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After Surgery, Surprise $117,000 Medical Bill From Doctor He Didn’t Know
New York Times ^ | 20 September 2014 | Elisabeth Rosenthal

Posted on 09/22/2014 12:10:28 PM PDT by Lorianne

Before his three-hour neck surgery for herniated disks in December, Peter Drier, 37, signed a pile of consent forms. A bank technology manager who had researched his insurance coverage, Mr. Drier was prepared when the bills started arriving: $56,000 from Lenox Hill Hospital in Manhattan, $4,300 from the anesthesiologist and even $133,000 from his orthopedist, who he knew would accept a fraction of that fee.

He was blindsided, though, by a bill of about $117,000 from an “assistant surgeon,” a Queens-based neurosurgeon whom Mr. Drier did not recall meeting.

In operating rooms and on hospital wards across the country, physicians and other health providers typically help one another in patient care. But in an increasingly common practice that some medical experts call drive-by doctoring, assistants, consultants and other hospital employees are charging patients or their insurers hefty fees. They may be called in when the need for them is questionable. And patients usually do not realize they have been involved or are charging until the bill arrives.

The practice increases revenue for physicians and other health care workers at a time when insurers are cutting down reimbursement for many services. The surprise charges can be especially significant because, as in Mr. Drier’s case, they may involve out-of-network providers who bill 20 to 40 times the usual local rates and often collect the full amount, or a substantial portion.

(Excerpt) Read more at nytimes.com ...


TOPICS: Business/Economy; Government
KEYWORDS: deathcare; yourhouse4aspirin
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To: Lorianne

Similar thing in a smaller amount happened to a coworker of mine. Several thousand dollars for a guy to be in the surgery, who did 1 single thing; can’t remember what it was. Outrageous crap like this is why the libs think we have to gut the whole system instead of just fixing it and penalizing criminal over-chargers.


21 posted on 09/22/2014 1:18:40 PM PDT by vpintheak (Keep calm and Fire for Effect!)
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To: Buckeye McFrog

It may very well be propaganda.

However, after dealing with my parents’ medical situations and bills I know for a fact that they have been billed by doctors who never saw them or were involved in diagnostics behind the scenes. I have tracked these people down and confronted them on their bills and they have backed down.

This problem is rife in Medicare.

Another problem is hospitals not releasing records of what was done during a stay in the hospital ... test results etc. They tell the patient to “follow up with your doctor” after discharge but there is nothing to follow up with without the information. So the doctors have no information and have to re-order the tests ... sometimes this makes no sense since you don’t have the same problem after your hospital stay as during it.

I’ve had to keep detailed journals of what tests they SAY they are taking my parents out of the room to perform. There is no evidence whatsoever that these tests were performed and the medical records are difficult if not impossible to get to take to the regular out of hospital doctors afterwards.

In one case when my mother was in rehab I and other relatives noticed a man with a white coat come to the door of my mother’s room every couple of days, peer in, and leave. Then weeks later we received bills from some doctor who said he ‘examined’ her on 10 occasions at $111 per exam. Maybe his job is just to diagnose whether the patient was still living or not and he could determine that by just looking in?

The system is corrupt.

That is not to say that the New York Times might be engaging in propaganda ... but some of this stuff goes on I know for a fact. I never would have believed it if I hadn’t seen it for myself.

I really fear getting old and burdening my child with having to keep an eye on things for me when I’m ill as you should NEVER EVER under any circumstances go to a hospital without a personal advocate keeping track of what goes on, especially if you are older.


22 posted on 09/22/2014 1:18:48 PM PDT by Lorianne
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To: Lorianne

If you have medical power of attorney for your mom you should not have any trouble at all getting copies of all of her medical files. How do I know? I gave it to my wife and she gets a copy of everything plus the hospitals and specialist doctors send copies to my regular MD so he knows what is going on.


23 posted on 09/22/2014 1:47:28 PM PDT by B4Ranch (Name your illness, do a Google & YouTube search with "hydrogen peroxide". Do it and be surprised.)
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To: steve86

Yes, “Drive-by doctoring” has been around for a long time. When our first child was born in 1983, natural childbirth with no anesthesia, I was shocked to get a bill for a few thousand from an anesthesist - they claimed that they were on-call and available so they were entitled to the charge as if they had actually done something. I told the insurance they shouldn’t pay as there was no service nor anyone even in the room (our deductible had been more than met) but I believe they went ahead and paid. What a racket.


24 posted on 09/22/2014 1:57:45 PM PDT by LibertyOh
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To: Lorianne

In dealing with elderly patient bills, I’ve been dinged for $100 for a drive by follow up after surgery. And I’ve been successful in getting those taken off the bill. But $100,000 is a little extreme for an assistant surgeon.


25 posted on 09/22/2014 2:08:26 PM PDT by Vermont Lt (Ebola: Death is a lagging indicator.)
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To: Mariner

I’d still bitch about getting up at six for a 7:30 am surgery. Everything is relative.


26 posted on 09/22/2014 2:09:53 PM PDT by Vermont Lt (Ebola: Death is a lagging indicator.)
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To: Lorianne
I have seen instances when consultants are called in by the attending physician, such as an infectious disease ( ID) physician or a hospital intensivist. The ID physician mainly looks at your labs and culture results, and orders the correct antibiotics for the patient. They do an essential task, but when patients go home they do not remember the role this physician performed. They then complain to the hospital.
Or,they have had surgery, and the patients blood pressure runs high, or they develop some congestive heart failure. The surgeon is not going to manage that, he /she is going to call the intensivist to manage the BP or CHF issues.
Both instances would result in a patient not having an understanding of the roles those physicians have done in helping them. There are other specialties that also get called in to manage the care of a patient, without the patient knowing, but these consults are essential.
Therefore, the premise of this article is nonsense, and I have never heard of a $100,000 charge for a surgical procedure. .
27 posted on 09/22/2014 2:45:42 PM PDT by kaila
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To: Lorianne

These scams started in the 90’s after the government got so involved in Health care. They have been growing worse every day.

Just try going into a hospital and asking how much something is going to cost. They don’t have a clue if they wanted to. You could go in and get a few stitches and the bills will be rolling in for a year or more. You have a third party that bills you for the hospital physician because the hospital does not hire the physician’s directly. You have hospital fees. You have x-ray fees. And you will keep getting new bills for the several different doctors they have read the x-rays. It was not like that in the 80’s.

You have to get medical care in order find out what you will be billed. No other bushiness could get away with it. And no other business could get away with charging thousands of a percent over cost(Without disclosing ahead of time) for a procedure or medication. But they are doing it now.

Its like passing a law that gas stations do not have to post the price of GAS. You fill up your tank and go to pay and find out you just bought gas at $10,000.00 a gallon. Sucks to be you. Oh the law does not allow that. Unless you are a hospital.


28 posted on 09/22/2014 2:49:30 PM PDT by Revel
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To: Lorianne

“The system is corrupt.

That is not to say that the New York Times might be engaging in propaganda ... but some of this stuff goes on I know for a fact. I never would have believed it if I hadn’t seen it for myself.

I really fear getting old and burdening my child with having to keep an eye on things for me when I’m ill as you should NEVER EVER under any circumstances go to a hospital without a personal advocate keeping track of what goes on, especially if you are older.”

More than that Lorainne. To some degree it is pretty much standard procedure in many places these days. And perfectly legal as well.


29 posted on 09/22/2014 2:52:44 PM PDT by Revel
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To: Revel

The reason why hospitals cannot give a price quote with any degree of certainty is that every patient is different.
If my gas tank is new, does not need any work, filling it up would be a simple task.
If my gas tank has rust, it is difficult to open the cap, and therefore more problematic to fill up the tank, then the price should be higher.
As a nurse who has since the 1980s, the same thing happened back then. Multiple consultants are not a new thing.


30 posted on 09/22/2014 2:57:47 PM PDT by kaila
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To: kaila

I meant-
As a nurse who has been working since the 1980s...


31 posted on 09/22/2014 2:59:37 PM PDT by kaila
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To: Revel

Very well stated.

This is a huge problem that we are not doing anything to address. And like you said it’s been going on for a long time. Obamacare didn’t start it but my guess it’s not going to stop it either. If anything it makes the system even more complex and complexity invited corruption and fraud.


32 posted on 09/22/2014 3:13:58 PM PDT by Lorianne
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To: Lorianne

The system is not corrupt. You just do not understand it, and then infer that the people involved have evil intent.
Your example of your mother in rehab- that physician peering in was most likely managing her medical problems while she was there, ordering her meds, etc.
Upon discharge from the hospital, you stated there was no medical records available. A hospital is required to have a discharge summary. Your physician just needed to call the hospital, and get it faxed to them.


33 posted on 09/22/2014 3:25:37 PM PDT by kaila
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To: buckalfa

Anesthesiologists, CRNA’s, Pathologists, Cardiologists, Radiologist. the CRNA and the anesthesologis you will never remember form the operating room, same for a radiologist/cardiologist who is doing a reading.


34 posted on 09/22/2014 3:25:57 PM PDT by markman46 (engage brain before using keyboard!!!)
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To: kaila

farther back then the 80’s i saw lots of consults in the 70’s and the patient never remembers


35 posted on 09/22/2014 3:34:08 PM PDT by markman46 (engage brain before using keyboard!!!)
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To: markman46

They never do remember , yet without those consults, the patient would most likely have a huge risk of a worse outcome.
i am sick and tired of the physician haters. People who think they are corrupt and greedy.
The majority of physicians, nurses, PAs, etc. work hard, and take good care of their patients.
If you want to complain, complain about the government regulations that is making it increasingly more expensive to deliver care.


36 posted on 09/22/2014 3:48:31 PM PDT by kaila
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To: Lorianne

“you should NEVER EVER under any circumstances go to a hospital without a personal advocate keeping track of what goes on, especially if you are older.”

Truth


37 posted on 09/22/2014 3:52:12 PM PDT by combat_boots (The Lion of Judah cometh. Hallelujah. Gloria Patri, Filio et Spiritui Sancto!)
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To: steve86

Wifey and I have both had some relatively minor surgeries and procedures....and we’ve - beforehand - stressed firmly and to anyone within earshot that we do NOT authorize anyone or anything not approved by our insurance.


38 posted on 09/22/2014 3:55:30 PM PDT by ErnBatavia (It ain't a "hashtag"....it's a damn pound sign, number sign, or octothorpe. ###)
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To: kaila

I’m telling you my experiences.
It is not like what you are saying.

And there is corruption in the system (especially in Medicare) and it has been documented. Here is but one article on the subject

http://www.newyorker.com/magazine/2009/06/01/the-cost-conundrum

I did not infer that everyone in the medical system “has evil intent” .... but there is corruption.


39 posted on 09/22/2014 5:02:34 PM PDT by Lorianne
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To: Lorianne

I read the NY Times article. Most of the complaints in the comments were that patients were being treated by out of network physicians when they were in the hospital. That is not corruption, that is a problem with the system. However, there are so many different insurance policies that physicians cannot be on every policy out there. If a hospital forced physicians to accept junk policies, they will not keep their privileges there.

i also read that you stated that someone was peering in the door of your mother’s room, but you neglected to say why your mother was in rehab, and what her medical needs were. If she was in rehab, than I am sure she needed medical followup in rehab by a physiatrist and medical internists..

Third,no one wastes their time taking people to fake tests in the hospital. The nursing staff would revolt over that.

The article that you linked was interesting, but it was about a town that was above the norm in medical costs, it was an outlier, not the norm.


40 posted on 09/22/2014 5:30:25 PM PDT by kaila
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