The Mystery of My Medical Bills (I may be a Cyborg)

The birth of Toddler BITA nearly three years ago left me with an umbilical hernia. On the 26th of January my hernia took issue with a section of my intestine and attempted to strangle it to death. This is the story of that ghastly attempted murder, and of the baffling bills that followed. I might rant. I intend to try not to, but I make no promises.

The Attempted Assassination

I started to get cold and clammy (a.k.a going into shock). The bulging section in the area of my umbilicus where my hernia was attempting to assassinate my intestine started to turn blue. Mr. BITA was about 45 minutes away at work, and my mother, who was visiting at the time, decided to call 911. Soon we had paramedics and firemen swarming around our living room. They attempted to get an IV started to administer some morphine but were unable to get a vein. Eventually they popped me into the ambulance and away I went on my first ever ambulance ride.

 

Mr. BITA met me in the ER, where I lay shivering uncontrollably. I threw up more than once. It took five attempts by three different people before they managed to find a vein and get some blessed painkillers into me. Two hours later I was in surgery. The brave surgical team rescued most of my intestine from the villainous clutches of my hernia. Four inches had to be sacrificed for the greater good. They also stitched up the hernia, and with any luck, it will never bother anybody ever again.

 

I spent the night in the hospital, and was discharged just after lunch the next day, with a prescription for painkillers. I was on a liquid diet for one week. I lay about at home being pampered by my mother and my husband. My toddler was not impressed by my inability to carry her for over six weeks. She did very much enjoy looking at my scars though, and frequently asked for an audience with my abdomen.

 

Time passed. I healed.

Then the crazy medical bills started to trickle in. Oh boy.

 

The Cost of the Ambulance Ride

The first part of my medical adventure cost $2,226.43.

Crazy medical bill #1

The hospital the ambulance took me to is 2.4 miles from my house. They appear to have rounded that up to 3 and charged $50/mile. As I mentioned above they attempted to get a vein. They did not succeed. Nevertheless, I had to pay for all the supplies that were used. So be it.

I did as directed, filled out my insurance information, and returned the bill to them with a copy of my insurance card. Three weeks later they sent me the same bill again. Mr. BITA called them and they said that they did not have a relationship with my insurance company. “We are not contracted with your insurance company”, they said. They had forwarded my bill to my insurance, but had no idea what if anything would come of that, had no way of tracking it and they considered us on the hook for the entire amount. Mr. BITA then called our insurance company. They assured us that they would be paying the lion’s share of the bill, but not to the ambulance company. We needed to pay the ambulance folks the $2,226.43 and they would send us a cheque for whatever they covered.

We did as we were told. Eventually we received a cheque for $2,003.78 from our insurance company. My initial reaction was one of relief. We only had to pay $222.65. Then I read the explanation of why I had to pay $222.65 and the artery in my head started to throb warningly.

 

The ambulance provider was out-of-network and I was charged accordingly.

The fucking ambulance that shows up in response to a 911 call is out of fucking network. I had no choice in the matter. There isn’t another emergency number I can call. When I called 911 they didn’t offer me a menu of ambulance services to choose from. How can an essential service, and one with a sum total of zero choices, be out of network? What the everloving fuck?

 

Bills from the Doctors

The next couple of bills to trickle in were the charges of the various doctors who had cared for me that day.

In some cases caring is perhaps overstating it just a tad.

Take this bill. The ER doctor charged us $667.

Crazy medical bills #2

 

Why Mrs. BITA, you say, I am surprised at you. Why do you begrudge this poor doctor his slice of the cake? I’ll tell you why. The ER nursing staff were heroes. The ER doctor, on the other hand, not so much. He popped his head around my curtain and said, “Could you lift up your gown please?” I did. He was standing about three feet away from me. “I’ll call in the surgeon”. Then he left and was never seen nor heard from again. He spent about 30 seconds three feet away from me. He never touched me. And for this he charges $667? What a fucking joke. I take small comfort in the fact that he didn’t get the whole $667. Insurance only coughed up $407.42 and we paid $45.27. I still think he was grossly overpaid.

 

The next bill was from the anesthesiologist. We were charged $2,394.

Crazy medical bills #3

I don’t begrudge him a dollar. He had an excellent bedside manner and knocked me out most successfully. That isn’t the whole story though. I did not react well to the drugs, and I came out of anesthesia fighting. My first hazy memory as I swam into consciousness is of hitting the anesthetist as he tried to hold me still. Once I was fully awake I wanted the ground to open up and swallow me whole. I apologized profusely and he brushed off the whole incident saying that this “happened all the time”. Yep, he earned his money. After insurance did their bit, we are on the hook for $149.37.

 

The Hospital and Insurance Play Numberwang

We then received a bill from the hospital for $6,712.

 

The back of the bill was blank because of course, it is completely normal to charge someone nearly $7,000 for something and to neglect to itemize or explain what the fuck the charges include or how you came up with the magical figure of $6,712. Mr. BITA got on the phone again and asked for an itemized bill.

We received a four page bill a few days later. The first three pages are filled with tiny print and are chock full of illuminating nuggets such as

27B162 0718 454610 1 SET PRIM INFS PORT 22M        $148.00 and
27B162 0718 454607 1 SET ADM IV MX+MNBR 40I        $28.00

Thank you very fucking much. This is exactly what I had in mind when I asked for an explanation of the bill. Everything is as clear as mud now.

This is page four of the detailed bill.

No, your eyes are not deceiving you. That is a bill for $152,313. My artery started its rhythmic pounding again.
A few days later we receive this explanation of benefits from our insurance provider. The dictionary says that an explanation is a “statement or account that makes something clear”. I would say this would more accurately be described as an obfuscation of benefits.

If you think those numbers don’t add up, you’re not alone. $134,337 just disappeared and was never heard from again. Here is some more funky math from page 3 of the explanation obfuscation.

Why, thank you. That cleared it right up. Obviously $82,407 – $0 = $0 in the alternate universe where the rules of numberwang mathematics apply.

And are you curious about the over $82,000 worth of sterile supplies for my laproscopic surgery? Well, sucks to be you. You, and I, are shit out of luck. We’ll have to take our curiosity to our graves. Maybe they removed all my organs and replaced them with sterile supplies? Maybe sterile supplies is code name for a top secret biomechatronic body part and I’m now actually a cyborg? One can only speculate.

 

In Summation

We have emerged from our medical emergency relatively unscathed, both in body and in pocket. Our out of pocket expenses total $3,379.39 and we have suffered no long lasting damage other than the strong urge to smack someone hard upside the head. We have an HSA. We will not be raiding it to pay these bills. We will pay out of pocket, let our HSA grow unmolested, and file away the insanity to claim at a later time. I can’t wait to pull these bills out twenty years from now to claim from my HSA and get my artery going all over again.

28 thoughts on “The Mystery of My Medical Bills (I may be a Cyborg)”

  1. I’m stressed out now having seen all these confusing bills, and they’re not even mine! These are some of the fundamental issues that need to be addressed in the U.S. healthcare system if we want meaningful change. Not only are some of the charges absurd, but there’s zero transparency. Patients have no idea what’s covered or how much things will cost. You can’t even tell what you paid for even with the itemized bill! Anyway, I’m glad you had decent insurance coverage. These are the kind of incidents that ruin people without health insurance overnight.

    1. I’m very grateful for our insurance. I am lucky, and I know it. I can’t imagine what it must be like to be assaulted by these giant indecipherable bills without solid insurance in your corner.

  2. I received a mystery bill for $800 many months after my husbands surgeries and ICU stays, when I though I had paid it all (and paid, and paid, and paid…). I made the mistake of asking for an itemized bill. Now, two surgeries, an ICU stay, a hospital stay, a lung drain, an abscess procedure, a wound vac, tons of drugs, etc. make for one heck of a bill. It was literally a book, and filled with all kinds of things that I couldn’t tell what they were. Luckily the hospital waived the $800 after we called. Glad to hear you’re doing better.

    1. Your bills are a Goliath to my very modest Davids. Given how much stress you were under at the time, you should be proud you did not turn homicidal. They would certainly have had it coming, and a jury of your peers who have received similar bills would have acquitted you in a heartbeat.

  3. You have the a slightly different type of mud from us in NL, with the same transparancy.
    Sometimes, if you’re a creative thinker, you can guesstimate what the item might hint at (IV might be some tools or action to find veins and put medicines in your blood. I would not hold my breath finding out there is also a I, II and III of the the same item, though)
    We have DBC (Diagnostics Treatment Codes if I translate the dutch to a language that might clarify it a bit more). They are the names docter-administrators have come up with to describe a treatment (incl. all its services of every level, and its tools, etc). It has a fixed price. However. 1 visit to the doctor might be part on 1 DBC, 2 visits to the docter might be part of 1 DBC, but 1 visit to the doctor might also be covered by 2 DBCs. And the names are only slightly less cryptic than on your itemized bill. Wanna swap systems?

    Insurance companies still think that by seeing these names and numbers, patients can hint when frauds are happening in hospitals. Lovely thought, great ideal to strive for, but my crystall ball (nor my googling experiences as a data scientist) have a high enough wizard level to tear though the mud.

    1. My sister lives in Amsterdam, but both she and her husband are (knock on every wood object in vicinity) very healthy so I’ve never heard about the Dutch medical system from them. Would a similar kind of procedure there end up costing you about the same out of pocket? Or are there lower caps on what you would pay? Is the entirety of the DBC cost paid by you or is it split between you and your insurance company?

      I’m always curious about how health insurance works in other countries and we hear such good things about medical care in Western Europe.

  4. Oh the joys of medical billing in the U.S. Someone, anyone, please help us! This system sucks and there’s no transparency on the bill itself and billing administrators at the hospital asare just useless in my experience.

    Thanks so much for sharing all these glorious details as we are about have fun with the system ourselves… Baby#2 will be here any day now.

    1. When Toddler BITA was born I was so happy/distracted/sleep deprived that I paid no attention to our bills. I just paid what we owed and never gave it a second thought. This time there was no adorable baby to distract me. All I had to show for my surgery was some missing intestine and a few tiny scars. Plenty of willpower left over to attempt to understand the bills, and definitely enough surplus energy to rant and rave.

      While I am sure your upcoming billing will be about as ridiculous, at least you’ll have a baby Swan to show for it. All the best – I wish you a short labour and an uneventful birth.

  5. I share your frustration, Mrs. BITA. It makes me crazy when we get charged obscene amounts of money by the hospital and don’t get to know why. The lack of transparency has got to be part of why the costs are so obscene. Our hospital doesn’t even have a number you can call to talk with a live person about your bill. I was charged $2000 for a procedure that my doctor ordered me to have and didn’t explain–turns out, it was a procedure that was not necessary and that I would not have elected to have done if given the opportunity to do a cost/benefit analysis. Thanks for this honest post!

    1. I would have been livid if I was tricked into doing a $2000 procedure. That is ridiculous! Did you ever confront them?

  6. I’ve got a similar story, my wife got dehydrated at the horse races and the EMTs wanted to rush her to the hospital that was literally across the street. We had already given her Gatorade and she was feeling better but the race track didn’t want to be liable, so they called and ambulance against our consent and rushed us across the street. We spent less than 10 minutes in the ER, the doctor walked in and said “well you look fine, why the hell are you here? Go home, We left, then 2 months later we were hit with multiple bills totaling over $4,000 and cost us about $1,750 out of pocket, for literally no medical care! Also 8 months later I got another bill from the hospital for services by a random doctor we never met for another $150. The cost was so small it wasn’t worth my time to fight it, but when I called to pay the bill they said it was sent to collections. I’ve called the collections company many times and they don’t seem to have a record of the bill. Fun times.

    I’ve talked to my doctor friends about the ridiculous costs charged by the hospitals, and the “discounted” prices if you have insurance, and they seem just as frustrated by the costs as well. It seems to be a convoluted system that is broke and the business side of the hospitals don’t want to take the time and effort to revamp the price structure because they are raking in money.

    1. Oh ugh. $1,750 is a metric ass tonne to spend on nothing at all. If the comments on this post are any indication almost everyone has a ‘I got ripped off’ story. What a sad state of affairs. I don’t know exactly who all are to blame for this shit show, but it makes me happy to imagine that there must be a special place in hell reserved for anyone profiting from this madness. I’m thinking maybe daily baths in boiling oil and having someone read the Twilight books out loud to you for twenty hours a day.

    1. As long as my cyborg bits don’t make airport security an absolute pain the ass, I’ll be a happy panda.

  7. Insane! It’s amazing how many people just pay the bills and never actually look at them. Well, I just checked my bank accounts to see if that $134,337 might have magically wound up in my accounts but alas I see nothing. Bummer – I guess that’s why they say easy come easy go. I’m so glad you came out of this ordeal and thank goodness your mom was there to help!!

    1. My mother was a life saver. She kept the gears of our life well oiled and running smoothly (and our stomachs full of tasty home cooked meals).

      I don’t blame people for not looking. What is the point when even when you do look as hard as you can nothing makes sense and the bills don’t follow any known laws of mathematics?

  8. Scarily enough I’m looking at your bills and I’m slightly jealous cause comparatively my insurance stinks. Our last visit at the hospital was baby birth. 6k out of pocket later our second baby was born. The actual bill was in the 20k range. 20k for 2 days of a hospital room, 2 meals, and 20 mins of pushing (quite literally). One can only imagine what the bill is with a problem birth without insurance…

    1. Oh ouch. Our bill was nearly 35k for the birth (She was born 56 minutes after we pulled up at the hospital, a vaginal birth and I used zero pain medication). We only ended up paying around $2500 out of pocket though.

  9. That’s just unbelievable… At school, we have to account for every damn penny these days. And people double and triple check every thing we do that relates to the use of public funds. It was annoying at first, but it certainly helps with transparency! I wonder what they would do if you challenged certain charges. The lack of details would make it an interesting conversation. This is one of the reasons I like what they are doing at Amino.com. It wouldn’t help with an emergency situation like this – but it’s time for people to start asking questions and better understand all of these charges. Most importantly, glad you are feeling better!!

    1. Another one similar to Amino that I heard about on NPR is guroo.com. I’ve never used either service myself (I’ve incurred medical bills only twice in this country – once for Toddler BITA’s birth and this was the second time). I’m glad these folks are working on bringing some small measure of transparency to this mess.

  10. Yep, I think you were definitely abducted by aliens and this is all just hush money to keep someone quiet.

    Luckily we’ve only had to deal with a couple of unexpected hospital visits and the billing is always a nightmare. Make me think that Enron’s accounting wasn’t so bad after all.

    Glad to hear you are doing better and still have a sense of humor.

    1. When aliens and abductions are mentioned I am immediately reminded of the Southpark episode where Cartman is abducted and probed by aliens.

      I think some hospital accounting departments produce more fiction than James Patterson.

  11. The healthcare system here is broken…I have no idea how to fix it though. I work in government and I’m gonna say that I’m pretty spoiled with great health insurance so I am very lucky. The medical bills and lack of transparency is totally outrageous. For our first child, the doctors kept sending my wife back home saying she was not ready to give birth. They were wrong because the 2nd time we went home…the baby decided to come! There was no time to go back to the hospital and my wife basically delivered the baby herself. I called 911 and mama and baby were taken to the hospital via ambulance. They gave us TWO bills for the ambulance…one for my wife and one for the baby…and both bills charged for mileage! I made sure the hospital didn’t bill for delivery…that’s for sure.

    1. Oh holy fuck! First of all, kudos to your wife. I would have had a heart attack at the idea of having to handle the birth by myself at home. What a story your first born is going to get to tell!

      I can’t believe they tried to bill you twice for ambulance mileage. Oh wait, no, given how broken the system is, actually I can.

  12. I was terrified to read this post once I saw “umbilical hernia”, the very diagnosis I received two weeks ago when I suspected appendicitis. I was fortunate to go home unscathed with pain magically vanished, but I’m a bit freaked to imagine this lovely thing rearing its ugly head some months or years from now. So glad you’re coming out of this ordeal healthy and financially fit! What a ridiculous billing fiasco. Perhaps you really are a cyborg 😊

    1. Oh no. Be careful with it. I had a couple of episodes where it hurt, and then resolved itself. I even had it seen once about a year after the birth. I was told that the surgery to fix it was elective and that the recommendation was not to bother. I should have bothered.

      Here is the other thing: if I had had it done as an elective surgery, they would have fixed it with a patch. As an emergency surgery with the intestine involved, they could not put a patch in because the area was considered contaminated. A patch fix has a much higher chance of success than a fix without. I was told that the chances of my hernia not recurring were only 25-50%. Those are sucky odds.

      I hope that your hernia turns out to be of the laid back chill variety and is not of the same murderous stock as mine was.

Leave a Reply