.

[Number 6]

You need to check out your EOB when it comes from your insurance company. There is no way the hospital gets anywhere near that amount for three CT scans. My experience in NYS is that the hospital will get under $300per scan. The radiologist will get something like $100 per. You can call up your insurance company and see what their contract with the hospital is. These are simple (non contrast) scans, no?

[Number 6]

All hosptials and physicians charge the private pay patient well above what is "reasonable and customary". They see this as a way to make up for treating no pays. If you have no insurance (or your insurance does not cove the service), always, I repeat, always negotiate with the provider. If they get something like the BCBS rate they well be pleased. Bad debt writeoffs on private pay patients are over 90%, in my experience.

[Shirleevee]

Number 6,

I agree. My husband and I were just talking about this today. I once negotiated a heart scan from $2500.00 to $500.00. The hospitals and doctors would rather have something than share with a collection agency.

[barb1191]

If you are on Medicare with or without a secondary provider, the patient is NOT liable for the balance of the service charged by the health provider.

There is a federal law that prohibits a provider to "BALANCE BILL" a Medicare patient (meaning that the provider bills the patient after the insurance has made payment (which will not be the full amount billed by the provider).

The provider will bill you for the balance and you merely call them and tell them that, by law, you are not obligated to pay this and that their balance billing is ILLEGAL!!! PLEASE DO NOT BILL ME AGAIN FOR THIS CHARGE AND REMOVE THE CHARGE FROM MY ACCOUNT.

Unfortunately, this information, protecting senior citizens, has not been well published and the medical profession will rely on your lack of knowledge about this type billing. You must be your own advocate and don't allow this to happen. The providers are forced to accept what Medicare and a secondary insurance will pay for the service. The Medicare patient is not liable for the uncollected charges. i.e., "balance billing."

[islandgal]

I think I read in The Sun recently that there was going to be help for residents making decisions about Medicare and secondary coverage in 2009.

Does anyone know anything about where and when?

[islandgal]

Bump

[Number 6]

But..... If you are on Medicare and do not have secondary insurance the physician MUST bill the 20% that Part B does not pay. They cannot, by law, just write it off. This is not balanced billing.

[barb1191]

Hopefully, this link will describe Balance Billing better than my effort.

http://www.odh.ohio.gov/odhprograms/.../medbill1.aspx

[Number 6]

That is correct. A Medicare benificary may be responsible for the 20% copay should they not have a secondary as well as any uncovered service. Should you have a Medicare Advantage Plan, then all bets are off. There is co pays, co insurance and uncovered services. They are just like private insurace. What I also wanted to point out is that the physican or hospital is mandated by law to make every reasonable attemept to collect this money.

[rshoffer]

Originally Posted by thegreenerside

My wife just received an itemized bill from The Villages Regional Hospital for an emergency room visit a couple of weeks ago (she is doing fine). The doctor ordered a CT Scan of her head and of body non contrast. TVRH is billing our insurance company as follows and wondered if that seemed abit high. I am assuming that these totals do no include the reading of the scan by the doctor or technician.

350 CT Scan 1,327
351 CT Scan/Head 3,414
352 CT Scan/Body 2,172

Most insurance companies establish "usual, reasonable and customary" fees for everything, including CT scans. Any hospital can charge anything they want.... by agreement, they have to accept what the insurance company covers. It's a big game.... another example of how broken our health care delivery system is. Read the recent issue of Time magazine.... we pay the most of anyone in the world yet we're in the worst shape.