A few weeks back I went to the emergency room late Saturday night for a kidney stone.  This was my 5th one and I needed pain meds.  Every time I have had one, I go to the ER, get pain meds, go home and see my urologist.  Four of the five previous stones had to be surgically removed by a simple 45 minute endoscopic out patient procedure.  This involves general anesthesia, a simple procedure with no cuts, then go home with pain meds and usually go back to work the next day.  Anyway.....ER doc says you have a 7mm stone (no biggie..had them that size before), so I ask for pain meds and tell him I'll call my Doc tomorrow.  He says no way...this is life threatening...if your ureter gets totally blocked you will lose the kidney.  So I get admitted.  Sunday I see the staff urologist (SU) since my normal urologist is 30 miles away and does not practice at this hospital.  I give the SU my history with kidney stones and he says no problem...he says stay a second night and we will remove it Monday morning first thing.  Monday morning rolls around, SU comes in later and says he decided to wait a day to see if it will pass on its own.  I say there is no way...its BS...its 7mm....get the lecture from the SU about losing the kidney.  Tuesday rolls around...SU comes in and says today is the day....I have it removed, but still can't go home.  I have stay another night for "observation".  In the mean time...I am basically sitting in this hospital room bored to death, with hardly any pain because the stone was not moving and had no ureter blockage...wasting time.  So...Wednesday finally rolls around...I am fine...but they do not discharge me until 4 PM!  During my entire stay, I had an IV with fluids, antibiotics, and very few pain meds....I ate their crappy food, saw the Doc a few times, saw the nurses about every four hours, and had the stone removed.

Today I get the statement from the hospital.  My total bill was $97,000.00!!!!!!!!!!!!!!!!!!  Yes, that is ninety seven THOUSAND dollars.  I have awesome insurance (United Health Care)...and see they discounted the bill for the insurance down to $85,000.00!!!!!  My portion was only a $250.00 co-pay....thank god for good insurance.  Looking back on the whole chain of events....that hospital and docs were just milking the insurance.  This should be criminal.  I seriously doubt I would have had the same treatment if I walked into the ER with NO insurance.  I have sent a similar e-mail to United Health Care outlining how I think the hospital took them for a ride.  Not that it really matters to me with my $250.00 co-pay...but what they did was just ludicrous.  We as a nation, wonder why our health care is so high...how the hell can the hospital justify these costs, because we know the nurse, doc and other labor costs are just a fraction of the overall bill.  I know there is the huge liability insurance expenses...but I paid their premium for the entire month.  The true costs of Obama Care has hit home for me....we as a nation are bankrupt and done...we are dying of cancer....a slow and painful death....our "leaders" are our tumors and they have run us in the ground.  If they took me on the 97K ride for a simple kidney stone...imagine what really sick people will do to the system....

Someone has to pay for all those people that camp out at the ER every time they get a hangnail.

And the insurance company will really pay about 10-15K.

A buddy of mine who works in an ER told me that only 25% of ALL ER visits end up getting paid for, either insurance or otherwise.

A limb must be missing for me to visit the ER. Very few ailments that are not life threatening can't wait until morning. I refuse to pay thousands (even if it is my insurance company paying it) for something that my general practitioner will treat for a $100 visit. Kidney stones suck...have had them a few times myself. Luckily I have gotten the symptoms early in day so I can hit my doc or urgent care for help.

So many factors, so little time.

Fuck it, Learn To Swim.

Not life threatening. Did he say you had hydronephrosis or hydroureteronephrosis? I can understand admitting you and doing the procedure the next day. I can even see waiting to see if you pass it on your own depending on where the stone is. But it sounds like they had other things going on to get to you which resulted in a longer stay. During this "observation" period, did you urinate or have any problems urinating?

that is a long story.

YOU are paying for medical care for deadbeats and illegals!......it's THAT simple!
I work in a hospital.....I see it EVERY DAY!!!
Medical Welfare.....YOU and I pay for it!!!
And with Obamacare.......it's only going to get worse!!!

No one ordering or doing the tests knows how much they cost most of the time. That isn't our job to know how much the test costs.

Have you ever asked them what kind of stones they are?  Mine are calcium based so I increased my intake of fruit juices high in citric acid.

97k? Did you get your shit pushed in for that price too?

Good God, that's outrageous.

You might consider changing your lifestyle choices that lead to your chronic kidney stones.

who's to say "lifestyle choices" are what precipitates his stones?

This. The $97,000 bill was just the opening bid in the kabuki dance the hospital does to try to recover every conceivable penny of cost they can foist onto the 3rd parity payer (insurance), to which they (insurance company) issues a hearty "fuck you, we will give you $20,000 because we know what it really cost to take care of our insured party, and it ain't that."

To which the hospital says, "Ok, $20,000 it is, and $250 co-pay from the patient".

The hospital and urologist did not get any more for keeping you an extra day than they would have for a day more or a day less. There is a diagnostic code that says what a certain procedure costs, that is what the insurance pays, and the hospital can keep you 6 hours or 6 days, and the reimbursement doesn't change. That is why they usually try to get your ass out the door; the ones that come in under budget they make money on, the ones that stay longer, they lose money on. If they kept you, they probably thought you needed it, honestly. They may have been wrong, but it was not to make more money. The urologist may have wanted to make sure he got to do the procedure, but the hospital didn't care who did it, as long as it was someone with privileges to do so at their lithotripsy center or OR (can't remember which way you went).

You're paying for the FSA OP. If they find out someone has insurance, they push the fucking charges higher and higher. They don't give a fuck what percentage you or your insurance company pay. They care about covering costs for the 1100 dickheads who went to the ER on your nickel for some bullshit reason like a stubbed toe.

Read this:

http://www.time.com/time/magazine/article/0,9171,2136864,00.html

Sounds like a raping to me


Posted Via AR15.Com Mobile

Dad spent several weeks in the hospital a few years ago. Being an engineer and having nothing to do, he tracked everything given or done to him. When he got home and got the bills, he then went over ever single line item and circled every one that was false. [padding seems to be a big thing] He then called billing and disputed the things that were NOT done. Before he even submitted the bill to his insurance company, it was about 30K lower then the original bill.

The floor nurses got a kick out of it for some reason and he sent them all a big subway lunch after he started to feel a bit better at home.

No problems urinating from day one...of course it burned like hell after the surgery....but I had no issues....the Doc never mentioned any of those conditions you listed...he just said the stone was lodged in my ureter and "might" cause a blockage that could lead to renal failure.

I had an outpatient procedure two years ago that the insurance company decided to deny as a preexisting condition. Hospital sent me a bill for $75,000 then, without me even talking to them, sent a letter two weeks later saying they would take $4,500. I wrote that check fast as hell.

No infection...I even asked why the antibiotics...they said it was precautionary and standard procedure.

Yep...same here...calcium oxalate

Seriously.

I'd like to see the line item breakdown of this 97k bill.

I don't have any solid idea either, but at least I know that you needed medical expenses above 7% of your income (I have had that) though I think the cut-off has since changed.

Blimey, even having my kidney removed in a surgery that took several hours and 4 days in hospital only cost $55,000.

You know how I know you're not a doctor.

People without insurance subsidize insurance companies by paying higher fees for like services.

Exactly.  Obamacare does nothing to address cost of healthcare (despite the name "Affordable Care Act") it only deals with widening access to care.  It will actually only make it more expensive since more non-payers accessing health care means that the precious few who actually do pay for it will just be milked even harder.

All of the hospital bills are inflated. My son spent 14 days admitted for Severe Esophigitis(sp). Final bill from Boca West Medical Center, $297,000. That does not include a single bill from the multitude of doctors and specialists that he saw.



My insurance company has told them them to "eat a dick".



I'm sure I will be dealing with this BS for years to come....





 

Why would you go to the ER?

Your not a doctor, but you play one on TV

Nail on the head

My thoughts exactly...I am no Doc...but have previous experience and this time was a first.

Because there were no clinics open at 1130 pm Saturday night to give me immediate pain meds....if you have had kidney stones before then you know what I am talking about.

wait till 2014 when it really starts kickin in

No way the hospital got 85K from UHC.




























 

Bingo! Give that man a cigar.

No, your insurance company didn't tell them that.

 

BCBS of Alabama has rejected all charges submitted by West Boca Medical Center as "not medically necessary". I'd call that telling them to "eat a dick"!



The fact that he could not eat/swallow does not matter. As far as the insurer is concerned, he could have gone home the same day he visited the ER. Infection and 104 degree temp be damned.





 

As long as his vitals were stable, pain was controlled on oral meds, kidney function was good, and he could keep the pills down, no need to keep him inpatient. Levaquin is generic, write him some pain meds, flomax, send him home.

Unless his creatinine was elevated or hypotensive (making you worry about sepsis) or something, he could have went home from the ER.

Who knows but sounds fishy.

You'd be proud:  I treated a patient with Post-Infections Acute Disseminated Encephalomyelitis as an outpatient last week.  MRI in the ER and outpatient steroids.  I probably saved the system 15K.

OP went to the ER, are you retarded?

TLDR

You are a victim of the war on drugs......

Had you been able to go to the pharmacy and buy real pain killers , none of this would have happened.....


Root cause analysis

Going to the ER for a kidney stone is perfectly logical and insurers agree.  Fast pain relief and fast diagnostics. An obstructive kidney stone is a bona fide medical emergency. Where would you go?