I Want To Know How Much It Costs!

As I sat in the hospital the other day, I was again reminded of how frustrating it can be to deal with financial matters relating to health care.

“How much does that procedure cost?”

Have you ever asked that question at a doctor’s or hospital office?

I have rarely received a straight answer.   In fact, most times the individual responds with a shocked look and then responds with an answer like, “I don’t know” or “I have no idea”.   Even worse, I get this response: “It all depends.”   To which I respond, “Just tell me an average amount I should plan for.”   I then receive the worst response ever, “It all depends on your insurance and care provided.”

I just want to know how much it costs!

Believe it or not, my doctor actually had a set number for cash-paying customers.   He even gave a discount for pre-payment of the fee!

Can you imagine going into Wal-Mart, picking up a gallon of   milk without seeing or being able to obtain a price?   Then at the checkout, it would be a magic formula of one part random fees, one part insurance company garbled language and rates, and another part how nice you spoke to the person?

Tell me about your experiences with hospitals and doctors and their clarity of fees.   Am I the only one?

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  1. Gail Parmentier on February 10, 2010 at 4:27 pm

    Joe, I have had that issue in the past. Not recently, but in the past yes. Maybe this is where part of the healthcare reform needs to come in. 🙂

  2. Steph G. on February 10, 2010 at 4:45 pm

    I now work in a hospital in admissions and it is unfortunately true that we are at times unsure of how much it will cost. Some doctors have a set all inclusive cost for certain things, pregnancies are one of them. You pay X amt and it will cover all of the visits you must make. However, for most surgical procedures you may receive a ball park estimate but it does ultimately come down to what all happened in the the procedure and how much you insurance covers, which includes where you are on your deductible and out of pocket costs. When I had my sinus/septoplasty surgery the final hospital bill came out to $21K and my insurance covered everything so I didn’t owe the hospital anything. However there was around a couple of hundred dollars that I had to pay out to the clinic that the doctor practices from to cover the doctor charges. So all in all, my $27K surgery only cost me a couple of hundred dollars which was better than the couple of thousand I thought I would have to pay. It is a bad deal, but unfortunately most people don’t realize that most hospitals operate on a 3% margin. So it seems expensive but there are a lot of variables into why it is that way. Hope that helps some.

  3. Marion Karr on February 11, 2010 at 1:46 am

    This is a question my wife and I have begun asking now that we changed from a traditional healthcare insurance plan (that was costing us $1300 a month to cover a family of 4!) to a health savings account plan. Even though we have a much higher deductible and all services are out of pocket it does come out of a tax free savings account. Even if we pay our full deductible this year we are still going to save over $2000 this year.
    Because we are going to have to pay full price we will be keenly focused on what that dollar amount is going to be every single time we walk into the doctor’s office.

  4. Juli on February 11, 2010 at 4:52 am

    AMEN brother! I had carpal tunnel surgery on both hands in Nov and Dec. I do have insurance but tried my hardest to find out exactly what I would owe after I had met all my deductables and so on. I also tried to verify that everything would be covered and I wouldn’t have any surprises. This is what I discovered. Because I did not need “approval or an approval code” for my procedures I was not ever 100% sure that it would be covered. The insureance co. said they thought it would be covered, but then again they don’t guarantee covereage over the phone. I had to take them at their word. Then I called the Doctor and tried to figure out about what to do when I owed a balance after the surgery. He said not to worry about it, that I could set up a payment plan with them. Really? A little unnerving, but it all worked out. I actually ended up owing less that I thought and I was able to set up a 6 month payment plan to pay off the balance with them. Yep, unfortunately, I didn’t have the cash to pay off the balance, but it worked out. It was still scary to have all that uncertainty though.

  5. Jackie on February 11, 2010 at 6:05 am

    Hi Joe – 1st, congrats on your new baby! I’ve never written before but read your posts. I met you at Grace Community Church in Clarksville TN when you came to speak. This subject hits a raw spot, so here I am! I had gall bladder surgery last December and thought I had a great health plan (I work for a big pharma company). The hospital gave me a 25% discount if I prepaid them, and my portion was only $125 which I didn’t think it was too bad..and I think my portion for the surgeon was $30. But for the last 2 months I’ve been getting bills from here, there and everywhere..for itty bitty amounts. Two different ones for Anesthesia (how many Drs. does it take to knock me out?) One from Radiology for $5.72..and the list goes on! I agree with the above, healthcare does need to be reformed, but not by ObamaCare! I made a few phone calls, but it wasn’t worth my time to haggle on these – so I paid them. But can you imagine how much fraud can be going on? Anyone could send me a bill for $10 or $20 bucks and I’d pay it to get it off my desk! This was same day procedure in one building (the surgeon’s office was even there!) so after you bill my insurance, send me one bill, done, over, finished. There’s gotta be a better way to consolidate services and be able to tell you up front what your total cost will be! Reform should be the Health Plans, and Doctors billing departments, and hospitals all sitting down and coming up with a plan on consolidation – leave the government out of it (and I’d love to sit on that committee!)

  6. Gail Parmentier on February 11, 2010 at 6:49 am

    Oh Jackie, don’t get me wrong. I certainly AM NOT a fan of ‘Obamacare.’ If I wanted to live in a socialist country, I’d move to 1. I like your idea ~ get the docs, insurance co. & billing departments together & leave the government out of it. I think the gov’t THINKS they have to stick their nose in it because they think those parties wouldn’t be able to effectively come to a conclusion. And that my dear friend is a sad state of affairs. Thankfully we serve an awesome God who owns the cattle on a thousand hills.

  7. Jay on February 11, 2010 at 6:57 am

    This is year 2 for our family in a HSA. One of the goals of this type of insurance is to make healthcare consumers out of us. When a 3rd party pays do we really care what it costs?? Let’s keep asking “what is this going to cost me?”. I believe the more we act as wise consumers we’ll reach a tipping point where providers will respond. The arrogant providers that don’t we’ll move our business to the responsive.

  8. Lisa Whitener on February 11, 2010 at 8:54 am


    Have you tried to find out what the cost of a prescription is with and without certain insurance? I worked for an insurance company when the whole Medicare RX program started. Trying to help the elderly figure out if they are better off with a plan and what plan is a nightmare. Now there are websites available to comparison shop but how many elderly do you know that have internet and can use it? I know a lot of them do but there are tons who don’t.

    The reason is that the base rates change depending on the contract the pharmacy (and in your case, hospital) has with each insurance company and the way the facility codes the procedure/medicine. But I’m not even sure that is the brunt of it. Otherwise, they could easily say, “oh, BCBS insurance? It costs $xxx. Oh, Humana, it costs $xxx.” But they don’t/can’t.

    The insurance company won’t tell the facility how to code it either. The facility has a book of codes they must go by. So, depending on how the facility codes the procedure, the rate the insurance company has agreed to can change.

    It’s really great if you have an agent that can help you sort it all out. For example, we had a guy that had a sleep study that was rejected by his insurance company as an uncovered procedure. Well, it turns out that the specialist’s initial consultation had been billed as part of the sleep study. That office visit was covered but the billing clerk didn’t know how to find the different codes in her book. The insurance company told me that they couldn’t tell me the codes but that yes, there were two codes and it needed to be re-billed. Our customer would’ve had to pay all that bill if we hadn’t gotten involved and gotten it re-billed.

    So much we, in general, don’t know…….

  9. Joel on February 11, 2010 at 9:49 am

    Hello all,

    There are severl problems here. One I took experienced this although I was sick with a cold called asked how much since at the time I didn’t have Health Insurance. I was Told $89. I get to my doctors office and I asked again before filing out the paper work I was told $129. Hmm I said thats different than on the phone, Well we will be running a few tests so thats brings the amount up. OK?? I saw the doctor and went to pay, I was then told my bill was $169. I was like whoa wait a mint argued to no avail and paid the $169. I also put at the bottom of the check paid in full. I’m glad I did cause then they tried to bill another $55. Now When I obtained health coverage for myself sometime later I did my research. I found out that basically the Insurance Company and the Healthcare personnel already know what the charge will be and you should as well. Google Usual and Customary Charges, Then call your Insurance Agent (if he is worthanything he should know this info), review your plan, Next call your doctor and go over with the office personel. IF you don’t know what your going to be charged after this, replace The party that wouldn’t give you the info. If neither your agent nor you doctor did what you asked, replace them both. Thats IT PERIOD! Remember they both work for you.

  10. Joseph Sangl on February 12, 2010 at 7:00 am

    Great conversation everyone!!! Now … what can each of us do to address these issues????

  11. Dee on February 13, 2010 at 10:17 am

    Hi Joe, I don’t think we can plan on decent health care reform. Too much polictics, too much money to be made in sick care. People need to get educated. I suggest, getting a High Deductible Health Plan and a Health Savings Account which will allow you to manage your money instead of the insurance company by keeping your premium down. Know the health care professionals that you use, interview them, someone said it earlier, they all work for you. Shop pharmacies. Most importantly take care of yourself to avoid additonal medical costs. Exercise regularly, eat more fruits and vegetables, less fat and sugar, manage your weight and cholesterol yourself. Take Juice Plus, fruits and veggies in a capsule! Fruits and Veggies are proven to help your body heal. If we would take responsibility for our health most of our medical costs could be planned and manageable, ie pregnancy, annual wellness checkups. Of course emergencies can happen which is why we have our emergency fund!

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