ANA Discussion Forum
Archive => Archives => Topic started by: bklase on March 26, 2005, 01:26:06 am
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I belong to an HMO and am considering surgery via the House Ear Clinic. Could someone give me an idea about the average anticipated costs involved with surgery and recovery?
Thanks so much.
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hi. i'm not sure on the exact cost, but it shouldn't matter as long as you get pre-approval from your insurance. i called my insurance the day after i was dx'd to find out what was covered. they said that they would only pay for out-of-network procedures if they met 4 criteria..
1) couldn't be performed in-network (i live in kalispell, mt..easy one); 2) must be performed by a beech street physician (you can look this up online); 3) must be medically necessary; and 4) must be referred by an in-network physician.
i would get on them early and stay on them. fortunately for me, i work for medical billing and talk to my insurance at least once a week for my job...so i know the people there and haven't had a hard time getting pre-approval. talk to your referring docs too and have them write letters to your insurance stating that they prefer and recommend House.
well...i hope this helps! i plan to have it in writing when i go there (i'm scheduled on april 14th for middle fossa w/ dr brackmann and hitselberger at House for my 8 mm left AN) so that way they can't say no when the get the bill...
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Thanks for the input...I'm trying to determine a ballpark dollar amount since most likely I will have to cover between 20-50% of the costs. (I like to be fully prepared with few surprises).
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Based on input to the original ANA Listserve, I have seen posts indicating insurance payouts (much less than the total charges) as low as $30,000.00; and figures as high as $148,000.00. I think the average cost is about $70,000.00. I believe GK treatment is about the same. A lot depends your provider/carrier network, and possibly the location of the provider within the states.
Becky
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ok..as you may know, i'm having middle fossa in two weeks at House. i received their fee schedule today:
test and examination in office: (abn & other hearing tests) $1020.00
combined surgeons fees: $35,000-$45,000
internist: $2344.00
anesthesiologist: $2704.00
hospitalization: $ as per hospital and ins
neurogergeon -initial exam: $433.00
facial nerve monitor: $2969.00
hmm..so that totals from $44,470-$54,470 not including the hospital fees....hope this helps.
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I had a large (4.5 cm) glomus jugulare tumor and a 2 cm carotid body tumor removed at the House Ear Clinic in June, 2004. The surgery was complicated and involved. Kristin had the fee schedule correct for the House Clinic. My hospital fees were around $115,000. The hospital will be St. Vincent, which is across the street from the House Ear Clinic. They are wonderful. I live in Florida and made the trip to LA for the procedure.
Also, St. Vincent Hospital has a guest house attached to it for the family of the patient to stay at extremely reasonable rates.
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Hi
I work in the insurance field. Be sure to check your insurance policy for you out of pocket maximum. This is the maximum amount you will have to pay out and then the coverage goes to 100% for in network services.
Hope this helps!!
Cheryl
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I had my surgery at Stanford in 1998 and the total cost was just over $110,000. That was for a 5 day stay, 2 of which were in ICU.
matti
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I have seen $80,000+ worth of bills come in the mail after my surgery. But just like rntiggergirl said, with all the tests and doctors visits I have done this year, I have paid quite a bit out of pocket. I have now reached my peak of $2000 out of pocket for the year, all I had to pay for surgery was $768.ÂÂ
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it has been a HUGE headache for me and my insurance! i got everything pre-approved and in writing before i went to LA that my surgery would be paid at in-network benefit levels. (see above!) however, EVERY single claim that has come in has been processed as out-of-network. so everyday i've had to call my insurance and tell them to reprocess as in-network. i finally talked to someone w/ a brain yesterday and she is taking over all my claims and going to fix everything.
ps. my 4 day hospital stay (that includes surgery day) totaled $41,000. (this is not including any doc charges)
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Has anybody had any experience with the insurer Mamsi regarding AN surgery costs?
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Has anyone used Medicare and AARP Suppliment for surgery cost at HEC and St. Vincent? If so how did they pay? I am 66 yrs. old and have been diagnosed with a 3 cm AN. I am waiting for the call from Dr. Brackman to tell me his opinion as to which type of treatment I need.
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Still tabulating (LOL), but I'd peg my wife's surgeries to be in the neighborhood of $45-50,000 (USD).
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It amazes me how different everyone's expenses are. You would think it would pretty close to the same not 10's of thousands different.
I had my surgery in Fl and all said and done it was around 80,000 including a 5 days in ICU and doctors fees. I paid about 1100.00 out of pocket.
Ercmedia1 where in FL are you? I'm on the east coast but had surgery on the west coast.
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I've seen 96,000$ in costs from St. V's .. but by wife as told me she's gotten seperate bills from Dr. Hits office ... that all total, this little 4cm ball of meat costs 170,000$ !!! (baha and local doctors) wish I still had it to sell on eBay ;D
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Wow, how much is that per pound?! :D
Rob
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We've had the 2nd surgery bills hit and are up to about $75,000 now I'd say
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We've had the 2nd surgery bills hit and are up to about $75,000 now I'd say
*mouth drops to floor!* :o :o :o
Pls give Amy a BIG hug from us!!!!!! :)
Phyl
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As they say down under - Cor blimey.
No wonder you guys need insurance and can't afford it on your own.
My op (in Oz) which was on the expensive side coz I had 2 surgeons was around $10k including 4 days in hospital.
Gammaknife treatment is FREE.
Come join us in the land down under as the good ship Princess batty wench sails around the sunburnt country.
Laz
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It appears as if everyone's situation is different, depending on your medical insurance, where you live and what physician(s)/hospital you use. Here are the financal details of my experience having a large AN tumor removed:
My highly experienced surgeon and his very capable female assistant billed my insurance company about $28,000. - total - for a 9 hour, very effective AN removal surgery. While that is quite reasonable, considering the extensive surgical skills needed, my astute, adult son pointed out that it still comes to $3,000. per hour I reminded him that it was well worth it to me and would be, even if I didn't have any medical insurance. They did a great job.
The anesthesiologist charged about $7,000. and the ICU was $5,000 + meds, per day. A 'regular' room was $3,000 per day, plus meds. I was in the Surgical Intensive Care Unit four days and a 'regular' room for a bit less than a day. My total bill - doctors and hospital + meds and miscellaneous charges was around $90,000. My pre-op tests (MRI, CAT scan, blood tests, primary physician check-up)) ran around $9,000, total. Blue Cross 'discounted' much of that total and paid about half, which the doctors, hospital and labs accepted as payment in full, according to their contract with BC.
With my Blue Cross medical insurance I am only responsible for less than 10% of most of these bills (zero - on some of them once I met my annual deductable). The MRI cost is over $5000. per scan but BC again 'discounted' some of that and the MRI facility has agreed to take small monthy payments from me to pay off my portion of the bill, (10%) so the financial burden, while unexpected and unwanted, is not too onerous and makes my annual $2200. premium for my medica over the next year l coverage look like a much better deal than I ever realized. A serious surgery and a hospital stay in ICU will have that effect. :)
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After all, it is Brain Surgery , do you want a union min. wage worker doing it ? I did not think so ;)
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Actually, I would have thought the surgery would have been much higher. My GK was $66,000. And it's FREE in Australia? Cor Blimey is right!!
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One of the major reasons for the high cost of medical treatment in the U.S (apart from greed) is insurance.
Even in Oz where medical litigation is very rare, insurance costs are around 25% of income for surgeons.
Jim, I think your annual insurance bill is cheap and I agree with Joef - it is brain surgery and the alternative is - well, if it aint attacked, it will eventually kill you so ..... don't need to say anything else really.
Laz
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Mine cost $178,000, took little over 18 hours, and spent about 6 days in recovery. (stroke ward). Luckily the hospital had an agreement and accepted what the insurance paid, about 130.000. With follow-up appiontments and eye wash. I probably paid $4000 out of pocket. The system worked for me and I had no problems with the care. Luckily I can still work and keep my insurance incase something else is needed. Like gas it's probably not going to get any cheaper EVER!
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Tell Rita with Dr. Brackmann's office and see if they will work something out. When I thought I was going to HEI my insurance would only pay as out of network.
It would have been cheaper for me to self pay than use insurance and pay out of network price. Ask what the cash price would be with out insurance.
Also, Oklahoma City doctors were quoting around $149,000 for hospital and doctors. HEI and House doctors were quite a bit less.
Go figure that one.
Sandy