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  1. #1
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    Doctor bills - are they too excessive?!

    I am sure most of you have had broken bones, surgeries, casting, etc., but here is my question: how expensive were they for what you had done?

    I think my doctor is overcharging my insurance company and I would like to make sure this is what's really happening. Last year I broke my tibia, but the bone held together. I did not need a surgery, no treatment, just cast. He charged my insurance company $7,000 for just the x-ray and for placing the cast on. Every 3 weeks he called me for a visit and he was charging for the x-rays and the visit. My bills from that breakage were in excess of $15,000

    This year I broke my wrist. His x-ray, which was done the same day of the injury, revealed no fractureI, but he suggested an MRI just in case. I had no pain and no swelling, so for 4 weeks, while waiting for the MRI appointment, I was riding with no problems. Finally I had a call for the MRI, which I did. He knew the results the following day, but never called me. He waited 9 days for a scheduled appointment we had to tell me that I have a fracture. Again, I went to his office where he gave me a wrist immobilizer and did no treatment. He charged my insurance company $4,275, where the 275 was for the x-ray and the 4,000 was for treating my fracture. He did nothing!!!! He just gave me a wrist immobilizer.

    I've had numerous emails going back and forth with his office where I expressed my disappointment over the fact that he did not notify me of the fracture as soon as he knew after the MRI. Instead of him feeling guilty, he continues to overcharge me.

    Any suggestions?
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  2. #2
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    It has always bugged me too. I am switching dentists because of that. Some Drs will lower their pricing if you tell them you are uninsured. When there is an ins company involved its all out gouging. I don't think there is a whole lot you can do.

    My Dr wanted to send me for a 1500 dollar MRI. My ins would'nt cover it so I looked around and found one for about 300 or so that I paid myself.
    You will be scarred for life if you click my avatar

  3. #3
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    All the MRIs I had ever done (to many to count) have always been in the $1,500 range. Thank God I am insured. With the wrist, it is officially my 39th broken bone.
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  4. #4
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    Remember......what your doctor charges and what they ACTUALLY get paid ate 2 different numbers.

    They do overcharge.....but that is because they know the the insurance company is is gonna low ball them.

    My OS charged nearly $15k for my broken ankle surgery.....insurance paid out just under $8k.
    I crashed hard enough on my Tallboy to break my leg,
    The carbon is way more durable than most people.

  5. #5
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    They charged you 15K for a surgery, which is acceptable. I was charged 15K for nothing. I had no surgery, no treatment, just cast. I know insurance will not pay them 100%, but still, I think they are overcharging.
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  6. #6
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    Wow..I am emergency room rn and my wife works for an orthopedic surgeon . We both think that is excessive...the 1500 dollar MRI is pretty average though.

    Sent from my ADR6425LVW using Tapatalk 2

  7. #7
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    The treatment, as he called it, was not even done in the ER. It was done in his office and he did nothing. He just made me turn my wrist up and down, checked my range of motion, and gave me a wrist immobilizer. Then boom, charges my insurance and calls it on the bill - treatment for 4,000.
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  8. #8
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    Quote Originally Posted by ivanovnv View Post
    I am sure most of you have had broken bones, surgeries, casting, etc., but here is my question: how expensive were they for what you had done?

    I think my doctor is overcharging my insurance company and I would like to make sure this is what's really happening. Last year I broke my tibia, but the bone held together. I did not need a surgery, no treatment, just cast. He charged my insurance company $7,000 for just the x-ray and for placing the cast on. Every 3 weeks he called me for a visit and he was charging for the x-rays and the visit. My bills from that breakage were in excess of $15,000

    This year I broke my wrist. His x-ray, which was done the same day of the injury, revealed no fractureI, but he suggested an MRI just in case. I had no pain and no swelling, so for 4 weeks, while waiting for the MRI appointment, I was riding with no problems. Finally I had a call for the MRI, which I did. He knew the results the following day, but never called me. He waited 9 days for a scheduled appointment we had to tell me that I have a fracture. Again, I went to his office where he gave me a wrist immobilizer and did no treatment. He charged my insurance company $4,275, where the 275 was for the x-ray and the 4,000 was for treating my fracture. He did nothing!!!! He just gave me a wrist immobilizer.

    I've had numerous emails going back and forth with his office where I expressed my disappointment over the fact that he did not notify me of the fracture as soon as he knew after the MRI. Instead of him feeling guilty, he continues to overcharge me.

    Any suggestions?
    Well, just look at the comparisons, and then tell US what you would suggest. Compared to ANY other First-World, civilized nation, your bill would be outrageous. And it's not like you are paying X-times more than anywhere else in the world for X-times more excellent care. That contention is pure BS.

    For that matter, look at mortality and longevity and infant mortality stats that compare the U.S. with the other civilized, industrialized, first-world nations.
    We ain't even anywheres NEAR the top in any of those categories.
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  9. #9
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    I would ask for the radiologists written report and see if you really have a fracture.

  10. #10
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    No they are charging the usual and customary amount. The usual and customary amount is what is much greater than what it should be. A few things inflate the cost such as regulation and the legal system. If anything our country need radical legal system overhaul (as well as healthcare reform).

  11. #11
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    I had a Tibal Plateau Fracture that required external fixation for twelve days,to allow the swelling to go down. Then open reduction,medial,lateral internal fixation with hardware removal.i.e. 2 plates and fourteen screws during a 6 hour surgery to put it back together.
    Cost between E.R. visit to 2nd surgery was just short of $100,000. Insurance paid just over $32,000.
    My out of pocket was about $800.

    So what's billed and paid are not always the same because the insurance( UHG )and their providers have "contract pricing" agreements.

    I ended up total out of pocket $3,500ish. On billed services that were almost $160,000

    All those years of paying in and not needing to use the coverage, was more than made up for in this one rather mundane crash.

    So yes the whole system need an overhaul,but I am thankful that it worked for me,this time!

  12. #12
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    Have you seen a doctors Insurance bill? And as has said before the insurance company is going to rape the doctor so they rape back (its not rape-rape).
    I had a flood in my house and office. Same thing. At home with no insurance the bill looked reasonable. At the office they billed for a ton of stuff that wasnt done and materials that werent used because insurance paid them about half the claim which with their padding came out to be the amount they need to run a business.
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  13. #13
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    Quote Originally Posted by ivanovnv View Post
    All the MRIs I had ever done (to many to count) have always been in the $1,500 range. Thank God I am insured. With the wrist, it is officially my 39th broken bone.
    Wow, in Australia if the MRI is ordered by a specialist the cost is $0.00. We are certainly lucky.

  14. #14
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    Short story. One surgeon quoted me 20-30k and left me in pain. Another one quoted me $500 with a half cast and gave me a bottle of perc's to ease the pain...I DO NOT have insurance. This was for a broken pinky finger -displaced fracture.

  15. #15
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    You are lucky you did not need a surgery and even luckier for meeting an honest doctor :-)
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  16. #16
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    JointTech nailed it. The health care industry in the US has inflated fees to patients by 400-500% because of liability insurance. The legal system has "empowered" the patient with the right to litigation when he feels disserviced by his clinician and as a consequence, the herd suffers because of it, and everyone involved in the transactions prosper. I am a veterinarian and we are a cash industry. A surgery that would cost a $100,000 if done on a person would ring in around $3500-$5000 in veterinary patients, but that's because animals are considered property so damages claims cannot exceed the market value of the animal (rarely over $3k in small animals but much more in equine). And go figure, our clients seem to get along just fine without being able to sue us left and right for the (common and predictable) misfortunes that come with practicing medicine- things do not a simply cannot always go well.
    Keep the rubber side down

  17. #17
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    Plus colleges are taking more of the "value added" benefit from education away from the professional. Like in college costs going up at a multiple of inflation.
    lean forward

  18. #18
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    Quote Originally Posted by MTBCanuck View Post
    JointTech nailed it. The health care industry in the US has inflated fees to patients by 400-500% because of liability insurance. The legal system has "empowered" the patient with the right to litigation when he feels disserviced by his clinician and as a consequence, the herd suffers because of it, and everyone involved in the transactions prosper. I am a veterinarian and we are a cash industry. A surgery that would cost a $100,000 if done on a person would ring in around $3500-$5000 in veterinary patients, but that's because animals are considered property so damages claims cannot exceed the market value of the animal (rarely over $3k in small animals but much more in equine). And go figure, our clients seem to get along just fine without being able to sue us left and right for the (common and predictable) misfortunes that come with practicing medicine- things do not a simply cannot always go well.
    Really, I have a Ridgeback the cracked a canine. At least that's what the vet said when he broke his canine cleaning his teeth, that is that it was cracked before and broke when he cleaned that tooth.

    Long story short, while I had my doubts that the tooth was cracked before the vet broke it; I opted to see the dental specialist at UC Davis vet hospital in Dan Diego and have a root canal done on my dogs tooth.

    Total cost about $3k without a crown on the tooth.

    That same root canal with a crown on a person cost me about 900.00 and I thought that was expensive.

    So tell me again how veterinary car is less than than human health care…

    Not that it matters, ill happily pay whatever it cost to keep my dog healthy and Alive as long as possible, I can't imagine not having him. But vet care is quite possibly one of the most over priced parts of pet ownership.

  19. #19
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    DWill, it would be redundant for me to argue with you based on apples to oranges comparisons. Your dog required general anesthesia (making up the bulk of the cost) while you likely just had a local block and mild systemic sedation (if any) not to mention you possibly only saw the deductable amount, not the amount billed by the dentist. If you tool a price list for comparable services on an apples to apples basis there would be no comparison in the fees (veterinary much lower). I understand that a big ticket item like a root canal can sqew your perception toward vet care being overpriced but if you consider the average veterinarian only makes about $50K after going through 4 years of professional education (lowest income for a medical professional) you might be less compelled to think prices are unfair, even if individual speciality services (ir root canal in canines) are still "high" (ie in the consumer good/service category such as box of macaroni and cheese vs. ferrari).

    Regardless, glad to hear you go to great lengths to look after your pooch
    Keep the rubber side down

  20. #20
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    Yes, they charge too much. For a bad dislocated finger and a small break (two small chips under finger) they charger me 3900 to set the finger, three X-rays, and two finger splints. They had to take three X-rays because they didn't set it right the first pull. (still no movement) And i told them this but sent me for an X-ray anyway. Its been one month and i can now at least bend it to a 90 degree angle.

  21. #21
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    To the OP, thanks for posting your experiences. I think this just highlights what's wrong with the medical care system here in the US. The sad fact is that Obamamama Care will only drive up medical costs and insurance costs (why do you think the insurance cos supported it), with the tax payers, (yes, that 10% of the population) footing the bill.
    Special Interest is alive and well, at least for the foreseeable future.

  22. #22
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    Well this is UNBELIEVABLE stuff, the average person here like me doesnt pay a cent to see a doctor, X-rays are free, if i break my arm its free to fix it, we have medicare that pays for all that, i just show them my card and thats the last thing i hear of it, yes we pay for it in out taxes but after reading these stories im damn happy about that.
    The only thing thats not free is dental work.
    Whats going on over there?
    Dont ever let the truth get in the way of a funny story....

  23. #23
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    Americans are scared of the word "socialism", even if it saves them and the govt money.

  24. #24
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    Six weeks ago, I was bitten by an Eastern Brown Snake. They are pretty nasty snakes. They're the second most deadly snake on the planet and one ounce of their venom is enough to kill 12,000 adult males, supposedly.

    Total cost to me for health care here in Australia has been $0.00. The Ambulance Service charge for taking me to hospital, for 53 kilometres or 33 miles was $960. The New South Wale's government paid a subsidy of $471 toward the bill, so the balance of $489, is paid by having private ambulance coverage, which is a family cover, costing $86 for the year.

    Self portrait with pressure bandage, tightly put on to slow the flow of venom.




    Australia has a first world SOCIALIST health care system, for when the sh*t's hitting the fan. When the fan isn't on, our system is probably like everywhere else. People waiting long periods for treatment or the well insured paying big bucks, for a speedier service delivery.

    Since mid November three people have died from being bitten by Eastern Brown Snakes in Queensland. Luckily, I was bitten in New South Wales.


    Warren.
    Last edited by Wild Wassa; 12-16-2012 at 06:49 PM.

  25. #25
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    Another member was bitten by a rattlesnake and paid around $100,000 for the dr visit.

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