Kidney Stone Follow-up, Part III

The bills from March's kidney stone fun in California just keep coming. The ambulance company and its employees have taken their cut. The lab got theirs. The CT scanner owner, operators and physician got theirs. The drug manufacturer got theirs. Even the hospital got theirs. Who was left out? The emergency room!

Yes, the emergency room is a separate facility from the hospital proper so they get to do their own billing, charging for various activities all over again.

They billed my insurance company $625 for the attending physician (Dr Barbie Barrett) and $55 for the "non-invasive pulse oximet." Once we deduct my insurer's discount, I'm left to pay $233.83.

Revised totals:
Total billed: $14,006.40
Insurance discounts & coverage: $12,452.90
My out-of-pocket expenses: $ 1,553.50

What am I going to do next time?

1. Take a taxi, not the ambulance. That would save $2k overall and $220 for me. Yeah, it may mean I'll have to wait while more profitable guests are being processed but I can endure a great deal of pain for this kind of money.
   
2. Decline attempts to feed me the oxygen. Kidney stones don't affect my lungs.
   
3. Reconsider the CT scans. They cost $7k, approximately 50% of the total and about the same of my out-of-pocket expenses. They counted the torso scan and the pelvic scan as two separate incidents even though they were done simultaneously, which flatly sounds like gouging to me.
   
4. Decline any additional ultrasound scans. They're not going to show much the CT scan didn't and it cost me personally an extra $200.
   
5. Take the painkillers but think about declining the anti-nausea meds & such. I've been eating my own cooking for nearly 40 years: nothing upsets my stomach anymore. All things considered though, they weren't that expensive.
   
6. Question everything. Is this procedure/medication/whatever truly necessary? How much will it cost? Are there cheaper alternatives?

The big questions in my mind right now are: if I had another kidney stone issue, is going to urgent care less expensive overall to (a) my insurer and (b) my wallet than the ER? Would an urgent care facility simply punt me over to the ER anyway and charging me for the transfer? I'm not sure how to answer these sorts of things but I'm inclined to go down to our neighborhood hospital and talk to someone in urgent care admissions about this as a pre-emptive measure.

I repeat: thank god I'm upper middle class with very good health insurance and disposable income. This sort of thing would decimate anyone in lower middle class with less than good (or no) insurance.

Kidney Stone Follow-up, Part III

The bills from March's kidney stone fun in California just keep coming. The ambulance company and its employees have taken their cut. The lab got theirs. The CT scanner owner, operators and physician got theirs. The drug manufacturer got theirs. Even the hospital got theirs. Who was left out? The emergency room!

Yes, the emergency room is a separate facility from the hospital proper so they get to do their own billing, charging for various activities all over again.

They billed my insurance company $625 for the attending physician (Dr Barbie Barrett) and $55 for the "non-invasive pulse oximet." Once we deduct my insurer's discount, I'm left to pay $233.83.

Revised totals:
Total billed: $14,006.40
Insurance discounts & coverage: $12,452.90
My out-of-pocket expenses: $ 1,553.50

What am I going to do next time?

1. Take a taxi, not the ambulance. That would save $2k overall and $220 for me. Yeah, it may mean I'll have to wait while more profitable guests are being processed but I can endure a great deal of pain for this kind of money.
   
2. Decline attempts to feed me the oxygen. Kidney stones don't affect my lungs.
   
3. Reconsider the CT scans. They cost $7k, approximately 50% of the total and about the same of my out-of-pocket expenses. They counted the torso scan and the pelvic scan as two separate incidents even though they were done simultaneously, which flatly sounds like gouging to me.
   
4. Decline any additional ultrasound scans. They're not going to show much the CT scan didn't and it cost me personally an extra $200.
   
5. Take the painkillers but think about declining the anti-nausea meds & such. I've been eating my own cooking for nearly 40 years: nothing upsets my stomach anymore. All things considered though, they weren't that expensive.
   
6. Question everything. Is this procedure/medication/whatever truly necessary? How much will it cost? Are there cheaper alternatives?

The big questions in my mind right now are: if I had another kidney stone issue, is going to urgent care less expensive overall to (a) my insurer and (b) my wallet than the ER? Would an urgent care facility simply punt me over to the ER anyway and charging me for the transfer? I'm not sure how to answer these sorts of things but I'm inclined to go down to our neighborhood hospital and talk to someone in urgent care admissions about this as a pre-emptive measure.

I repeat: thank god I'm upper middle class with very good health insurance and disposable income. This sort of thing would decimate anyone in lower middle class with less than good (or no) insurance.

Car Insurance

Last week, we received a notice for our semi-annual Ameriprise car insurance premium due in July. It's gone up quite a bit, from $960 semi-annually to $1,223.

Today, I telephoned to reduce our deductibles from $100 to $500, reducing our premium to $1,016.

A few months ago, we checked with State Farm but their quote was $200 higher than Ameriprise. A friend recommended Liberty Mutual: they are $312 more expensive than our current Ameriprise policy, even with a 5% University of Maryland alumnus discount.

I'm going to keep digging around to see what else I might potentially find. What I'd really like is some sort of online insurance brokerage where I could put in all of our data in one shot then have it obtain quotes from various insurance companies. Anyone know of such a facility?

Edit: Progressive's web site quoted us $987. Their comparison rate feature only offered a number from one company, Allstate, and that was $1269 at the low end.

Edit2: Esurance quoted us $906 semi-annually, 21st Century $1,066.71.

Car Insurance

Last week, we received a notice for our semi-annual Ameriprise car insurance premium due in July. It's gone up quite a bit, from $960 semi-annually to $1,223.

Today, I telephoned to reduce our deductibles from $100 to $500, reducing our premium to $1,016.

A few months ago, we checked with State Farm but their quote was $200 higher than Ameriprise. A friend recommended Liberty Mutual: they are $312 more expensive than our current Ameriprise policy, even with a 5% University of Maryland alumnus discount.

I'm going to keep digging around to see what else I might potentially find. What I'd really like is some sort of online insurance brokerage where I could put in all of our data in one shot then have it obtain quotes from various insurance companies. Anyone know of such a facility?

Edit: Progressive's web site quoted us $987. Their comparison rate feature only offered a number from one company, Allstate, and that was $1269 at the low end.

Edit2: Esurance quoted us $906 semi-annually, 21st Century $1,066.71.