Medical Billing, How Medical Tests Are Charged !

11/3

       I was at my Dr.'s the other day, I wasn't feeling so hot...Since I have a heart condition ( Congestive
Heart Failure,) he had me take an EKG , after the tests he said I can't see anything but with Congestive
Heart Failure usually it's on the right side, so he wants me to take a Cardio Echo Graham I had one two
years ago, the kicker is the co-pay is $400- !!! I bitched about this and he told me how the hospital makes
the billing, your charged for the heart test and then they charge you for being in the hospital for the test
which isn't true because the Heart Institute  is on the other side of town  the hospital here owns every
bldg. that has specialty's ! It's called rip off alley !!!  So I told him I would think about it !..

                                                                    Cheers.......Joe.......

Joe, I'm starting to get like you about these co-pays.  I have osteoporosis and need some poison shot every six months - cost $1000 and co-pay $500.  I'm trying some natural products, exercise and weight loss first - may be sorry but $1000 a shot just seems way out of line for something so many of us suffer.

Of course, the type of insurance affects what they pay for.  I'm switching to Humana next year because their co-pays for what I use most are better than what I have.  My trip in the ambulance for a fall cost $350 (5 miles). I couldn't drive - guess I should have called a cab but I couldn't move.  The new insurance ambulance is $200 copay. 

Same for MRI.  Have to go to an MRI specialty place, not hospital, for the MRI for my shoulder, knee and hip from the fall.  I wonder if I really need MRIs - in the old days doctors could tell what was wrong by examination.

I don't know.  Medicine is certainly helping us live longer, but the cost is prohibitive.  Call your insurance and ask them where you can get the test for the leasat copay.  Mine told me if I had it done at the hospital I would have a larger copay than their MRI specialty place.  Same for physical therapy.  I went to some private place instead of the place I knew was the best - and I never got full use of my arm, etc.

The answer is stay well.

10/4

              DK..

                     I hope your feeling better, trust me it's no fun getting older ! Here there's just
one heart institute that's it and it's owned by St. Vincent's now there building a new patient's
building on the hospital; grounds, there will be no more semi-private rooms but private rooms
only ! I can just imagine what that costs ! I have Humana and I think it's great for prescriptions
( Generic,) I pay anywhere from $1.65 to $8.00 and that's for pills and inhalers, if I didn't have
the insurance I would pay $75- for one inhaler ! I see commercials on TV for Humana now you
can change your insurance till Dec. check it out, dear friend even though we view politics
differently, I love you , admire you for your writing and wish the hell you get better !!

                                                       Love Joe...

When I read posts like this I get angry.  I'm angry because I know it could be much, much better for all of you.  I believe it is arrogance that is a big part of the cause.  When I think of the medical care I have and how it has saved our lives and kept us from poverty, I am pissed.  I believe the arrogance is refusal to copy programs that work as they do in Europe.  It seems that if it is not an American idea, it is not even considered.  Sanders was the only candidate that referenced Europe when it came to healthcare.  He wanted to implement a similar program for America.  The opposition was against that and labeled it socialism. 
I have no co-pay and our prescriptions are completely paid for.  My wife takes 17 (seventeen) tablets daily.  I now take eleven since my latest operation.  I am monitored on a weekly basis.  This past week I had a CT (MRI) as follow-up along with blood tests.  It showed everything was working well.  Often people suffer due to the unknown.  Trying to save money by halving pills and/or not going to the doctor due to cost can be life-threatening. 
There is and can be a better way.  Forget labels. i.e., socialism and do what will save your life and the lives of others.  No one should be in poverty due to medical costs and in a country that likes to proclaim "the best or the greatest" it is a farce. 
Canada is not far away and they show by action that they care for their citizens.  Getting pissed off at "lack" may be the only way to affect change.  Remember that there is a better way.  There is nothing more important than saving lives.

10/5

            Abe..

                  I hear you ! It's the hospitals that are charging huge fees, I go to my primary Dr. and
I pay nothing ! When I go into my Humana I see he charges $100-, they pay him $65- I pay 0 !
It's the dam hospitals what they feel like they want to charge for tests ! My prescriptions are very
good prices , I pay a month $30- for five prescriptions that includes two inhalers, plus five different
pills, and that's for three month refills on all my prescriptions . At one time before I got Humana
Medicare one inhaler alone was $75- , my drug Carvediol I was told was $75- it's a rip off....

                                                                Cheers  Joe....

Joe and Abe, you are such thoughtful men in a time when the worst of men are on the political stage (Sorry, Joe - but that means Trump, Ailes, Christi and most of Trump's surrogates - arrogant men who are in the dark ages regarding diversity and women).  It's good to know men who are respectful, thoughtful and caring, even if it's just in this forum from which so many people have dropped.

Unfortunately, the lobbyists control our medical situation in this nation.  The people are also controlled by their political affiliations that put getting elected above what is right for the nation. Those who have don't want to contribute to those who don't and they elect representatives to promote that position.

Actually, Medicare for the most part, operates pretty well in an expensive, lobbyist controlled environment.  What we don't pay in taxes to support a universal, single provider system for everyone, we do pay with co-pays for users. 

Beyond Medicare, it's an untenable hodge podge where the insurance carriers and pharmaceutical companies have more control over patients than the few remaining medical doctors who still give a hoot and haven't drowned in the paperwork.  My medical care even in this "good" system is controlled by the insurance company, not the physician.  Getting care for my acrobatic fall ramifications has been difficult beyond belief.

We have Kid Kare, Medicare, Medicaid, Veterans, Affordable Care Act, Family clinics, some hospital group plans, some religious affiliated plans - need I go on.  Therefore, you can pretty well figure those who can't find a slot - die.

I do agree about arrogance, Abe.  Just ask any foreigner that has run into U.S. tourists - they behave entitled, arrogant, unsatisfied and make no attempt to use the language.  We have many foreign tourists here where I live, and they are generally the ones who say "hello" in passing on the beach and other than not understanding that we line up like cattle for everything - they are generally very appreciative and pleasant.  They do crowd a line, skip to the front, and step in front of people being served.  I have to remind myself of the crushes at counters abroad and forgive them for not knowing we are cattle. They all speak some English, most quite well.

If Trump is elected, medical care will be a disaster for all but the elite who often don't even use insurance to have the best care.  Many physicians in my wealthy area provide concierge medical care paid by the month by the patient and don't take insurance. 

President Obama is a gentleman, so are the V.P. candidates.  It's just the rotten apples spoil the basket.