online hospital pricing

[bolus]

Here's the OHSU price link. Scroll down to hospital price list and they have three different spreadsheets, procedures, medications, and surgical supplies. Kidney is only $65,000 at OHSU, what a deal!!

Billing and Insurance

Thanks

damn.... Tisagenlecleucel (who the hell comes up with these names?) medication costs $712,500

Hello there, $75,000 heart valve


I looked up some of the procedures I used do as a resident getting paid about $8/hr. One catheter I used to put in in the ICU costs $3700.

 

[partsed]

Put me down for the tylenol suppository. Mere pocket change.

It is amusing when the first thing the nurse does is scan your wristband and the then each packet of medication that they are giving you!!
Bleep!! $6.00 aspirin, Bleep!! $1.00 tissue

 

[NW Backpacker]

All US hospitals are supposed to put up there prices online starting yesterday.
View attachment 533912

I like the idea of posting the costs online. Should be required for all hospitals, clinics, doctors, and dentists, broken down by insured, cash, etc. That should result in price competition that will drive costs lower. If prices don't start going down then we WILL get single payer - people aren't going to put up with the outrageous costs much longer.

Insurance is part of the problem - people with good insurance don't care how much it costs because they don't pay it. Another problem is probably government - I heard that in the old days the doctor was paying 2 or 3 other people, and today he's paying 16 other people! Not sure how much malpractice litigation adds to the cost, but could be significant. EDIT: And the ACA is a huge problem - when you are forced to buy a product, or when the government makes one system the only option, then they can charge anything they want and we have to pay it.

Other things I'd like to see:
>Free market health insurance sold across state (even national) borders with no government rules (for those who don't want ACA policies). I think the insurer's would come up with good catastrophic plans that are affordable.
>Required to give cost estimate to patient when they set the appointment. Today, people in the office don't know costs - you have to call billing for that info.

 

[No_Regerts]

We need something like True Car for hospitals. True Doc. Just plug in what you need and you get an itemized bid from 6 local docs.

 

[ob1]

Today, people in the office don't know costs - you have to call billing for that info.

In my experience, as it is now in the ACA reality, I don't think anyone knows what the bottom line is (or if they do, they won't admit it). The primary physician says that's not my job, ask the billing department. The billing department says you need to ask your insurance carrier. The insurance carrier says we can't tell you without detailed coding information submitted by the physician (which can take days or weeks and making another doctor appointment just to get) Meanwhile, if you are faced with an urgent condition, you can be faced with the choice of just getting a procedure done and hoping it won't turn into an astronomical bill.

rope-a-dope
/ˈrōpəˌdōp/
noun
INFORMAL•US​

1. a boxing tactic of pretending to be trapped against the ropes, goading an opponent to throw tiring ineffective punches.​

The term "Good Insurance" fascinates me. If that is defined as insurance like the "way it used to be" before the goobermint got involved, (where you could get covered without a massive deductible or an equally draconian premium), where is that to be found ?

I am not putting this all on the insurance carriers. After all, insurance companies are not and never were intended to be charities (despite the apparent concept fostered by many). The changes we have seen are a natural reaction to the additional wish list requirements thrown on them by the ACA drafters. (But...I can now get free birth control pills and sex change coverage...yaaahoooo)
Let us not forget the immortal Christmas Eve comments made by Nancy Pelosi upon the passage of the ACA........

House Minority Leader Nancy Pelosi said of the Affordable Care Act, in 2010: "We have to pass the bill so that you can find out what is in it."

 

[NW Backpacker]

In my experience, as it is now in the ACA reality, I don't think anyone knows what the bottom line is (or if they do, they won't admit it). The primary physician says that's not my job, ask the billing department. The billing department says you need to ask your insurance carrier. The insurance carrier says we can't tell you without detailed coding information submitted by the physician (which can take days or weeks and making another doctor appointment just to get) Meanwhile, if you are faced with an urgent condition, you can be faced with the choice of just getting a procedure done and hoping it won't turn into an astronomical bill.

​

The term "Good Insurance" fascinates me. If that is defined as insurance like the "way it used to be" before the goobermint got involved, (where you could get covered without a massive deductible or an equally draconian premium), where is that to be found ?
QUOTE]
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MY REPLY - CAN'T GET IT OUT OF THE "QUOTE":

My experience (trying to determine MY cost before having a procedure done) has been exactly as you describe.

Yes, by "Good Insurance" I was referring to employer-provided insurance with a deductible of say $1,500 before the ACA back when premiums were fairly reasonable. Kind of like $500 for a decent 1 bedroom apartment in those days. Or a new Ford Ranger for less than $10K advertised in the paper.

But inflation is low, right?

 

[CoastRange57]

I had a knee replacement 10 days ago and was back in two days later for 4 days with a bowel obstruction. I know the knee was $ 50,000 plus and who knows what the obstruction was.

Maybe I should has issued an RFP and taken low bid. Naw, insurance got this one so I don't really GARA. The older I get, I only want to be healthy and mobile. But being in the hospital, the bean counter in me looks at where the money is pissed away. It is pissed away on finger cut transports and emergency room visits by homeless people who clog the system to get a meal and warm room for a while. Saw at least 4 of these in the 6 hours I was in the ER last week.

 

[CoastRange57]

I cant find OHSU's either. knowing them, they buried it as far as possible.

For good reason. Of Oregons PERS retirees, there is about 5 of the OHSU specialty doctors who are in the top 15 or so of the highest paid teat suckers. Poor Johnny Delashaw, retired brain cutter is only taking down about $ 50,000 a month in retirement, with several others in the 20k range.

 

[Lilhigbee]

Single tylenol suppository costs $6

$6 for a TYLENOL?? They can shove that up...uh...oh.

Was doing some research and found this;
The Rise of Cash-Only Doctors Who Don't Take Insurance - Pros & Cons

And this. These guys don't have a problem putting their prices out;
Self-Pay Urgent Care Pricing | Portland Urgent Care

@bolus what do you think about the direct pay doctors??

 

[Mikej]

I had a knee replacement 10 days ago and was back in two days later for 4 days with a bowel obstruction. I know the knee was $ 50,000 plus and who knows what the obstruction was.

Maybe I should has issued an RFP and taken low bid. Naw, insurance got this one so I don't really GARA. The older I get, I only want to be healthy and mobile. But being in the hospital, the bean counter in me looks at where the money is pissed away. It is pissed away on finger cut transports and emergency room visits by homeless people who clog the system to get a meal and warm room for a while. Saw at least 4 of these in the 6 hours I was in the ER last week.

Hows that knee doing? Know a guy, former coach at Corvalis high who had BOTH of his done. And one of my long time customers had her right knee done last spring. Got to talk with her and watch the healing of the knee on a regular basis. Quite fascinating I think. I think because I have one in my future. Last mid Nov, took out 41ccs of fluid and put in some goodness back in. Hope that fluid stays minimal for at least 6 months.

 

[mortar maggot]

As a guy who just got out of the hospital a few hours ago, after a 6 day stay.

Let me decide my next medical catastrophe look up all the costs at 27 different hospitals, then the outcomes for that particular treatment, so I know where to go for medical help.

Then hope like hell I am not out of the area and just go to the nearest ER

 

[CoastRange57]

As a guy who just got out of the hospital a few hours ago, after a 6 day stay.

Let me decide my next medical catastrophe look up all the costs at 27 different hospitals, then the outcomes for that particular treatment, so I know where to go for medical help.

Then hope like hell I am not out of the area and just go to the nearest ER

Take care of yourself there brother. That had to have been a rough go. I wish you the best.

 

[CoastRange57]

Hows that knee doing? Know a guy, former coach at Corvalis high who had BOTH of his done. And one of my long time customers had her right knee done last spring. Got to talk with her and watch the healing of the knee on a regular basis. Quite fascinating I think. I think because I have one in my future. Last mid Nov, took out 41ccs of fluid and put in some goodness back in. Hope that fluid stays minimal for at least 6 months.

Knee is doing fine. My advice is that you gain absolutely nothing by waiting. Once your start compensating other body parts start suffering, and your recovery becomes longer and more complicated. I wish I had done this 2 years ago which is what my saw bones said. I know half a dozen people who have had it done in the last 3 months. My sawbones is doing 4 a day 4 days a week.

 

[bolus]

$6 for a TYLENOL?? They can shove that up...uh...oh.

Was doing some research and found this;
The Rise of Cash-Only Doctors Who Don't Take Insurance - Pros & Cons

And this. These guys don't have a problem putting their prices out;
Self-Pay Urgent Care Pricing | Portland Urgent Care

@bolus what do you think about the direct pay doctors??

My first clinic had a membership fee. about$40 a month. we still billed insurance but did not take copays and had unlimited email and phone visits and mostly same day appointments.

The patients who had it thought it was great. But it did not bring in a ton of business fast. People are way too used to not paying directly.

For the doctors direct pay is great. a small clinic will have to hire a billing company or several staff members just to deal with billing. Medicare pays about 6 months after the bill is sent in. Which phone company or utilities company would let you pay your bill 6 months late? Plus we have staff that deals with jsut getting pre-authorization from the insurance. so about 2 full time staff for every doc and insurance does not pay extra to cover their salaries. Medicaid pays ~20% of the bill, Medicare 30% and the private insurances pay somewhere between 25-60% of the bill.

Our most common private insurance here pays about 27% of the bill. They just lowered that for every doc in my area by at least 10% and are having the docs compete to keep it from going even lower. We all hate the insurance company but they know that they have their little monopoly. (I know of several docs already left the area since they could not afford to keep their clinics open).

People still need insurance to pay for MRI's, meds and hospitalizations. So it is hard for them to fork out another $100-150 visit bill on top of that (even though it is much less than what is normally billed). So they are a niche right now.

Also - some urgent care's in Portland now staff naturopathic "doctors" Dont use them. they are cheep for the companies to hire but are not trained at all in any medical care. Might as well go to a florist to get a tooth pulled.

 

[NW Backpacker]

How to save $$ on the cost of a colonoscopy if you need one:

If you have not had a colonoscopy for 10 years and have no symptoms insurance may cover the cost fully - they call it a screening colonoscopy. However, if you have symptoms of intestinal problems, or if they are discovered in a test (blood detected in stool test, etc) then it is called a diagnostic colonoscopy and insurance may not pay until you meet your deductible. Read your insurance literature to find out if it works this way - if it does, get the procedure before you have symptoms.

EDIT: There may be an age limit (minimum 50 years old) to get the fully covered "screening" colonoscopy - check with your insurer, and make sure everyone involved is "in-network" if that makes a difference in your costs. I've heard horror stories about people getting massive out-of-pocket bills because a doctor was not "in-network". Ouch.