My wife needed surgery for carpel tunnel syndrome. I don’t remember the total cost, but I do remember the billing “procedure.” When we showed up at the hospital, we pre-paid an “estimated copay” as they claimed they didn’t know exactly how much the insurance company would pay and how much we would pay.
The surgery itself went very well — including the time spend for the anesthetic to wear off, she spent about 5 hours there, just long enough for lunch. Within 30 days, we received the hospital bill showing a list of charges, how much the insurance covered and how much we owed (much less than our prepayment).
A few weeks later [so almost two months after the surgery], the hospital called my wife to confirm that the cost “was less than we estimated” and mailed us a check for the difference.
A month later [now three months after the surgery], we received another bill from the hospital showing charges for “anesthetic” with how much the insurance covered, and how much we owed (since we no longer had a prepaid balance). I wrote them a check.
A month later [now four months after the surgery], we received another bill from the hosptial for “nursing services” apparently for the 5-hour use of their facilities and eating their lunch. This bill also showed how much the insurance covered, how much we owed, and I wrote them another check.
At this point my wife asked me how many more bills we were going to get from the hospital, whether our total amount was now larger than, smaller than, or equal to their original estimate, and why they couldn’t send us just one bill listing everything. I had no answers.
But with government care, it's essential. And you're going to pay for it, one way or another!