A Helping Profession
My client was having a miscarrieage; she is uninsured. In the emergency room she was given epidural medication, then left alone for four hours. She miscarried by herself, in an observation room off the ER; the nurses checking every so often.
She was then taken up to obstetrics (cruel in and of itself), cleaned up, and placed in a bed.
Her bill is almost $10,000.
Now let's look at the problems on this bill. The anesthesiologist gave her an epidural and is billing her for 6 hours of monitoring. So I ordered the anesthesiology record and it is practically blank. After he anesthetized her, he simply left. His charge is over $1000.
The hospital is billing her for a delivery room she didn't use, and hundreds of dollars worth of non-sterile and sterile supplies that CMS says are not separately billable. The Cefotan she was given comes in boxes of ten for $120. My client was charged $78 per container.
What proceedures did the doctor perform? Aside from the initial evaluation and management, he apparently performed none. The E/M is coded as high as possible: as high as being hit by a bus, as high as a gunshot. At least he didn't charge extra because it happened after supper time.
She was charged $38 for 8 squares of gauze. She was charged for three trays of supplies, none of which is legally billable.
She was given an ultrasound that showed, yes, she was indeed having a first trimester miscarriage, something she disclosed in the history.
The only really legitimate charge is, sadly, the pathologist when it was all over.
What shall I do with this? In addition to being overpriced, the way this woman was treated is profoundly disturbing.
I'll admit that I don't have every piece of information - maybe the ER was particularly busy and no one could stay with her. Little doubt the staffing ratio is less than optimal for the physical care of patients, much less their psyches.
Providers are also being less than forthcoming with the records I need. It is difficult to even obtain an itemized bill much less anything with codes on it that will tell me precisely what happened to this woman, which doesn't play well with an advocate for the uninsured.
I shall be challenging this bill to try and bring it down by 75%. The only Doc at all sypathetic is the pathologist who dropped his fee when he heard she was uninsured. His bill I'll leave alone. Maybe.
Lin
Crossposted at http://www.signalhealth.com/node/505
She was then taken up to obstetrics (cruel in and of itself), cleaned up, and placed in a bed.
Her bill is almost $10,000.
Now let's look at the problems on this bill. The anesthesiologist gave her an epidural and is billing her for 6 hours of monitoring. So I ordered the anesthesiology record and it is practically blank. After he anesthetized her, he simply left. His charge is over $1000.
The hospital is billing her for a delivery room she didn't use, and hundreds of dollars worth of non-sterile and sterile supplies that CMS says are not separately billable. The Cefotan she was given comes in boxes of ten for $120. My client was charged $78 per container.
What proceedures did the doctor perform? Aside from the initial evaluation and management, he apparently performed none. The E/M is coded as high as possible: as high as being hit by a bus, as high as a gunshot. At least he didn't charge extra because it happened after supper time.
She was charged $38 for 8 squares of gauze. She was charged for three trays of supplies, none of which is legally billable.
She was given an ultrasound that showed, yes, she was indeed having a first trimester miscarriage, something she disclosed in the history.
The only really legitimate charge is, sadly, the pathologist when it was all over.
What shall I do with this? In addition to being overpriced, the way this woman was treated is profoundly disturbing.
I'll admit that I don't have every piece of information - maybe the ER was particularly busy and no one could stay with her. Little doubt the staffing ratio is less than optimal for the physical care of patients, much less their psyches.
Providers are also being less than forthcoming with the records I need. It is difficult to even obtain an itemized bill much less anything with codes on it that will tell me precisely what happened to this woman, which doesn't play well with an advocate for the uninsured.
I shall be challenging this bill to try and bring it down by 75%. The only Doc at all sypathetic is the pathologist who dropped his fee when he heard she was uninsured. His bill I'll leave alone. Maybe.
Lin
Crossposted at http://www.signalhealth.com/node/505
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