30 hours. $136,000 later.
While doing taxes I got to dig up my single medical event in 2019 and it is pretty crazy to think about. Though, before I dig into this - I want to make clear, the staff and service was phenomenal. This is simply a deep dive into the insurance, claims and statements that follow a medical procedure.
Lets just jump right into it - I paid $3,500 in 2019 out of pocket for my surgery. In the grand scheme of things - I'm very lucky insurance exists, but what makes up that $136k?
We can start at the breakdown of the provider, which for April 5 & 6 is:
- Tampa General - $125,164.23
- Doctor H - $6,104.00
- Doctor S - $3,731.00
- Doctor C - $67.00
I don't really want to put full names, because I don't think the doctor is truly involved with the pricing. I know the surgeon was the 2nd most expensive doctor, so I'm wondering who the others are.
- Doctor H - Anesthesiologist
- Doctor S - Neurosurgeon
- Doctor C - Pathologist
From my little knowledge of the medical industry and Google searches, I learned the following:
The average Anesthesiologist salary in the United States is $387,000 as of February 26, 2020, but the range typically falls between $335,300 and $438,700
salary.com - March 8
Though I would have thought my surgeon would have billed more, seeing how salary.com says:
The average Neurosurgeon salary in the United States is $607,101 as of February 26, 2020, but the range typically falls between $457,001 and $768,201.
salary.com - March 8
With the years and years of school and the stress of literally being able to kill someone makes sense of the return in pay with all those responsibilities. Though my guess is the large $125,000 bill from the hospital may have included some of the surgeon charges. So I requested an itemized bill from the hospital.
They actually sent it, but it said $121,964.23 was the total, yet my insurance says they billed $125,164.23. I did the difference report on that and it was $3,200 exact.
So that makes sense. At the time of my surgery I only had $300 of my $3,500 deductible. So I had to drop $3,200 for the surgery. That explains the price difference.
I don't want to spam the blog post with a ton of words, because I honestly have no idea what half of these itemized items are. I just want to bring up a few of them.
- 2 quantities at $313 a piece
- ESMOLOL 100 MG/10 ML (10 MG/ML) SOLN
- It can treat heart rhythm problems. It can also slow down a fast heartbeat and treat high blood pressure during or after surgery.
- Price only is $70.75 a piece online, so a 342.4% markup
HB OR SPECIALTY LEVEL 2 MIN
- This appears to be Operating Room, Level 2 billed per minute
- At $2,030 per minute (1st minute), then $228 every additional minute.
- I was billed at 284 minutes or 4.73 hours
- Quite longer than 3 hour estimate
- Probably due to the complications that arose (details)
HB ANESTHESIA GENERAL 1MIN
- Anesthesia while in Operating Room
- Billed at $153.41 per minute
- Total of 284 minutes or 4.73 hours
I remember the bar-code I had attached to my wrist was used every time I was taking any pills or being injected. They would scan my wrist and I assume the machine could immediately alert if I should not be injected with whatever. A very technical system that also has the benefit of turning into an itemized billing report.
Though as I end this post, I can't seem to understand the massive price difference of things.
Above I'm shown billed $136,974.93, but only "allowed" $29,759.72 which I believe is what my insurance believes my care provider should be paid. Why are these numbers different? What is there a nearly 5x difference in the numbers? It just my blows my mind how I spend one surgery and one night in the hospital and rack up $136k in charges.
What do people without insurance do? What do people do that spend weeks in a hospital? Is this the same elsewhere in the world? What classes do I need to take to understand the insurance/medical industry?
This stuff is confusing, but I'm glad my back pain is gone.