Archive for the 'Pregnancy Cost' Category

Don’t be so quick to write that check

So, here’s an interesting lessen: Don’t pay your hospital bills quickly.

I got a call the other day from the hospital. They offered me a 25% discount on my bill if I paid by the due date (which was in a couple weeks).  Of course I said yes.

The baby’s hospital bill really is: $678.62.

Still, this medical billing remains an exercise in silliness.  No wonder why doctors and hospitals complain so much about billing.  They keep doing silly things to themselves.

The Mother’s Hospital Bill – Caesarian Section

For fun, and before my insurance reduction, here’s the bill for my wife’s caesarian section delivery:

 

  CPT   Rack Greedy Net
  Code   Rate Markup Cost
OB/2 Beds     $3,507.00    
Pharmacy     $2,018.00    
Med/Sur Supplies     $296.00    
Non/Ster Supply     $67.00    
Sterile Supply           220.00    
Laboratory             19.00    
Lab/Immunology           326.00    
Lab/Hematology           186.00    
Anesthesia           329.00    
Drugs/Detail Code           500.75    
Recovery Room         1,766.00    
Labor         1,265.00    
Delivery Room        2,737.00    
      $13,236.75       TBD     TBD

The Baby’s Hospital Bill

As you will see, my insurance company negotiated a bulk 67% discount on the “rack rate” bill from my hospital. The final level of detail was not itemized.

Again, this is only for the baby. My wife’s care is in another bill.

(In case I don’t get back to posting for a while, the “rack rate” on my wife’s bill is only $13,236.75.  And this doesn’t include any doctor’s fees, lab work, etc.)

This a summary level bill. I’ll request an itemized bill in bit (hey, I’m paying for it).

  CPT   Rack Greedy Net
  Code   Rate Markup Cost
Nursery Level 1     $1,938.00    
Pharmacy           75.00    
Laboratory           19.00    
Lab/Chemistry          147.00    
Lab/Immunology          122.00    
Blood/Stor-Proc           74.00    
Audiology          125.00    
Drugs/Detail Code          119.50    
Circumcision          139.00    
        2,758.50   1,853.67     904.83

We had the baby via C-Section

Everyone is fine and doing well. But it’s time to pay the piper. The costs for us are broken out in 2 parts:

1) The Baby

2) The Mother

Because of some exclusions on our insurance policy (more on that later), we have resolved the baby’s portion of the hospital stay. Yes, he is weeks old and already receiving bills. Our cost will be detailed in the following posts.

More Office Visits

Here’s the details:

  CPT   Rack Greedy Net
  Code   Rate Markup Cost
OB Office Visits #7         160.00      90.00      70.00
OB Office Visits #8         160.00      90.00      70.00
OB Office Visits #9         160.00      90.00      70.00
OB Office Visits #10         160.00      90.00      70.00
OB Office Visits #11         160.00      90.00      70.00
          800.00     450.00     350.00

Office Visits 5 & 6; Glucose Tolerance Testing

Through the 28th week or so of the pregnancy; the visits are every two weeks. Here’s the latest bills. Also, we negotiated our rate with the physician doing the c-section. That will be a separate post.

  CPT   Rack Greedy Net
  Code   Rate Markup Cost
OB Office Visits #5     160.00 90.00 70.00
OB Office Visits #6     160.00 90.00 70.00
Glucose Tolerance 1hr tbd   63.45 53.45 10.00
Glucose Tolerance 3hr tbd   114.70 91.70 23.00
      498.15 325.15 173.00

Pregnancy Visit 4

No lab tests this time. And no lab work is planned for the 5th visit. But the dreaded glucose tolerance test is due at the 6th visit.

Here’s the cost:

  CPT   Rack Greedy Net
  Code   Rate Markup Cost
OB Office Visits     160.00 90.00 70.00

Ultrasound Cost

We received the insurance EOB for the 20-week ultrasound; the details are below.

A few thoughts:

1) The cost to us of $926 for a 45 minute procedure? I could hire the best attorney in the state at a lesser hourly rate. (btw: attorneys have overhead, staff, insurance too)

2) Many in the medical field bemoan the cost of insurance; for example, some would say that a major part of the $926 is insurance. Here’s an idea: allocate insurance to the procedure. Then you would have pricing transparency; you could see how much was insurance and how much went to the medical office. It would allow a better judgement of what is a reasonable price and would allow us consumers to shop doctors based on insurance rates (with the assumption that lower insurance = better a physician).

3) A $2,045 price for the uninsured? Thats not very nice. From the looks of this office, they weren’t doing too many medicare patients.

4) Lots of employees were just hanging around this office chatting. Didn’t appear too productive. Being unproductive = higher cost for the customer.

Here’s the data. I’ll add more detail when I get the real bill.

  CPT   Rack Greedy Net
  Code   Rate Markup Cost
X-Ray Services tbd   550 313 237
X-Ray Services tbd   395 264 131
X-Ray Services tbd   350 227 123
X-Ray Services tbd   350 165 185
Diag. Medical Exam tbd   300 150 150
Consultation tbd   100 - 100
      2,045 1,119 926

Pregnancy Costs – Current Score

I’ll update the current score as we have more visits.

Through the first innings, er, 3 doctor visits:

  CPT   Rack Greedy Net
  Code   Rate Markup Cost
OB Office Visits         640.00     358.00     282.00
Laboratory Services      1,349.96     590.96     759.00
       1,989.96     948.96  1,041.00

Pregnancy Visit 3 – Data and Commentary

The 3rd office visit featured a lower bill from the physician. Or course, I don’t know why.

More tests were taken (and they proved to be of value, as they found something that was quickly treatable). The net cost of the 4 tests was only $28, but if we didn’t have insurance, we would have been on the hook for $128. A very greedy markup of over 400%. Nice.

  CPT   Rack Greedy Net
  Code   Rate Markup Cost
Office Visit     160.00 90.00 70.00
           
cult, pres id ea isol uri 87088   22.73 13.73 9.00
cult, bacterial (ur) 87086   42.00 33.00 9.00
UA, complete automated 81001   40.50 36.50 4.00
cult typing, serol 87147   22.73 16.73 6.00
      287.96 189.96 98.00

Pregnancy Visit 2 – Data and Commentary

Here’s the data for the 2nd office visit. No lab tests were done, apparently.

  CPT   Rack Greedy Net
  Code   Rate Markup Cost
Office Visit     240.00 134.00 106.00

Yeah, no posts in a while…

But Quest hasn’t billed me in detail lately, so I don’t have any significant cost data yet.

Pregnancy Visit I – Data

Enough talk. Here’s the data.

  CPT   Rack Greedy Net
  Code   Rate Markup Cost
Office Visit     240.00 134.00 106.00
           
Cyto Auto Thin Layer Prep 88142   69.50 44.50 25.00
HPV, AMP Probe 87621   105.00 66.00 39.00
Laboratory Services 83891   3.33 - 3.33
Laboratory Services 83909   15.11 - 15.11
Laboratory Services 83914   347.53 - 347.53
Laboratory Services 83900   30.17 - 30.17
Laboratory Services 83901   196.43 - 196.43
Laboratory Services 83912   2.43 - 2.43
Laboratory Services 81001   40.50 36.50 4.00
Laboratory Services 36415   16.70 11.70 5.00
Laboratory Services 86592   83.00 68.00 15.00
Laboratory Services     312.30 264.30 48.00
(grouped above) 87340   - - -
(grouped above) 86850   - - -
(grouped above) 86762   - - -
(grouped above) 85025   - - -
(grouped above) 86900   - - -
(grouped above) 86901   - - -
(grouped above) 86592   - - -
      1,462.00 625.00 837.00


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