How to Ripoff Medicare: Outrageous bills for mom's minor mishap

[wordpix]

My mother, who lives in Washington, DC and has mid-stage Alzheimer's, accidentally put a tiny hearing aid battery in her ear canal, instead of the hearing aid itself. Here are her bills to get the little battery out. BTW, the battery was visible in her ear but tightly wedged in the ear canal.

Also included are my comments and outcome of each visit.

8/11: Hospital bill, Emergency dept. visit: $224.00

8/11: Dr. GC, Emergency dept. visit: 172.00
Clear outer ear canal: 271.00

Outcome: The doc was unsuccessful in removing the battery, resulting in trauma to the ear, which swelled and bled. I do not know why the doc charged for an emergency visit on top of the hospital charge, when he also charged for his shitty job to clear the ear.

8/12: Dr. CPM, ear specialist, outpatient visit, new: 155.00

Outcome: The doc looked at ear, could not see battery due to swelling and scab, and told us to come back in 2 weeks.

8/25: Dr. JW, ear specialist in Dr. CPM's office
outpatient visit 90.00

Outcome: After trying different methods to get out battery, doc could only do so by getting behind battery with a thin, sharp implement, which was causing mom pain. Doc said he did not have any painkillers in the office, so mom would have to go to the surgical center. His partner was at the center and took mom that same day.

8/25: Dr. MAD, ear specialist
1 clear outer ear canal 375.00
1 clear outer ear canal 320.00* (* "payment is included in another service received the same day")
1 clear outer ear canal 1,020.00

Dr. DHC, anaesthesia for "ear surgery" 690.00** (** "anaesthesia" was one pill of percoset/dilaudid)

Outcome: The battery was removed in 5 min. Mom loved the "anaesthesia" cocktail. I do not know why she was charged 3x for one procedure.

TOTAL $3,317.00

The medical bills for this little medical mishap are outrageous. We, the taxpayers, are paying for these absurd medical bills through Medicare, which pays from 1/6 to 1/2 of each bill (based on what formula, I don't know). Not only should the insurance cos. be closely examined, but so should medical bills.

I am spending tomorrow on the phone to see what's with some of these bills. :grr:

[earth mom]

1. I had similar bills for an ear problem a couple of years ago and I have so called "great" insurance.

Medicare is NOT the problem.

It's the out of control insurance companies who are making everyone jump to their sick, twisted and greedy tune! :grr:

[wordpix]

5. I did not say or mean Medicare was the problem. I said Medicare was being ripped off!

That's what I intended, anyway.

[dysfunctional press]

2. the reason for two emergency room bills-

one is for the hospital, and one is for the dr.
the third part is for the procedure itself.

[wordpix]

7. again, why are we paying for the dr. + procedure when dr. is DOING procedure?

:shrug:

and besides, he did a shitty job and caused her a lot of pain, and was unsuccessful to boot.

[dysfunctional press]

8. if you go to your dr.s office, and have a mole removed...

you'll get charged for the office visit itself, and then also for the procedure.

that's how they do the accounting.

[earth mom]

10. My point is that my bills were about the same. It's the Health Care System that is screwed up

in this country.

I'm still not better from my ear problem either and it's 2 frickin years later!

Thousands down the drain, misery for 6 months and still a clogged ear 2 years later.

Not only that, but I was treated like crap and felt like no one really gave a damn about my condition or about curing it. It was really depressing and discouraging.

I don't ever remember being treated so badly by so many different doctors-I saw at least 6 and only 2 were kind and didn't treat me like I was going to the drive through window at a fast food joint.

This country needs to take it's cue from Canada, England, France, etc. and run our Health Care as they run theirs.

It's the ONLY solution that makes sense.

[elleng]

3. I'm in DC. What hospital?

[wordpix]

6. Sibley

[sandnsea]

4. My ear doctor is $155 a visit

and he's cheaper than my GP who is $200+. Anasthesiologists are always expensive, that fee is for not killing your mother, not the pill.

What's annoying is that the ER doc didn't refer your mom to a specialist from the beginning. Or that there wasn't someone with ENT experience at the hospital who could have seen your mom. That's the part that is really unacceptable.

[wordpix]

19. i think it's outrageous to have to pay $200 for an office visit. Who's getting most of that?

The doc?

[SoCalNative]

9. Hospitals and Doctors ALWAYS over-bill for procedures

knowing that they will only get a fraction of what they bill, especially since most of them agree to accept payment at the contracted rate with the insurer.

They bill more than they know they will receive so that they can claim the difference as a loss against their earnings come tax time and, if a publicly traded company, can justify lower dividends that are paid out to shareholders.

[elleng]

11. One of the things Prez O wants to do

is somehow address this sort of thing, and encourage/force 'best practices' to be used, so we won't have to pay for unreasonable services. When you're finished, send your conclusions etc. to someone in the admin?

[TreasonousBastard]

12. You're right! My mother went through the same thing...

a few hours one morning in the hospital for a test and a bill for $7,500.

There have been a number of studies and articles about how the fee for service system we have is at the bottom of the problem. Here's one from the New Yorker:

http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?currentPage=all

The New York Times and NPR have been doing weekly, sometimes daily, pieces on similar problems.

Here on Long Island, we have a problem with the three local hospitals not in a fight with Medicare (which they can't win) but with Blue Cross. Blue Cross claims it's paying too much and the three hospitals claim they're getting paid too little to survive:

http://www2.timesreview.com/ST/stories/T100809_Empire_jal

I don't have an answer, except to throw the whole thing out and start over, which won't happen, but this sort of insanity has NOT been addressed in any of the Congressional plans out there, and could be far worse if a government option has as few controls as Medicare.

Obama has mentioned it, but just mentioned it. It was supposed to be a priroity, but the White House seems to have made passing anything they can get as a priority.

[Cleita]

13. And why are you blaming Medicare?

You can pay for it yourself if you are so outraged.

[wordpix]

15. who said I was blaming Medicare? I said Medicare was being ripped off

and FYI, I AM paying most of this bill, since Medicare pays very little.

Besides which, seniors like my mom have been paying taxes all their lives and I have no problem with them getting a little back now that they need it.

Geesh, READ the comments, OK?

[Cleita]

16. If you are paying most of the bill, why is Medicare being ripped off?

Medicare only approves amounts and procedures according to their guidelines. The health care providers can bill anything they like, but Medicare doesn't have to pay anymore than they approve and neither do you other than the copay if they accept Medicare assignment. That means you only have to pay 20% of the Medicare approved amount, not what they billed you for. Your post is not making sense unless you have a Medicare advantage plan, which means your mother signed away her Medicare rights to an insurance company like Cigna or Blue Cross. Then you should be blaming the insurer not Medicare.

[wordpix]

17. OK, Medicare AND my mom are being ripped off---the point is, the bills are

OUTRAGEOUS! My mom did not lose her ear, or her hearing---she had a small object in her ear that needed to be removed. Two weeks later, it was removed after hours at various docs and a total bill of $3300---you don't see that this is an outrageous amount of money for what was actually a very small 5 min. procedure?

[Froward69]

14. Whoa!!! My Deaf nephew did the same

thing 25 years ago. the most difficult part was getting him to sit still. (he was 7)
we used a crochet hook and tweezers. it took about five minutes. cost = 0 he was relieved and sat still from then on for what ever procedure, including haircuts.

Medicare fraud is rampant.
the Doc that messed up the first procedure should never have charges anything. after all he made things worse.

My dad never understood billing and after Medicare paid for procedures the clinic, Doc, and Hospital would send him additional bills and he would pay them. Until I caught on. now 4 years after his death the auditors are sending his over payments back to his estate. As the Hospital double billed the wrong family and got caught.

[wordpix]

18. well you are far brighter than 5 docs we took mom to

before the last one finally got the battery out. The trick was to give her a painkiller so the doc could get a small thin instrument behind the battery to pop it out.

It seems that could have been the cost of a pill plus pay the doc something reasonable to do a 5 min procedure. Instead, we and Medicare are stuck with $3300 in bills.