Could you make this procedure any more expensive?

[mmglobal]

I don't know how much my thoracic ESI costs. I had 7 lumbar epidurals (in 2000 - 2002) in the doctor's office with no imaging. I had one lumbar ESI in a doctor's office with flouroscopy.

The thoracic procedure is tougher. But, I still believe this is an office procedure with flouro.

Yesterday, I was in a full-on operating room with the doctor, two nurses, and an xray tech.

I don't know how this will be billed and paid. I had a $150 copay. I'll report back when I see an explanation of benefits.

Mark

PS... post your ridiculously billed or paid procedures..

[mmglobal]

In my 9 years as a spine patient advocate, there are two 'worst cases' that I remember:

There are two worst cases that I've seen.

1. A woman from NJ who was desperate for help was told that she needed a discogram before surgery. Insurance wouldn’t cover it. The center that did the discogram demanded CASH BEFORE the procedure. She gave them over $15,000 for her discography.
   
   I can get a lumbar discography with post-disco CT for about 2K. A more expensive center with all the whiz bang (and only marginally necessary) equipment might be 6K for everything, soup to nuts. (that includes surgery center and anesthesiologist) IMHO, the doctor who performed her procedure is a criminal.
   
   
2. A man from central California had unrelenting lumbar pain following a car accident. His surgeon who did a very poor job in his 2-level fusion (misplaced screws into the spinal canal), did his surgery for a lien on his accident settlement. This surgery should be about 60 – 100k… very expensive might be 150K. The lien on his settlement for surgery costs (for the INVESTMENT they made, performing the surgery) was for $265,000.00. For him, that comes AFTER the 40% lawyer’s take. That means that the first $441,000 of his settlement went to cover a surgery that should have cost less than ½. IMHO, the doctor who performed the surgery is a criminal.

[jsewell]

Wow those are criminal doctors and or centers. I had my thoracic discogram performed at a center . I made the reservation 2 weeks before the procedure. I had the procedure, it was very beneficial proving my 2 thoracic discs were the cause of extreme pain. Then the insurance statement that they were paying zero. the reason was the center never did get pre approval which was necessary. They nor the doctor ever got paid and they told me i am not responsible. I do feel bad for the doctor as he had nothing to do with all of this , but i'm sure it was an easy write off. some day if i ever get money, i will pay him back. His charge was $2,000. I'm not sure what the center charged.

Marc,
My surgeon does all ESI's under flouroscopy and anesthesia. They used to be done at the hospital, but now the orthopedic practice has their own surgery center. At times they have charged me the $150, but I think i always reach my deductible so fast , it is usually only once a year. I forget what the whole astronomical charge is, but i don't have to pay any more. They take what insurance gives and that is usually it for me.

I am enrolled in a medical insurance billing program right now, and we are told if the patient will pay, take it. If they ask for a cash discount pretend you were just about to give one. so everyone paying cash ASK for the cash discount.
judy

[Maria]

Mark,
I hope that surgeon gets his license suspended vs. handslapping re the 2nd one.

Re first where cash demanded up front for discogram I am wondering what all my discos in Florida cost as the PM there did it bigger than I've ever seen anywhere re prepping the patient with IV and meds for tum prior to procedure and full blown procedure room staff. At the time my Nurse Case Manager had said I could have had a few cosmetic surgeries done for the cost of his discogram (w/fluroscopy of course). He was the only person who would take my out of state WC insurance in Fla. while living there so there was really no choice. One place I had intially contacted before I moved that was supposed to take me decided to ask for cash up front for initial assessment and treatment. They wanted $1500 for the intial visit and if treatment was suggested I would have to pay for that even though WC had already given authorization for intial assessment and would have for ESI's and meds back then (2003). WC did not agree to me paying up front and then them paying me back and they would not see me any other way. Besides the guy that I ended up with that was as close as I got to anyone else accepting me at all.

Re here.. much less pomp and circumstance w/ESI under fluroscopy. I cannot get them auth'd anymore tho so whatever..haven't felt the need for one in quite some time, thankfully. Hope my PM won't drop me since I'm only getting pain meds now as I've been seeing him for 7 years.

With my regular medical insurance they won't cover anything for my low back but if they did I have an 80/20 plan and Medicare where appropriate (according to Medicare) picks up the other 20%. This also doesn't apply to my low back as Medicare like my regular insurance won't pay for anything as it's WC related.

So how ya feeling? Hope if you don't have some relief yet you soon will.

[dshobbies]

Criminal? These doctors violated their hippocratic (sp) oath by taking advantage of their patients and doing them financial harm. Aside from having to return these outrageous charges, they should have their licenses revoked.

[mmglobal]

Sadly, there has been no occasion to even challenge the process for either of the two patients I mentioned. Neither of them have the energy or tools to go after such egregious behavior.

[Aaron]

My total billed amount for the last ESI in Tspine is in the range of 8000 total. Dr, anest, hospital etc.