Wednesday, December 30, 2009

Medical Math

Several months ago I started getting a shooting pain in my shoulder/arm when I stretched and reached toward extremes of range of motion.  It didn't get worse, but didn't get better either and finally I decided to see my doctor about it, more from a sense of not wanting to be sorry later that I didn't treat something while it was treatable than because it was bothering me all that much.  It still didn't get better and she sent me to an orthopedist, who sent me for physical therapy.  Luckily, whether it was the PT, or because enough time passed, I improved and was discharged after three one-hour sessions.

The physical therapist was very nice and I have no complaints about her work.  She saw me three times, for a little less than an hour each time.  She started by applying heat to my shoulder.  She then instructed me in some exercises and watched me do them.  When I finished the exercises, she iced my shoulder and then applied some patch that used electrical current to push anti-inflammatory medicine into the muscle.  While she was seeing me, she also had another patient there, and she would alternate her attention between us.  I had no problem with that either; it seemed a more efficient use of her time than sitting there watching me read a magazine while my shoulder warmed or cooled, or counting while I did exercises I already knew how to do.  I paid a small co-payment on my way into the office, and my insurance was billed for the rest.  While I didn't know the exact amount, I figured that it would probably be in the $100 range.  Since she had another patient there at the same time that would give her a $200/hr billing rate, which is more than some lawyers in my office charge.  A week or so ago I got the bill.  It was over $1300, or more than $400 per session.  Today I got the  EOB from my insurance company.  Between my co-pay and what they paid, the total actually paid was......a little over $300.00.  I just don't get medical math.  I can't think of any other business that would send out a bill for $1,300, get paid $300.00 and be happy with that.

1 comment:

  1. What I found when the hospital that Jennifer went to thought that she was uninsured- they insisted on the entire amount. For her it was $17000 for seven hours and surgery IN the emergency room. They did not move her to surgical because she did not have insurance.
    After a year argument with our insurance company we paid about $500 for being out of network and the insurance paid $5000. I then came to understand why the health care system is so bad for those who are uninsured.
    BTW- I am convinced that the problems she has had in carrying a baby stemmed from the surgery done in the emergency room. Her current doctor feels that scaring from that surgery blocks the baby from dropping into the uterus. She totally lucked out getting our grandson- at least that is what he says. I think it is a bit of "God's hand" at work!


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