Doctors WTF?
 

My son broke his foot last month playing football. We just started seeing some of the bills for this. One of them in particular was the bill for the orthopedic surgeon who DID NOT perform a surgery. This bill lists $58.75 for the office visit and $1695 for a surgery that was never done. They never invaded his skin. Not even for shot. All he did was look at his foot take an xray and put a walking boot on. WTF!!!???

And this is on top of an ER bill that was only $851. The ER did more than this doctor did and charged less.

Ridiculous!:shake:

Oh just can't wait to give them a call Monday morning and hear their explanation now. I really wish I hadn't looked this up online now because it will have me boiling all weekend. These medical professionals may be needed but these types of things should get them put in jail. It's robbery.

now I don't feel so bad for spending $2000 in Cali last week...

just feel lucky you weren't hurt. You could have been raped at the collesium and then raped again by the doctor.

I have no idea how they can expect you to pay for something they didn't do.

that sucks dude...

kids are expensive and it doesn't help when medical bills are outrageous like that...

you think it will get overturned? You know..since there was no surgery? Maybe it was just a 'lets see if he doesn't notice' kind of thing?

That wouldn't surprise me, most people probably wouldn't think twice about something like that if their insurance is paying for it. The whole system is borderline criminal.

I know exactly what you mean. I went to a specialist for a shoulder issue last month. They gave me a shot of some sort of steroid and some cortisone.
I saw the bill, 2 shots came to 3,000 bucks. Thank god for insurance man. What a rip off. They actually called it a surgical procedure. The kicker is my shoulder is no better whatsoever.
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it's such a terrible thing man. I really hate how they charge out the ass, I think their logic is if it costs them a dime, then they will charge $100. That seems to be what it is. But it's a pretty evil business they got going there, I think they are in collusion with the pharmecutical companies, the health insurance companies and the companies that make the equipment, all working together to keep prices sky high and forcing honest people into bankrupcy all just so that they can all stay filthy rich.

I'm assuming it is a coding error of some sort but my insurance wouldn't have listed it as a surgery on the EOB if it wasn't billed that way. Either way, this doctor submitted a $1700 bill for taking an xray, looking at his foot and putting a walking boot on that was secured with ****ing velcro.

The ER bill was half that amount and they took xrays as well as put a temporary cast on it. They did more work than this doctor did.:#:cuss:

I thought Obama was paying for this stuff?

So how much was the x-ray that they performed?

$160

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As Rand Paul said it was a completely legitimate bill for those procedures.

we are ****ed either way

Nope.

The reason for outrageous ER visits and doctor care in general is primarily due to two things: The uninsured and malpractice insurance.

Our society has become so litigious that if you have a malpractice insurance in Haiti but treat someone in Peru, your malpractice insurance will cover you in the event of being sued.

But the United States is the only country in the world that does not recognize malpractice insurance from any other sovereign nation. If you practice medicine in any capacity in America, you must have American malpractice insurance.

Furthermore, the reason why an Advil is $200 dollars (or whatever) in an ER is to cover the cost of all of the uninsured people. Doctors have to treat patients by law, regardless of insurance coverage (or the lack thereof). Because millions are uninsured and will never pay for their ER visits (and more), the burden is pushed to the insured.

It's a ****ed up system and most people hardly know how it works.

It was a fuggin broken metatarsal that required no resetting and no surgery. $1700 is asinine. I don't give a shit about malpractice and uninsured issues. When a doctor bill is twice as much as the ER bill and the ER did all the treatment something is very, very wrong with the system.

I'm insured and feel completely ****ed over by the system.

Yeah Dude, it's all ****ed.

I had the same thing happen to me when I broke both my elbows. (bike accident) If you have an orthopedic surgeon look at the injury they will charge it on the bill like it was a surgery. All he did was look at the ****ing x-rays from the E.R. It is ****ing ridiculous the system is beyond broken.

:eek: JFC It may be futile but I'll be a thorn in their side for as long as I can and when I start to pay they will get $10 per month.

Dude, this is why there needs to be serious health care reform in this country.

No offense to you whatsoever, but most Americans that have insurance don't think there's a problem with the system until they actually need to use their insurance for a surgery or unfortunately, an ER visit.

Just think about the 30 million plus that are uninsured.

Could it be a mistake? I know DR's are outrageous but why would they list surgery when they didn't do it? Call them up be nice....if they don't fix it have your lawyer right them a nice ltter explaining that your not paying for a surgery that they didn't perform.....if all else fails key that dicks car!

Nobody is debating the fact that the insurance system is part of the problem. The fact that tons of people use the ER like it is a ****ing clinic is beyond ridiculous. Thats not the point for me though. I expected the $850 ER bill. I didn't expect a $1700 doctor bill for an office visit that took place 5 days AFTER the ER visit and the doctor didn't do shit other than literally look at a foot.

The way the system is now, the uninsured seem to get off easier than the insured do. They just don't pay the bill. I don't mean it to sound like I consider all uninsured people deadbeats because I know a good majority of them do their best to pay their debts but there are plenty that abuse the system too.

Either way, the doctors shouldn't get paid for doing nothing.

Keep in mind, I'm actually getting insurance help paying for this and I'm still pissed off because these bills are too damned high. My insurance shouldn't have to pay these ridiculous inflated fees anymore than the uninsured person should.

I don't think its an error.....I had my thumb shattered playing football, and went to an ortho, all I got was an xray and a cast and my bill was over 2k.

casts are not covered by insurance, at least not mine and I have good insurance being a diabetic.

Just watch, the insurance payout will be much less than 1700 bucks.

The face price of bills are much higher than what insurance actually pays. Your co pay will probably be relatively small.

The nominal price of a bill is really a fictional number. They just have it high so that when you have an uninsured patient that can actually pay, it makes up for all the uninsured who never pay.

That's why you're totally screwed if you don't have insurance. That also explains why so many personal bankrupcies are medically driven.

When your insurance pays, you will usually get a notice that shows what they actually paid the doctor's office.

But those people never pay anyways, their the ones reaping the rewards for nothing.

I'm hoping for a nice surprise when insurance gets done with the bill but expecting the worst. The $875 ER bill dropped down to $181 after insurance but it is not subject to my policy deductible. This doctors bill is going to be much more painful with a $500 deductible.

Challenge that charge. It won't stand. And for good measure challenge any other charge that you feel you weren't fully aware of through the process. It's done because the can get away with it. You challenge it, they back off.

Just watch a few eposides of the Venture Brothers
cloning equipment in the basement

very insightful

Kill the doctor.

Your and idiot.
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Na, just hurt him real bad. He will then get raped by a doctor similar to himself.


Poetic Justice.

Dane and Deberg are correct in so many ways. I work in the healthcare field and that is exactly what happens. Joe taxpayer picks up the bill for all the uninsured or illegals that do not pay their bills at the hospital. That is why everything is so damn expensive.
Since you have insurance (and most of the working Americans do) partially your insurance and then your out of pocket pays for their services. The system has so many issues. Reform needs to be done on so many levels, but I am not a fan at all of this OBamacare. A lot of these people are getting their medical services already for free, thus someone ends up screwed paying the bill.

Gotta spread that wealth around.

ObamaCare essentially make the working man who has insurance pay twice for the uninsured broke-dick's - once for his premium and again when he stiffs the system after being cared for. Used to be just for his care, now it's for a premium too.

Health care in the US is in perfect condition. You will do well to remember that if you wander into DC

Not sure what to say, but donkey punching the Doctor might make you feel better for a while.. Then, when he wakes up, show him a video of you with his wife PIIHB. Not sure about you, but that always helps to make me feel better...

ya, I admit that I don't know all that much about how it works. All I know is that it's pretty messed up what they do to honest people. I'm insured and I haven't had anything major but if I do, I imagine I'll go bankrupt.

It really does work both ways, though. My Dad's a doctor and an honest one. Dane's right that two of the major drains on the health care system are malpractice insurance and illegals getting "free" care. That and a health insurance system that I feel like is bordering on fraud. My Dad has gotten checks for pennies on the dollar. Literally. Because insurance payments are so inconsistent, it's really hard to set prices.

I mean, not to say that there aren't crooked doctors out there. But I think it's unfair to badmouth doctors when it's really the ****ed up system that is driving most of the problems in the industry. And yes, I think Obamacare is a ridiculously stupid way to "fix" the system.

This, this, this.


I have said this from the day they started the health care reform bs. They reform insurance (I will leave that alone) but the problem is at the expense end of things. The problem is not people without insurance, it is with (using the example above) paying $160 for an x-ray. This is 100 year old technology, can anyone give me a good reason why it should cost this much for a simple and common procedure? In all truth, insurance is part of the problem because people usually do not see how horrible inflated the prices are since they do not pay them directly.

Reform medical care and pricing if you want to actually see a difference.

It's flawed but the next stage is ****ing disastrous.


You'll bend to their sodomy either way. In fines (and get nothing in return) or belch up much higher premiums and receive less coverage...

I would say that insurance is most of the problem, not just part of the problem.

Now, on the costs, I think there's something to be said for us paying for the costs of having the best medical technology in the world, bar none. X-rays are 100-year old technologies, but they are significantly more effective than they were 100 years ago and that's because companies are constantly investing in newer and better technologies. That innovation cost is reflected in the price. The question is, do we want lower prices at the expense of medical advances? (that's the same exact question I ask about pharma too--we can get cheaper pills too, but it will likely come at the expense of breakthrough pills coming to market).

The part I'd rather see controlled is the inefficiencies. I wish Obamacare would focus a lot more on this.

Send this shit here:

http://www.lonelyplanet.com/maps/nor...hington-dc.jpg

By law, the physicians office has to accept what insurance will pay, if they are part of that insurance system.

You aren't likely to end up paying $500 dollars over what insurance allows the doctor.

To take a personal example, I had a heart echocardiogram. The face price of the bill was around 1K. Insurance paid the doctor $256 and patient responsibiliy ended up being $78.

One of the major problems of medical care today is doctors and hospitals usually don't know the patient's financial responsibility when the doctor actually performs the service. Consequently, expensive health care issues can wipe out a patient and they don't know what exactly is coming until AFTER they've received service. Treatment planning that accounts for the patients ability to pay (and the sum total of patient responsibility for each service) might lead to better financial outcomes. (Fewer medically driven bankrupcies).

Interpreting the x ray is where the difficulty lies, and that requires skill.

This. My dad was a doctor in KC before retirement.

Just before he retired, medicare reduced his payment for seeing one of his nursing home patients to something like 19 or 22 bucks.

Right around that time, we took our cat to the vet. The vet charged 39 bucks to see the cat. Basically, medicare allowed a doctor to charge half of what it costs to treat a cat for my dad to check on one of his nursing home patients.

Btw, i work in marketing for a health care IT company. Our system predicts insurance payments to the doctor and costs to the patient with more than 90% certainty, and the doctor gets that information at point of service (when the doctor is actually seeing the patient).

I'd like to see an elimination of health insurance in it's current form altogether. I believe that if people actually paid for services rendered we'd see natural market forces drive down costs and improve performance. I think the government should have a role in mandating health savings plans and having a universal disaster plan to pay for things beyond a certain cost.

Our current system is like going to the grocery store, having the grocer send an invoice to a 3rd party who will determine what to pay for and how much, then sending you a notice of their ruling, then the grocer sends you a bill for your portion. Of course that's going to be massively inefficient and services won't be charged anything logical. Since grapefruit juice isn't covered or only pays $.60, the grocer is going to bill $500 for coffee to make up for it. It's all a shell game with massive bureaucracies and crazy profits for them.

Trust me... challenging the charge wont help and you will just waste a shit load of time getting the run around on the phone. I raised hell when I first got my bill and tried to fight it. Eventually found out that this is the standard charge if you consulted an orthopedic surgeon. Doesn't matter if they just looked at the x-rays. They charge it like it was a surgery.

Oh, it will get there as soon as one of the DC loons show up. It's kind of nice to be able to discuss these issues with sane people once in a while though.

Its not the doctor's fault. Its because of the "DRG" (diagnostic related group) and its how insurance and medicare determines what treatments and the compensation is allowed for a patient with a given complaint.

Sometimes, treatments can "cross over" between different DRG's, and sometimes similar treatments and diagnoses will pay out at higher rates (or lower rates) just because the patient comes in under a different DRG.

This reality creates one of the biggest health care fraud issues, because billers will want to claim the patient complaint fits the higher paying DRG schedule. This practice is known as "upcoding", and it alone accounts for hundreds of millions in FCA (fraud claims act) awards and settlements in a year.

Over the last decade, federal prosecutors and private qui tam cases return an average of 1.1 billion per year to CMS (Centers for Medicare and Medicaid Services) from health care fraud and abuse cases.

However, ABA studies on this issue have shown there's a positive correlation between the amount of fraud claims won by the government and new regulation passed by legislatures (both federal and state). That fact suggests that a certain portion of fraud claims are more about regulatory complexity than any ill intent. In fact, changing regulations can, in effect, act as a tax against health care providers simply due to mistakes made while adjusting to new regulations.

The solution here is obvious.

Claim the doctor slapped your child and draft a 40-page complaint asking for free trips to disneyland. Tell him to kiss YOUR ENTIRE white ass.

Did the doctor file the claim with your insurance? If he did contact him and remind him that he did no surgery and also remind him that the state insurance commissioner might be interested to hear that he may have committed fraud.

I suggest contacting the state insurance commissioners office first and getting the straight story of what can be done so you are armed with facts not just the ramblings of someone on a bulletin board.

Who knows, maybe you'll come out of that with a bag of pot too, then you'll get lifetime protection from the police because you're protected by "pot"... heck you won't even have to listen to what a cop says, you can just walk away..

Need transparent pricing.

You need to search the hospital billing websites. I am sure there are some and see how they deal with it.

Maybe a legal option.

This better not get moved to DC. People need to stop bringing up Obamacare and all the other DC bullshit. If I only wanted DC opinions I would have posted this over there. I wanted everyones thoughts here.

MODS, I know that some people can't avoid trying to make every issue a political one but please don't move this thread into that cesspool.

I used to work in insurance so I am well aware of what my part will be. I not only have deductible but I also have to deal with coinsurance AND whatever is deemed not covered by insurance. The only thing I know for certain right now is that it will start at $500 and go up from there. My gut tells me the walking boot won't be covered which I am certain probably carries another $250. The fact that insurances to pay for casts and boots is just another bullshit thing that is beyond rediculous.

I don't have health insurance and won't until I start my law enforcement career next year. I am currently paying a medical bill from last year. I dont care how nice it'd be to stop paying it, I won't stop till it's finished. I don't need that on my credit. It sucks that people don't pay them and make the uninsured pick up the bill.

Hopefully, the uninsured like you completely outweigh the uninsured that don't pay their bills.

agreed ... deberg is teh moran

I don't think we will be letting him play football anymore though. He barely got any playing time this year and when he finally did, this happens. Gonna screw up christmas pretty good for everyone.

Even if we do outweigh them, I doubt they'd fix that uninsured issue.

Doesn't the prgram offer some insurance? If not, you might want to ask.. I have a son who's done Football, baseball, and wrestling, and all without an ACL in his right knee. Heck, he's a scout to boot... We're very lucky that we have insurance, but we've always had policies offered through the programs too. I know it's a tough decision, but I'd hate to ever have to pull the plug on any kid's opportunity to play sports. If there's nothing offered, then you don't have a lot of choice, but at least ask if you can.

but, but, we have the best health care in da vurld!

Had same thing last year w/my son. Broken finger and they wanted to send us to 3 different specialists - all w/their hands out. Don't even get me started on our health care system. Friggin ridiculous.

No extra medical programs at his school. You are on your own. He also does swimming, tennis and track. It's not like he doesn't have other things to do.

These are the prices you get when you surrender your country to a "nanny state" and now the insurance cos. doctors and hospitals must make up for all "deadbeat Marxists and illegals that expect something for nothing and this will only get worse:thumb:

Benjamin Franklin had it right when he said that "when a society allows the poor to be comfortable being poor then you will lose your country soon thereafter. Paraphrase of course.;)

Benjamin Franklin was a queer

Yeeeeeeeeeeeeeeeeah riiiiiiiiiiiiiiiiiiiiiiiiiiiight so much so they lost count on how many illegimate kids he fathered. Sad to say but his sexual extracuricular activities were far from honorable unlike his commitment to freedom and liberty unless of course you say he took freedom and liberty to a new level sexually?:)

DC loon count: 1

Come on guys. Lets keep it on topic.

If mememe slithers out here, it's on you.

You started it!!:)

My colleagues and I just published a study on the wide variation in compensation among various physician specialties. The orthopedic surgeons are among the most lucratively paid, while primary care doctors and many other specialists make quite a bit less on average.

Here's a link with more details on our article:
http://www.ucdmc.ucdavis.edu/welcome...ician_pay.html

Part of the differences in pay have to do with decisions made by a little-known group that advises Medicare on how much they should pay for various procedures and services. An interesting story on that group can be found here:
http://www.publicintegrity.org/articles/entry/2571/

I can understand a specialist getting more pay than a family practice physician but $1700 for 10 minutes of time? We have been to two followups with this specialist and each one of them was exactly like the first visit and the cost was only $150 each. How do you go from $1700 to $150 and do the same thing in both visits?

I had an X-ray the other day. Paid $100 and will get $68 back through my insurance...

Sounds about right for an xray.