What does a big surgery like this cost?

[rich1752]

I am double covered with insurance. I have insurance and my wife does. They constantly fight each other on who is going to pay the bill. My bill so far is about 600K. I did stay at Cedar Sinai, which is an expensive hospital. My surgery took 12 hours and had both anterior and posterior. I stayed in hospital for a week. So far nothing out of pocket, but can't imagine not having insurance.

rich

[loves to skate]

Hi Evelyn,
I had a Medicare Advantage PPO Plan and I went out of network. I paid $750.00 for the hospital bill, nothing for the rehab hospital and about $1,500.00 for the Dr. bill. Being on Medicare, you should only have to pay 10 or 20% of the Medicare allowable amount which is way lower than the actual bill. My insurance paid my Doctor about $14,000.00 of his bill for $55,000.00. He didn't have a contract with my insurance company at the time. I have no clue how much the hospital bill was. Every insurance policy is different, so you really need to check with your insurance company what your share will be.
Sally

[jrnyc]

if i do this, i will want to know which doctors will be in that OR besides my surgeon..who will be assisting, who will be "monitoring" my spinal cord, etc..because those are the "surprise" bills afterwards!

jess

[Vali]

My surgery here 'downunder' cost almost $70,000. Medicare and my private health took care of everything. My out of pockets amounted to about $450.00.

[Shari]

Back out, Thank you for the belly laugh from your comment about the organ holder. It's so weird how there are certain things that crack me up when I look back on them. I have quite a few!!!

Thanks,
Shari

[Back-out]

I have been thinking a lot about this organ holder business, actually, It holds a morbid fascination for me as a perfect example of the imponderables of life and this experience.

I'm asking myself, "how does one train to be an 'organ holder' and just what is his job title? It can't help sounding either a little risque or musical.

(Cocktail party scene, Suave, laid back gent holding his martini across his manly chest being asked, "and what do YOU do, for a living?"

"Heh, I'm an ORGAN HOLDER!" Jaws drop, but admiration reigns, After all to anyone who knows, this is a dude who rakes in [$44,000 "/. 10 = 4,400/HR!! ) Good God, he might as well be on wall street! That's tidy sum.

Does one ever wonder if it was an organized scam of some kind? Especially his billing you right away in Collection after one year, with no prior billing. Come-ON! That's a racket...

(Did he do anything with them while he was holding them? Was he just holding them to the right or left as needed? Sheesh! )

[leahdragonfly]

Back-out

The "organ-holders' you mention are either general surgeons or vascular surgeons. Do not begrudge them, they are there to save you from bleeding to death if your surgeon accidentally injures a major blood vessel. They are also there to make sure your internal organs don't get injured. So although you have imagined a ridiculous name for them, they are actually quite important!

[Back-out]

I never thought they weren't necessary. I only begrudge the ones who accept a job (maybe it's the hospital's fault), for an unconscious patient whose insurance they don't accept. That's a huge bill to come at a patient - and a full year after the surgery too, with apparently no prior billing!

Shari's story has scared a number of us - and rightly so. I am thinking of working with a paid patient advocate to get something signed by the facility so there's no chance of a physician being called in who's not a preferred provider for my insurance! Most of all when I'm deep under and in no position to object. The humor was a way of dealing with the anxiety.

I also think patients need protection against this practice whatever the specialty. The hospital and primary surgeon are certainly sure to get guarantor signatures from the patient in advance, and the patient can afford such an unexpected loss far less than either one!

[Shari]

Amanda, You are too funny!!! I just hope while he was handling my organs, he used both hands, and a mask. He never intended to scare anyone. If you have the anterior part of the surgery, they have to be moved off too the side somewhere. However, I still wonder if he put everything back in the same place.

Shari

[mbeckoff]

I received the bill for the operation from the hospital and the 7 nights that I was in the medical center part of the facility. I have not received the bill for the rehab as of yet. The bill was $289,806.77. BCBS has picked up all of it except for $480.93. I was in Intensive Care 2 nights, a step down room 2 nights and then a private room 3 nights before moving over to the rehab.

I still have not received my surgeon's bill nor the kidney specialist that they had to call in for me.


For once, BCBS actually is paying something.Usually our policy does not pay for much of anything


Melissa

[jrnyc]

i am surprised at that comment about BCBS...Dr Anand in CA took BCBS and didnt take my Aetna HMO...maybe you have a BCBS tht is like an HMO...? i know some doctors wont take an HMO type policy, when they will take the same company with a PPO policy...pays much more....and also costs patient much more!
hope you are feeling better every day, Melissa..

jess

[mbeckoff]

no this is a PPO but my husbands company is very cheap. That is why I was very pleasantly surprised.

I had been feeling better until Thursday when it all went downhill and I am in terrible pain and cannot get any relief

Melissa

[ShariMSU]

My surgeons office and the hospital worked as a team and gained all prior approvals that would be needed for every step of the procedure and stay.
This was such a nice thing so that I did not have to worry and they took responsibility for it. I called to see if i should do anything and they said we have taken care of all approvals. My guess was it was more for their benefit, this way they did not do surgery or have hospital stay that they wouldn't get paid for. But of course it was explained as a service to me. Ok with me. Everything was covered 100%. I did have a $79.00 bill to hospital as we requested a single room and that was my portion even though room was $200 a night. Having great insurance was one reason I opted now for surgery, along with all the medical reasons.

[jrnyc]

hey melissa
i am so sorry to hear that you are in such pain...have you spoken to your surgeon? weekends are always bad in terms of reaching any doctor! i hope you at least get to talk to his office...and to him directly by Monday...maybe they can change the pain meds or something...? it does seem that most on forum write about recovery being alot of ups and downs, especially in the beginning......but i think you should talk to them about this...

hope you get some relief!

jess

[mbeckoff]

I called on Thursday and his nurse said that she would talk to him Friday because he was in surgery all day Thursday . Friday I spent most of the day sleeping. They did not call yesterday which is very surprising as they always call back. I will call on Monday

It is definitely up and down recovery

Melissa