Kidney Stone Follow-up

The after-effects of my kidney stone issue last month in California are kicking in. That is, the bills have started arriving.

The billings are in three different tranches so far:

1. the ambulance charges;
   
2. the CT scan;
   
3. general hospitalization.

The ambulance ride from my hotel to the hospital totaled $2,040.30. Of that, the $1,361.64 was for the emergency response, with a supplemental charge of $35.10 per mile for eight miles. The balance was composed of medical supplies, oxygen, monitoring and test preparation. The good news is that my insurance covered $1,821.81 so I'm on the hook for only $218.59.

The CT scan by the hospital's imaging associates charged $496 in total, $261 for the abdomen scan and $235 for the pelvic scan. These must have been done at the same time: until the bill arrived, I had no idea there were separate scans. My insurance had a negotiated discount of $323.96 then paid $154.84; I'm paying $17.20.

I haven't received a bill from the hospital itself yet, although I do have my insurance company's explanation of benefits statement. According to the EOB, my visit apart from the above charges totaled $10,145.10. This includes $3,390.69 and $3,272.11 for the CT scans, $2,500 for just stepping foot in the ER, about $200 in lab fees and the balance in miscellaneous drugs charges. There's also a $228.61 charge for "therapeutic services," whatever the hell that is. Good news: my insurance had negotiated discounts of $2,536.28 and paid $6,757.94. Bad news: I'm on the hook (theoretically) for $850.88. That bill has yet to arrive.

There is a separate EOB I viewed online for ER services from the same hospital on the same date. I'm not sure why it's being processed separately but I'm (theoretically) on the hook for that one too, to the tune of $233. I haven't received a snail-mail EOB or a bill for that one yet either.

Total Billings: $13,326.40
Insurance discounts & coverage: $12,006.73
My out-of-pocket expenses: $ 1,319.67

Thoughts:

1. All of this was for a one-time unforeseen non-chronic non-surgical health issue. I couldn't imagine what these people would be charging for something requiring surgery, an overnight stay, specialists, a huge battery of tests & scans, reconstruction, physiotherapy, etc..
   
2. Thank god I'm a white collar worker in an industry which traditionally offers good health insurance benefits.
   
3. Thank god my good insurance got me into a better hospital for faster treatment than if I had to wait in the queue with the unfortunate uninsured. Yup, not at all politically correct and I do feel for those without insurance but at the time I was in extreme pain. I'd prefer everyone could get care as good & fast as I did but all I can do at the moment is take some consolation that my absence at other hospitals meant someone else was a bit higher in the queue.
   
4. Thank god I have a high enough disposable income that I can afford even the comparatively small balance of $1,319.67.
   
5. I can easily understand how a single nasty incident could force a family or a young person who thought they were in perfect health and therefore could skip monthly insurance premiums into sudden bankruptcy.
   
6. This is my fourth bout with kidney stones although the first in 15 years and thus the first time I had ever been a patient in a US hospital. The hospital services were very good, fast, comfortable and professional. I have been a patient in a hospital in Northern Ontario and two in Toronto: all have been on par. The US hospital was no better or worse than any other I've had the misfortune to require.
   
7. While I did summon the ambulance with the intent of going to an ER, at no point was I asked if I wanted particular service or medications. I was told I was being wheeled to a CT scan as the wheels of my gurney were being unblocked; I had no idea there were two scans. I was informed about the medications as the IVs were being connected. My lungs & breathing were unimpaired: the oxygen feed was quite unnecessary. And naturally, no one talked about prices for any of this: I could have saved my insurance company and my own wallet some dollars here and there if I had known the relative expenses for each step. I was in pain but my mental faculties were unimpaired and I could still make rational decisions. Next time, I'll take a taxi or call a friend. I'll forgo anti-nausea meds and take just the painkillers.

I'll spare you my views on the proposed health reforms (decades overdue), the necessity of covering the uninsured (seriously in favour) and how I would swap the entire US nuclear arsenal & military hegemony for Canadian-style or French-style health care in a heartbeat.

Kidney Stone Follow-up

The after-effects of my kidney stone issue last month in California are kicking in. That is, the bills have started arriving.

The billings are in three different tranches so far:

1. the ambulance charges;
   
2. the CT scan;
   
3. general hospitalization.

The ambulance ride from my hotel to the hospital totaled $2,040.30. Of that, the $1,361.64 was for the emergency response, with a supplemental charge of $35.10 per mile for eight miles. The balance was composed of medical supplies, oxygen, monitoring and test preparation. The good news is that my insurance covered $1,821.81 so I'm on the hook for only $218.59.

The CT scan by the hospital's imaging associates charged $496 in total, $261 for the abdomen scan and $235 for the pelvic scan. These must have been done at the same time: until the bill arrived, I had no idea there were separate scans. My insurance had a negotiated discount of $323.96 then paid $154.84; I'm paying $17.20.

I haven't received a bill from the hospital itself yet, although I do have my insurance company's explanation of benefits statement. According to the EOB, my visit apart from the above charges totaled $10,145.10. This includes $3,390.69 and $3,272.11 for the CT scans, $2,500 for just stepping foot in the ER, about $200 in lab fees and the balance in miscellaneous drugs charges. There's also a $228.61 charge for "therapeutic services," whatever the hell that is. Good news: my insurance had negotiated discounts of $2,536.28 and paid $6,757.94. Bad news: I'm on the hook (theoretically) for $850.88. That bill has yet to arrive.

There is a separate EOB I viewed online for ER services from the same hospital on the same date. I'm not sure why it's being processed separately but I'm (theoretically) on the hook for that one too, to the tune of $233. I haven't received a snail-mail EOB or a bill for that one yet either.

Total Billings: $13,326.40
Insurance discounts & coverage: $12,006.73
My out-of-pocket expenses: $ 1,319.67

Thoughts:

1. All of this was for a one-time unforeseen non-chronic non-surgical health issue. I couldn't imagine what these people would be charging for something requiring surgery, an overnight stay, specialists, a huge battery of tests & scans, reconstruction, physiotherapy, etc..
   
2. Thank god I'm a white collar worker in an industry which traditionally offers good health insurance benefits.
   
3. Thank god my good insurance got me into a better hospital for faster treatment than if I had to wait in the queue with the unfortunate uninsured. Yup, not at all politically correct and I do feel for those without insurance but at the time I was in extreme pain. I'd prefer everyone could get care as good & fast as I did but all I can do at the moment is take some consolation that my absence at other hospitals meant someone else was a bit higher in the queue.
   
4. Thank god I have a high enough disposable income that I can afford even the comparatively small balance of $1,319.67.
   
5. I can easily understand how a single nasty incident could force a family or a young person who thought they were in perfect health and therefore could skip monthly insurance premiums into sudden bankruptcy.
   
6. This is my fourth bout with kidney stones although the first in 15 years and thus the first time I had ever been a patient in a US hospital. The hospital services were very good, fast, comfortable and professional. I have been a patient in a hospital in Northern Ontario and two in Toronto: all have been on par. The US hospital was no better or worse than any other I've had the misfortune to require.
   
7. While I did summon the ambulance with the intent of going to an ER, at no point was I asked if I wanted particular service or medications. I was told I was being wheeled to a CT scan as the wheels of my gurney were being unblocked; I had no idea there were two scans. I was informed about the medications as the IVs were being connected. My lungs & breathing were unimpaired: the oxygen feed was quite unnecessary. And naturally, no one talked about prices for any of this: I could have saved my insurance company and my own wallet some dollars here and there if I had known the relative expenses for each step. I was in pain but my mental faculties were unimpaired and I could still make rational decisions. Next time, I'll take a taxi or call a friend. I'll forgo anti-nausea meds and take just the painkillers.

I'll spare you my views on the proposed health reforms (decades overdue), the necessity of covering the uninsured (seriously in favour) and how I would swap the entire US nuclear arsenal & military hegemony for Canadian-style or French-style health care in a heartbeat.