Overcharged 38000% !!!

Pretty Grumpy in NC writes in :

I am writing this letter as a complaint about medical charges from Wake Forest Baptist Medical Center, which I think is excessive.

I would like to point out that I got excellent care during my stay at Wake Forest Baptist Medical Center. I am questioning charges in total of $763.50. I received my bill for my hospital stay for surgery on June 10, 2013. I noticed a charge categorized as “Cast Room” of $763.50. I called the billing department and asked for an itemized bill.

I received the itemized bill and discovered that the “Cast Room” bill was really a daily charge of $254.50 for “Basic Frame with trapeze”. I called about this charge and learned that it was the bar above the bed attached to foot of bed to the head of the bed along with a trapeze handle. This item is used to help get up out of bed.

I think these charges are excessive.

I contacted a local home health equipment company to see what the charge would be if I rented this piece of equipment, and they told me the same item is $20 per month! This just seems unbelievable that a hospital can charge over 38000% above the price I can get this equipment for my home.

I had similar surgery in 2009 there is no entry on this EOB for “Other Services” as in the current EOB.
I only used this trapeze to get out of bed the first day of my hospital stay. I would have appreciated the therapist who did my therapy, and observed that I was not using it on day 2 & 3, to ask me if I needed this piece of equipment on my bed. If I would have known I was charged this excessive amount per day, I would have said “no, go ahead and take it off”.

I accept paying an initial charge for the equipment since they had an employee come to my room and install the equipment, but a daily charge of this amount? I have paid my bill including one day of the $254.50 realizing this as a possible charge for labor, and the use of this piece of equipment for the first day, even though it took the employee less than an hour to put the equipment on the bed.

Also, I am surprised the insurance company would accept this charge for this piece of equipment. My EOB shows my insurance company accepted $458.10 of this charge, this is unbelievable!

I received a reply from the hospital billing that my procedure was billed under a DRG(diagnosis related group) methodology and basically this billing was a “package deal” and whether I used the equipment or not, it is still billed.

They basically said they could not reimburse because of this methodology.

The letter also stated that I am responsible for this charge.
How can a hospital get away with charging this much for a piece of equipment?

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  49. If you are a CEO of an insurer, why would you care about your reimbursements to hospitals or other providers? You can raise your premiums to whatever you want, and all firms want to become bigger and grow.

  50. It is true that unfunded mandates like EMTALA require hospitals to charge more to people who have insurance and can pay for their care.

    But there is a structural factor too/ Many developments in drugs and microsurgery have made hospitals less necessary. Patient counts and bed-days are down big time over the last 25 years.

    However the hospitals have large payrolls and construction debts and equipment leases and malpractice insurance costs etc etc.

    So they must charge more to each actual patient.

    There is no easy solution. I sometimes think that large federal subsidies for hospitals is the least bad alternative.

  51. Many factors go into determining costs in the hospital. Hospital write offs for indigent care must take into account the fact that some of the losses will be made up by accounts which will be paid. Unfunded mandates such as EMTALA must be funded by other means,rather than by patients who are entitled to emergency are regardless of the ability to pay. PPACA will attempt to level the playing field, or at least decrease the unfairness, by attempting to see that everyone who shows up in the emergency room has some kind if insurance. http://www.ratehospitals.com/blog/why-do-certain-surgeries-cost-so-much/ looks at why some items, such as surgery,are so expensive.

  52. Tell us what the front entrance way of this hospital looks like. I had a colleague tell me he went to a renovated hospital in Houston where he did his residency 20 years ago, and the front lobby puts 4 star hotels to shame!

    This is what health care has deteriorated into! It’s not about care, it’s about profit. But, lawyers are our modern day bank robbers, and they know where to go for the money, so, these high falutin’ hospitals are just advertising “we are raking in the bucks, come here for care and hope we do care.”

    Obamacare will impact on costs? Give me a break!

  53. Here might be part of the reason…

    Wake Forest Baptist Medical Center CEO Dr. John McConnell received a compensation package worth nearly $2.5 million last year , according to tax documents released by the medical center Tuesday. (believe this was 2011)

    I’d also suggest the Better Business Bureau…

  54. I have been helping individuals fight hospital charges for several years, and I do NOT think the villain is the insurance company.

    The uninsured are treated much worse than any insured.

    The villain is our national unwillingness to regulate hospitals. Courts of law routinely side with hospitals. Class action suits against hospitals actually work, but what a pathetic form of social policy (to hope that you are part of a class action!)

    In my writing I call for special Health Courts. Any unconscionable bill could be taken there and challenged legally. The courts would be paid out of federal funds, and no patient would have to have a lawyer. The courts would have authority to reduce or even cancel outrageous bills.

    Consumer laws already exist against fraud and price gouging. We need an activist President who would actively try and enforce them against hospitals, ignoring the lost campaign contributions that would surely result.

    Bernie Sanders, come home!

    Bob Hertz, The Health Care Crusade

  55. Your insurer will not be any help in fighting this charge – insurers are not there to keep costs down, they’re there to ensure providers get paid and make a good return to their investors – or in the case of BCBS of NC, reward executives with double digit bonuses.

    I would write the NC insurance commissioner and your local state rep and senator. Just imagine what the charge would have been if you were uninsured!!

    I wonder what the “Baptist” is for? You might consult the bible to see what Jesus Christ would say about such a makeup.

  56. “How can a hospital get away with charging this much for a piece of equipment?”

    You’ve already answered your question: because your insurer lets them do it.