Just got the medical insurance explanation of benefits for the AMS 800 operation at Virginia Mason Hospital in Seattle. They agreed to accept Medicare assignment of benefits...
Total Submitted Charges $74,055
Medicare Allowed: $15,264
Medicare Paid: $13,948
Supplemental Ins Paid: $1.316
I Paid: $0
Jeesh, our healthcare industry in the U.S. is crazy... If I did not have insurance of any kind I would have been billed $74K???? They wrote off $59K for Medicare???? Crazy business for sure!
OT, but since you brought it up: One thing I wonder is, did the hospital appear to be going out of business?(Was your surgeon's bill separate from the above? Does he seem to be doing OK?)
Either way, how long were you in surgery? Now comparing to real life situations and what most people earn per hour, the $15,000 dollars that was paid for you, what kind of hourly rate does that work out too? Also keep in mind that most likely that was a multiple room surgery suite, with anywhere from several to 10 or 20 operating rooms, each running with maximum assembly line type efficiency for at least an eight hour day, five days a week. I guess what I'm getting at is: these guys can still make a profit–and a mighty good profit–even at only $15,000 dollars for your surgery. If they could not, they would not accept Medicare or Medicaid anymore.
Just before I retired, I worked with(did the anesthesia for) a dentist/oral surgeon who would come to a small rural hospital to pull all of the rotten teeth out of mostly children and replace with dental implants and the occasional adult( up to age 26?) who still lives with their mother and was on her insurance. All of these were Medicaid cases, and Medicaid paid the dentist/surgeon $400 per case, his work on each case from 10 to 30 minutes. And the surgery center and anesthesia had their separate charges.
Now if you or I needed this done on a cash or private insurance basis– I'm sure he would charge several thousand dollars or more just for his fee, or maybe $5K or more total if done at his office. But this guy was willing to drive a couple of hours from the large Mississippi town he lived in, usually with some office staff to assist him. And he would do anywhere from 4 to 15 cases. I don't know how he did it, but somehow the man eked out a living at a mere $1600 to $6000 a day(8000 to $30K per 5 day week, though he probably only operated 3 or 4 days) . And he was even willing to travel in order to do that–he traveled from the big city to several different rural hospitals around the state most weekdays. It was only a small fraction of what he would've been charging to non-medicaid cases, but somehow he got by.
Post Edited (BillyBob@388) : 3/31/2017 9:42:02 AM (GMT-6)