Procedure Billed As Cost --------------------- ---------------------- ---------- Micro-ETS David H. Nielson MD $ 11463.00 * Hospital Charges Baptist Health System $ 3400.00 Pharmacy Armstrong Pharmacy $ 45.25 X-rays and Anesthesia Star Anesthesia $ 2640.00 ========================================================== Total cost for Surgery $ 17548.25 * Even though Dr. Nielson's receipt shows a charge of $ 11463 for his "Micro-ETS", it seems that he bills the surgery as 2 separate surgeries (one for the left side, and one for the right side). I remember him telling me that some insurance companies will only cover one side and it's hard to tell until they're billed. If my insurance company was one of those, Dr. Nielson agreed to only charge for one side (otherwise I'd end up paying $ 6000 out of my pocket). Tracing out my insurance statements, it looks like my insurance company only paid for one side. The insurance company promptly paid the first claim by Nielson (for one side). The next claim for the other side they considered it a "duplicate claim" so didn't pay it. Nielson's office sent another claim for the unpaid side and again, the insurance company didn't pay. So as promised, Nielson didn't pursue it further. At first, this caused me to believe that Nielson charged for three sides which drove the total cost up to ~ $ 24000. In any event, the numbers above are for what Nielson would have charged in the summer of 2000 if the insurance company paid for everything. In reality, the surgery cost about $ 6000 less than stated above, and I ended up paying only $ 1073.85 out of pocket. Here is what I had to pay out of pocket (what my insurance company wouldn't pay): Nielson made me pay $ 600.00 Hospital made me pay $ 428.60 I had to pay for Meds $ 45.25 =================================================================== Total out of Pocket $ 1073.85 |