topic Re: Medical Bills in Wellness

Medical Bills

ScrapHappy — Fri, 22 Aug 2025 13:17:54 GMT

My medical bills are coming in from the hospital since having surgery. The hospital is now charging a facility charge. So, I had a facility charge on my surgery day. I also had some tests, like nuclear medicine prior and had facility charge for that. The facility charge doesn't include the cost of the test(s)/surgery itself. The facility charge for my surgery day alone was $1500. I was outpatient surgery and was there 4 hours.

Re: Medical Bills

Winkk — Fri, 22 Aug 2025 13:34:14 GMT

I'm assuming you have insurance to cover this. If there are any questionable charges they should be the ones who reviews them.

Re: Medical Bills

Still Raining — Fri, 22 Aug 2025 13:40:50 GMT

Do you have prior bills where it was not charged?

Perhaps this just proves that the chargemaster is up to date.

Re: Medical Bills

cjm61 — Fri, 22 Aug 2025 13:46:18 GMT

@ScrapHappy That sounds crazy. I haven't heard of that kind of charge.

@Winkk No, the insurance company doesn't and isn't required to check the detailed charges. When my husband broke his back years ago he was bedridden for a few weeks. He had plenty of time to go through every detail of his medical charges. One in particular was an $1,800 charge for the drill used to do his surgery. He called the hospital and basically was told that is how much the drill costs. He said if he paid $1,800 for a drill he wanted that drill. They told him not to worry his insurance would pay it. He pushed and pushed, adamantly stating he would not allow insurance to pay if he did not receive this amazing drill. After all, a drill that expensive must be incredible. Well, that charge was ultimately removed and he never got the drill.

Re: Medical Bills

Carmie — Fri, 22 Aug 2025 13:47:56 GMT

Facility medical fees are always charged seperate from professional fees.

Wait until you see how many professionals were involved. Most are not hospital employees and they bill their own fees.

I hope you have insurance.

Re: Medical Bills

DrakesMomma — Fri, 22 Aug 2025 13:55:29 GMT

Having 20+ years experience in medical billing, a facility fee in this situation is standard.

Re: Medical Bills

Carmie — Fri, 22 Aug 2025 14:05:08 GMT

@cjm61 A surgical drill is not the same as what you can buy from a hardware store. They also have to be sterilized before each use and stored properly. There is more to it that causes the high cost.

All hospital bills that are itemized and will show the costs for equipment, drugs, supplies, facility use, room for stays, operation room, surgical equipment and the list goes on.

What most people don't know is the hospital is under contract to receive a certain amount of money for inpatient services and out patient services. They will get that amount no matter if their charges are higher or lower than the contracted rate.

I was shocked when I saw a hospital bill at work, ( I worked in health insurance) where the hospital received thousands more than their actual billing. I reported it for review. Then I got the explanation. Hospitals are paid per diem, not per itemized charges.

Re: Medical Bills

Desertdi — Fri, 22 Aug 2025 14:23:04 GMT

Yup...that "facility charge" is like RENT on the operating room. (I had to pay mine in ADVANCE when I had my cataracts done.)

Re: Medical Bills

cindyNC — Fri, 22 Aug 2025 16:44:30 GMT

It sounds like flat rate charges for car repair. My exhusband used to be a Toyota mechanic. He was paid the same amount per repair type no matter how long it took (rather than receiving an hourly salary).........so the faster he worked, they more repairs he did in a day, the more $$$ he made.

Re: Medical Bills

DSD2 — Fri, 22 Aug 2025 17:42:59 GMT

@cjm61 I so admire and applaud your husband for taking a stand!

Good for him! I wish more of us had his resolve.

Re: Medical Bills

SilleeMee — Fri, 22 Aug 2025 18:47:57 GMT

I get outpatient drug infusions when needed and there is a facility fee for each visit. My insurance covers that fee.

Re: Medical Bills

Puppy Lips — Fri, 22 Aug 2025 19:48:21 GMT

My neighbor was in a car accident. He was in the ER for 4 hours and got his arm stitched up. The bill was $61,000. That is insane. They have insurance.

The whole health care insurance industry is so messed up.

Re: Medical Bills

granddi — Fri, 22 Aug 2025 21:28:11 GMT

@Puppy Lips I don't think the insurance companies think that the system is messed up. It is working just fine for them.

If everyone had the same system the point of view might be more sympathetic. But corporate coverage, Federal Employees, Railroad Retirees, Military, all have different sets of coverage rules-esp drug coverage.

Re: Medical Bills

Carmie — Fri, 22 Aug 2025 22:41:20 GMT

@Puppy Lips wrote:
My neighbor was in a car accident. He was in the ER for 4 hours and got his arm stitched up. The bill was $61,000. That is insane. They have insurance.

The whole health care insurance industry is so messed up.

I am 100% sure, $61k wasn't paid. Hospitals bill high amounts, but they don't receive anything close to the amount they bill.

Auto insurance would be primary in any and all car accidents, then medical insurance would be secondary.

He probably had X-rays done as well as blood work and someone had to read the X-rays and labs,plus the ER physicians who stitched him up who may or may not be employed by the hospital want paid too. It would not have been just stitches.

My best guess is that the hospital received a few thousand dollars and wrote off the rest.

Re: Medical Bills

conlt — Sat, 23 Aug 2025 19:32:33 GMT

@ScrapHappy I saw a news piece on TV about hospitals etc. charging an facility charge. Even doctors offices. I hope insurance pays for those. I do not know but will educate myself on it.

Re: Medical Bills

ScrapHappy — Sat, 23 Aug 2025 20:51:40 GMT

@conlt wrote:
@ScrapHappy I saw a news piece on TV about hospitals etc. charging an facility charge. Even doctors offices. I hope insurance pays for those. I do not know but will educate myself on it.

My area local news has been running a series out health care. Mostly about patients receiving denials for coverage (but then after it's on the news, they receive an approval). Also about costs, etc. One man was being charged $14,000 in facility charges alone and it wasn't for surfery. It was, I think, for infusions (not chemo). They interviews the spokeswoman for the hospital (she also represents hospitals) and said if hospitals don't charge a facility fee, that hospitals will go under.

Re: Medical Bills

gardenman — Mon, 25 Aug 2025 12:44:58 GMT

@cjm61 wrote:
@ScrapHappy That sounds crazy. I haven't heard of that kind of charge.

@Winkk No, the insurance company doesn't and isn't required to check the detailed charges. When my husband broke his back years ago he was bedridden for a few weeks. He had plenty of time to go through every detail of his medical charges. One in particular was an $1,800 charge for the drill used to do his surgery. He called the hospital and basically was told that is how much the drill costs. He said if he paid $1,800 for a drill he wanted that drill. They told him not to worry his insurance would pay it. He pushed and pushed, adamantly stating he would not allow insurance to pay if he did not receive this amazing drill. After all, a drill that expensive must be incredible. Well, that charge was ultimately removed and he never got the drill.

In general, any tool/device used for a neurological procedure (brain, spine, etc.) gets discarded after use due to the risk of contamination with prions associated with Creutzfeldt-Jakob disease. Prions can't be disinfected like bacteria or viruses, so tools used in those types of procedures tend to be one-use tools and then discarded.

Re: Medical Bills

Puppy Lips — Mon, 25 Aug 2025 17:08:32 GMT

@Carmie wrote:
@Puppy Lips wrote:
My neighbor was in a car accident. He was in the ER for 4 hours and got his arm stitched up. The bill was $61,000. That is insane. They have insurance.

The whole health care insurance industry is so messed up.
I am 100% sure, $61k wasn't paid. Hospitals bill high amounts, but they don't receive anything close to the amount they bill.

Auto insurance would be primary in any and all car accidents, then medical insurance would be secondary.

He probably had X-rays done as well as blood work and someone had to read the X-rays and labs,plus the ER physicians who stitched him up who may or may not be employed by the hospital want paid too. It would not have been just stitches.

My best guess is that the hospital received a few thousand dollars and wrote off the rest.

@Carmie Yes, I know all that. They of course did not pay the $61,000. But that speaks to my previous comment that the whole industry is messed up. The medical offices/hospitals/labs, etc. bill highly inflated amounts, get what they can and then have to cover the costs of people who have no insurance at all.

Re: Medical Bills

Carmie — Mon, 25 Aug 2025 19:54:55 GMT

@Puppy Lips They actually write off the amount they didn't receive for tax purposes. They are contracted to get a set amount from insurance companies.

Medicare reimbursements are what what insurance compnies use as their reasonable rates called UCR.