One man's selflessness started an amazing chain-reaction that changed, and saved, a number of lives

If you've ever been hospitalized, you've been in my shoes.

Last fall I underwent neck surgery for degenerative disc disease that had resulted in several herniated discs, nerve damage and a compressed spine. The surgery was a success but some of the bills were baffling!

There were piles of paper, but not many details about what exactly I was being charged for. It turned out that in my case, a line by line, itemized bill was not automatically sent to me. I had to request one from Piedmont Hospital. Customer Service Manager Joe Ware explained why. "Generally we don't do that regarding inpatient care and neither do other hospitals because they can be very large, they can go up to 25, 30 or 40 pages," he said.

As Ware indicated, sending out only brief summaries is common practice among hospitals. We used Piedmont as an example only because that's where I underwent surgery and had access to the bills.

Once I got my itemized bill, the grand total was a little over$66,013.40!That was for a one night stay and a four level vertebrae fusion surgery. The charges included $22 for one sleeping pill, $427 for one dissecting tool, and $32,000 for four titanium plates and ten screws.

I brought it to Todd Hill, a fee based patient advocate who helps people decipher their medical bills. "The screws in your procedure were billed at $605 a piece for a total of $6050 dollars. We've seen those in our past research for $25 or $30," he said. "In this case, the markup is tremendous," he added.

Tremendous, perhaps but not illegal and not particularly unusual. The non profit consumer group,Georgia Watch conducted the Hospital Accountability Project in 2009 and found that in Georgia, hospitals mark up prices by an average of 300 percent. It says Piedmont Hospital is within that average. Other hospitals in Georgia mark up bills as high as 700 percent, or as low as 200. Ware said the inflated prices cover other costs like nurses and quality control, and also help pay for uninsured patients who end up not paying their bills.

Insurance companies, however, are given a hefty discount. Ware said insurers pre-negotiate those discounts in confidentialcontracts with health care providers. Consumers are billed full retail but due to their volume, insurance companies get a sale price.

For example, on my $66,000 bill, the hospital gave the insurance company a discount, (which is called an allowance) of $28,765. The insurance company paid a total of $33,499 and I paid $3748.

See the original post here:
Anatomy of a Hospital Bill: Who Pays Full Price?