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Insurance Hell All insurance-related matters are here: Medicare, worker's compensation, appeals, denials, insights, wins, losses. PRICING is here too. Note: This forum has posts from 2006 forward. Older ones are in the Big File.


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Old 07-05-2011, 10:42 AM
winecaptain winecaptain is offline
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Join Date: Nov 2010
Posts: 22
Default $52K Hospital Bill, $12K BCBS Approved

With all of the travel overseas to get these procedures done, it baffles me that I just reviewed my EOB and for the hospital portion, BCBS (it was a BCBS approved facility) covered $12K of a $52K bill and the rest gets written off. I understand hospital economics very well, however I wonder if shrewd negotiation could result in comparable (or even lower) cash pay pricing in the US could result in lower costs than European hospital visits at 25K Euros. One might think that a call to a local hospital CFO may allow a cervical disc replacement here in the US for some number near what they accept from BCBS. Even if it was $15K it would still provide a substantial cost savings as compared to an overseas trip... I have not seen the EOB for my physician and will add it to this post. My other charges (radiology, etc) have been approved at a combined ~$1,000. I will tally up all of the bills and approval amounts and post here when I get it all together. As we all know, the big bill is the hospital (which includes the Prodisc-C and it was $52K with a $12K amount covered by BCBS (providing a $40K loss or write off)...
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41 y/o Male, Successful Disc Arthroplasty Procedure (Prodisc C in Tampa, FL) with excellent outcome June 2011... January 2012 had 3rd episode of "throwing out my back", Lumbar Pain radiating down buttocks and into both legs, MRI shows centrally Herniated L5-S1, Bilateral S1 ESI scheduled beginning March 2012...
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