RANT: This HEALTHCARE BILL IS absurd

[00:00:00] OK, so I am just coming to you hot off the press here a little bit pissed off at my own medical bills

[00:00:10] and actually in reference to the medical bills for my two-year-old son. So background, because

[00:00:18] I just know that other people are dealing with these same ridiculous costs of services. The

[00:00:27] hospital just essentially billing a lot of the time, whatever they want. Sometimes things

[00:00:35] they didn't even do, which makes it very important that you monitor and follow your bills

[00:00:43] over time. And the sad reality is that you have to take time out of your day to fight these things

[00:00:50] and not to just get bounce between your insurance company and the hospital billing

[00:00:56] department back to the insurance company. Let me just tell you a little bit about what's got me so

[00:01:02] fired up right now. So back in June, my son had a lingering cough. He started to look a little

[00:01:11] bit more sick and so we ended up taking him to the outpatient office. And at his outpatient

[00:01:19] pediatrician's office, his charges for that visit were drum roll please. They were billed at

[00:01:34] 453 dollars. Now insurance covered about 284 of that, leaving a balance of about $16970.

[00:01:45] Okay, I'm not crazy about that. Hospital visits are broken down into low complexity,

[00:01:51] medium complexity, high complexity, and they were billed that way. So this is a high complexity visit

[00:01:57] which costs a little bit more than a medium, complexity visit, which costs more than a low

[00:02:03] complexity. So that's one charge right? Same day we are told to go to the ER because there's a concern

[00:02:11] that he may have a pneumonia. And so we go to the ER. Well now I have three additional bills from

[00:02:21] the ER, three separate bills, not three total services. The first bill is emergency visit

[00:02:31] physician services. The total bill is $381. The CPT code for the emergency department visit

[00:02:40] is a moderate complexity, 9-9-284. Now my insurance company paid $364 almost of this leaving

[00:02:51] $17 left. Whatever I'll pay $17 absolutely on top of the 1100 that my 1200 that my family

[00:03:00] pays in premiums every month. Okay so now also on the same date of service, red general visit or

[00:03:11] geology general visit. Build $35 in insurance covered $16. This $35 is for a radiologic exam

[00:03:21] chest to view a two-view x-ray, a very basic, basic imaging. $35 in insurance cover 16. No problem there.

[00:03:32] What are you so upset about? Well the last bill is same date of service emergency visit.

[00:03:41] A total bill of $4,900 in $19.51. Mind you we went from the outpatient office

[00:03:53] into the hospital and to the ER just the ER and were there for maybe three hours total, maybe three hours

[00:04:06] with a very very basic work up. Walked away with over $4900 build to us and insurance covers

[00:04:16] about $2600 that leaves us with a bill from this ER visit of $2300 not including the outpatient

[00:04:26] visit before we went to the ER, not including those secondary you know minimal charges associated

[00:04:33] with the same ER visit but now let me break it down to you. So the first charge is titled emergency

[00:04:41] room. It is ER level four which is indicating a moderate degree of complexity, it is the same

[00:04:51] CPT code of 99284 but now it's under a different provider, a physician assistant by the way

[00:05:02] that apparently is not covered under physician services. So this emergency room part of this $4,900

[00:05:11] plus is $1,600 using the exact same CPT code that I was charged the exact same date of visit

[00:05:22] but apparently as unique in that it covers physician services. Now my son did not see a physician

[00:05:31] the entire time that he was in the ER yet they're saying that the physicians I guess working

[00:05:39] behind the scenes that somehow between the room that we were in for three hours and these

[00:05:48] nebulis physicians hanging in the behind the curtains of the ER cost us $1,600. That CPT code

[00:05:58] of 99284 in total they're charging $2,000 for it but it gets better. There's a lot of money not

[00:06:07] covered yet. You have a several laboratory charges the laboratory charges by the hospital

[00:06:18] are about $2700 this is for a kid who has obvious congestion who we wanted to rule out whether or

[00:06:28] had an ammonia and something that needed be treated with an antibiotic. And in the ER the same things

[00:06:37] that would have costed a tenth of the price as an outpatient visit when they are done in the ER

[00:06:45] we are talking about a probe to check for a bunch of different potential respiratory pathogens this is

[00:06:53] a swab that is done in the ER. A probe is stuck up the nose to get a respiratory sample from

[00:07:02] the nasal pharynx and we are getting a charge for Chlamydia pneumonia probe $623. Now I looked

[00:07:13] up the CPT charge for that $35 okay we've got a micro plasma probe $623 again the CPT code charge

[00:07:30] associated with that $35 both of those are 20x what they would naturally be reimburse for it.

[00:07:38] So they're charging 20 times more to me individually as the guarantor for my son than what the

[00:07:45] government would pay out with government insurance for that same charge. We've got a Board of

[00:07:55] Teleprotosis PCR test $471 the CPT code charge for that is $66 and then we have an infectious

[00:08:06] agents these other parts of this respiratory panel that hard to find a charge on that but we're

[00:08:15] being build $921. Now here's the best part and it's this is where ridiculousness comes in this is where

[00:08:26] hospitals don't give a damn what they bill you they only care that you pay it and then if you come

[00:08:34] back and say hey this isn't right they may or may not listen to you on this one they damn well

[00:08:42] better listen because they charge for specimen collection venipunkter we specifically ask them

[00:08:52] to not get any blood drawn because we did not want our young son to be terrified of going into the

[00:09:00] hospital and they charge just $50 for somebody collecting blood that was never collected.

[00:09:10] Not to mention that we got charged $60 for Zofrane for an administration of Zofrane

[00:09:19] which on Danza-Tron Zofrane maybe $3 maybe but we're talking about one dispense

[00:09:31] in my personal favorite backstory on this one when I did my surgery rotations I had this

[00:09:40] wonderful little surgical rotation guideline book that was very succinct and it part of it was

[00:09:49] emphasizing that we need to take into account what our patients have to pay for things especially

[00:09:55] in terms of imaging and what kind of information is that going to get for us now an MRI is the

[00:10:01] most costly and in that book which is definitely outdated at this point don't get me wrong but in

[00:10:08] that book it made a very easy to remember cost table for different imaging MRI most expensive they said

[00:10:18] $1,500 I'd say you could very easily kind of double that for today's charges. CT scan

[00:10:27] a little bit less specific you don't see as much or as well with a CT scan

[00:10:33] $150 again we could double that $300 make up for inflation over the last 10 years or so make up for

[00:10:40] this just crazy inflation in healthcare and then you have an x-ray the recommendation is always

[00:10:48] if an x-ray can tell you what you need don't go and get an MRI don't go and get a CT because then

[00:10:55] you're costing the patient loads of money their insurance may not even cover it when you could

[00:11:01] have gotten the same information glean from an x-ray x-ray $15 we'll say $30 okay fine the chest x-ray

[00:11:13] that was done for my son in the hospital not including the separate bill for the radiology general

[00:11:22] visit in services the same CPT code build twice one for the physician services one for the physician

[00:11:30] assistant in the hospital this 71046 when it's billed by the physician services it's 35 dollars

[00:11:43] when it is billed by the hospital services 574 dollars that's about 20 times more than what

[00:11:58] x-ray should cost this shit is crazy it is already out of hand it's getting more out of hand

[00:12:09] and we are the ones who are sitting here with these bills we are the one spending hours

[00:12:17] trying to negotiate some sort of reasonable price we are the ones who are sitting outside of the

[00:12:26] with our sick kid unfortunately having to think about whether or not walking into that ER

[00:12:34] and pursuing a medical work up for our sick kid if we're going to be able to afford it

[00:12:43] that there's no place for that in a healthcare system it's immoral it's unethical it's not right

[00:12:55] this is ridiculous to get in total all encompassing what was billed on this one day for this

[00:13:09] one problem which again turned out to be somewhat mild and I mean that in terms of he was

[00:13:18] not admitted to the hospital he didn't need to be admitted to the hospital it wasn't that

[00:13:22] serious we're talking about 5500 dollars now I'm sure that some other people listening to this

[00:13:32] have better stories in that and I would love to hear them because I really do think that putting

[00:13:37] pressure on these systems from patients from the people who are being most affected by it putting

[00:13:44] pressure on our politicians to do something about this is the only way through this mess

[00:13:52] the hospital can bill whatever they want there are not regulations and people don't realize that

[00:14:00] they can bill you whatever they want to bill you and again it's over promise and under deliver

[00:14:09] this is my rant of the day on just the state of healthcare and how corporate health care is

[00:14:18] really destroying not just our healthcare system but it's destroying Americans health you can see

[00:14:28] that pretty clear in the numbers I'm talking about life expectancy I'm talking about maternal morbidity

[00:14:35] in childbirth in the US versus other first world country look at any of these major outcomes

[00:14:42] the United States is in a very piss poor position so take it take what you will from it I just wanted

[00:14:52] to get on here and have some sort of outlet and give other people an outlet for

[00:14:58] talking about health frustrating these things are I mean you just want to get a modest

[00:15:07] degree of reassurance and certainty from the healthcare system that your kids okay

[00:15:13] that your family members okay that you're okay and you know the the billing numbers are just

[00:15:24] insane they're insane how can I be charged twice for the same CPT code at the same hospital

[00:15:33] seeing one provider and then be charged twice for the same CPT code for the same x-ray

[00:15:41] one for hospital services and one for physician services if I walk into Walgreens

[00:15:49] do I have to pay for them to keep their lights on do I have to pay for their employees

[00:15:56] or is that built into the cost of the services why do I have to pay for the for the physician

[00:16:03] that's employed by the hospital why do I have to pay for the the the room 16 hundred dollars

[00:16:12] to spend three hours in room on top of all the other money that I'm paying the hospital

[00:16:20] on top of paying 20 times or more for certain services this shit's really getting out of hand

[00:16:29] so help me in doing something about it please help me in doing something about it I don't know

[00:16:35] what else to do other than spout this on the airways and try to gain traction for this channel

[00:16:42] so then I can spread these messages more to more widespread audience so that maybe we as a

[00:16:49] group can get some change made in our system operates anyway enjoy this kind of replaying

[00:16:58] of a of a previous episode and as always like subscribe thanks for listening all that good stuff

[00:17:07] yeah now let's say