Hi guys,

I need to have surgery in the next few weeks and found out my private health insurance doesn’t cover much of the accomodation for my surgery.

Does anyone know how much it costs to stay at the Mater in North Sydney each night?

Thanks ☺️

I see a physical therapist who works in the therapy clinic of our local hospital. I don’t have a copay for the visit, and the entire amount of what I pay goes toward my annual deductible. I have the EOBs for a couple of visits they have not billed me for from March-April 2024. Does anyone know how long the hospital has to bill me before they’re not allowed to bill me anymore? I’m in Washington state.

Hey guys, I flew from overseas to the US specifically for a specialist appointment and wasn’t prepared for the nightmare that is US healthcare billing.

Before my visit, I received several Good Faith Estimates (GFE). Most were irrelevant (e.g., for major surgery or post-op care) but had uninsured discounts. The GFE that was relevant for the visit can be seen here in picture. That GFE listed costs with no insurance discount noted, just a line saying, 'Based on your insurance benefits, no discount is applied.' Naively, I thought the lack of a discount was an oversight, given other GFEs included uninsured discounts. My international patient contact once called it a 'package' in an email, which I assumed was standard for my condition since the doctor typically performs a set of procedures (evaluation, endoscopy, injections) on first visits.

At my visit, I had the evaluation and endoscopy, but no injections (mutual decision with the doctor). Afterwards, I received a massively inflated bill ($1700 more than GFE for the endoscopy for instance).

I raised the issue with financial counseling, and they claimed I did not qualify for the "special pricing" because I did get injections (wtf? so I pay more for less?). After some back-and-forth, they “courteously” adjusted the charges back to the GFE. However, when I inquired about an uninsured discount, I was then also courteously told: "There's no discount for package price as it's already discounted, that's why it's called package price."

My issue is that nowhere in the GFE does it say this was a "package". There are no mention of packages being not eligible for discounts in the GFE, nor in the hospital's "Uninsured Patient Discount Policy" from 2025. In fact, there are no mentions of the word package at all anywhere in any of the documents I saw. This was only ever referenced by the financial counselor and international patient service in email on two occasions.

My questions:

• Is this legal? Can they refuse an uninsured discount on a GFE-listed price after the fact because it's a "package"?
• Can I dispute this ?

If this is standard practice, that's fine I will pay—but I have zero trust at the moment in the financial counselors after they already tried to charge me $1,700 more than my GFE for a ridiculous reason. Would really appreciate insight from anyone familiar with US healthcare billing. Thanks.

I went for carpel tunnel and received a shot and almost 800 dollars for them injecting its wrong

Spent the better part of an hour trying to get my Anthem BCBS "advocate ' to understand surprise billing. She thinks it only applies to unscheduled services. Useless. I'll have to contact the ancillary provider and see what they can do. This provider contacted me 3:different times prior to 3:different authorized outpatient procedures at in-net facilities with an in-net physician to screen me for any potential anesthesia issues/ suitability for surgery in 2024. The first two dates were JUST billed and processed as out of network. One denied for time filing and is showing as my responsibility on the Sydney app, the other applied the small allowed amount to my out of network deductible and shows me responsible for the entire amount. The last date of service was billed last year and processed in-network (no patient responsibility - out of pocket max met). Just ranting at this point.

This is my first time as an adult getting surgery that's coming out of my pocket. I'm having surgery to get a Cyst removed and $2,878.98 is my prepay estimate. And there's just no way I'm gonna be able to have that money in time. Is there a possibility of me being able to do payments after my surgery?

I'm going to try to keep thing short and to the facts. A couple months ago I went in for a doctor's (dermatology) appointment. The service received by the nurses and the doctor himself were bad. I was rushed through the appointment, the doctor didn't fully address my concerns, didn't look at my skin, I was there specifically for face-skin concerns, and seemed overall dis-interested, and like he couldn't wait to just leave. At the end of the appointment, nobody came back in to discharge me. I didn't get a summary or discharge papers from the nurse. The doctor said he'd send a cream/ointment to my pharmacy, and he never did. I honestly don't even know if the cream would work because the doctor just didn't care. I am being charged about $350 by the clinic.

I called my health insurance provider hoping to get some guidance, but they said it was between me and the clinic. I called the clinic's financial department, and they took down all the information but in more detail. I just received a letter form the clinic saying that after a "review of my visit and the medical documentation, our department concludes that all care provided is consistent with their department standards and best practices." I guess not sending medication to the pharmacy is part of those "best practices," lol.

Anyone have any idea one how to go about escalating this or disputing this bill? I don't want to pay for such a bad experience, especially when I didn't get anything out of it. State is Minnesota.

I had a Functional Endoscopic Sinus Surgery using STEALTH last month to remove a cyst from my frontal sinus. It was billed as a "HC Surgery Level IV" ... Surgery took all of 45 minutes (no hospital stay).

I am having a hard time locating definitions for the different surgical levels, but it would seem that Level IV is significantly more involved than what I had done.

For reference, my wife had a total hysterectomy recently and it was only billed at a Level II Surgery (costing significantly less than my surgery on a per minute basis).

Any insight would be great.

I recently received two medical bills after a procedure, one from the hospital and one from the anesthesiologist, and I’m trying to make sure I’m not being overcharged or double-billed.

The issue I’m concerned about is that I was charged for an epidural twice – once by the hospital and once by the anesthesiologist. The first epidural didn’t work due to a mistake on the doctor's part, and they had to do it again.

My main concern is whether it's standard practice to be billed for both attempts, even though the first one failed because of an error, or if I’m being charged unfairly for something that should have been covered under the initial charge. I’m attaching the bills here – can anyone help me understand if these charges seem legitimate?

Any advice or insights would be really appreciated. Thanks in advance!

I got a simple chest ultrasound done at the hospital on my doctor's recommendation to check something out (it ended up being nothing). The ultrasound was quick and smooth, no issues during the procedure. A few weeks later I receive a bill for $1,152.95. The bill went through my insurance, they only actually paid around 6% and put the rest towards my deductible for me to pay the hospital. That was frustrating and unexpected, but I checked my plan's information and it does seem in accordance with the plan that I have.

All that aside, this seemed like a LOT of money to charge for something like this, so I went to the hospital's website to check if they had any information on how much they charge for certain procedures. After a bit of looking I found this page https://www.uvmhealth.org/medcenter/patients-and-visitors/billing-insurance-and-registration/price-transparency which has a download for a csv file containing "all standard charges for items and services we provide, including privately negotiated rates with contracted health insurers, discounted cash prices and gross charges, which are also known as list prices." The website says that "A new federal price transparency regulation requires U.S. hospitals to publish data on all of the charges for services we provide."

By looking up the CPT code from my bill in the spreadsheet (after downloading a special csv file viewer because the file is too large to open in Google Sheets!), "76604," I was able to find my procedure, CHG US CHEST REAL TIME W/IMAGE DOCUMENTATION at rows 11,583 and 11,584. There are a ton of prices listed there because it shows information for all kinds of situations and insurance plans, but the highest price out of all of them is only $355. In fact, the very last column is labeled "standard_charge|max," and the price listed there is $301.50.

In addition to the gross charges spreadsheet, on the same webpage there is also a price estimator tool, which gives you an option to search for your procedure and pick your insurance to get an estimate. My insurance wasn't listed, so I just clicked "no insurance" to see what the estimate would be without insurance for a chest ultrasound, and the estimate returned was $433 with a discount of $195 for a total of $238.

All in all, I am pretty confused at how my bill was calculated and how my charge seems to be around 4x the cost in the gross charges spreadsheet that the hospital provides. I called the billing department last week and asked for an itemized bill and for the charges to be reviewed. They sent me an itemized bill which had only one "item," the ultrasound, for the full amount. Not what I was expecting when I asked for an itemized bill, but ok. The billing department got back to me today and said their review revealed no mistakes were made in the billing, even though I told them about the information in the spreadsheet. Is there something I'm missing? If it's a federal regulation that requires them to make this price info transparent, then how can the bill be so far off? What if I had used those tools to make an informed decision if I could afford the procedure before I got it done, only to receive an enormous bill later? If anyone has any suggestions for next steps of things I could try or people I could contact please let me know.

About 2.5 years ago I developed a small bump on my inner-thigh. It never grew, never hurt, never did anything. Fast forward to this past Tuesday, I wake up with a very mild burning sensation, it was slightly enflamed and proceeded to grow 2-3 inches over the course of a few hours before my body finally pushed it out entirelly, leaving a rather large hole in my leg. (Epidural Cyst, apologies for how disturbing this was).

just received this medical bill from the ER visit as I had no idea what to do about the hole in my leg and was slightly freaking out.

Nurse looks at my leg for 5 seconds, says everything is fine and gives me an $8 anti-biotic prescription.

Then I get this bill.

What are my options? Because this is some grade A bullshit.

This is a bit of a hybrid billing and insurance question.

Had a surgery on my head, less than 2 hours. Got the bill today from the Anesthesia group and they billed:

$2194.17 for the MD $1001.99 for the CRNA

I have seen that depending on the circumstance, the split is either 100%/0% or 50%/50% or 0%/100%. I cannot find anything that would be an odd split. Almost 69% for the MD.

My concern is not with the split as much as it is that they are wanting me to pay 2 co-pays. Not sure that should be proper.

Anyone know what is correct here?

Thanks.

Okay is this normal. I have some thyroid problems, so a few months ago I went to the emergency room during one of my flare ups because I was light headed and my thyroid hurt and when I got to them I said I felt like I was having a thyroid storm. So whatever I sit and I wait my turn and they go to check my heart rate and blood pressure while they ask what’s wrong, I’m like completely out of it not fully there but my mother in love (bless her soul) was there to explain everything and even write down my blood pressure and heart rate, it was like 124/72 so that was healthy. We go back to waiting room and they give me an ekg. Weird because I said my thyroid was bothering and because my heart rate was healthy. Whatever. I ASK if they can draw my blood to check my thyroid levels as I’m pretty sure it has something to do with it considering my thyroid feels like a golf ball is stuck there. Whatever they do it, FOUR HOURS LATER IM STILL IN THE WIATING ROOM. I start to feel better and ask to check myself out considering I haven’t gotten any news, must be fine? So I go to the desk to leave, still not haven seen a real doctor yet mind you, and tell her I’m leaving. She’s like okay here’s your dismal forms, and on it it says that I didn’t want to go back there and get treated and preferred to stay In the waiting room, uhm what???? Nope. Never even asked. It also said I was treated by a doctor, I mentioned it to her and she was like “oh that’s weird”. Whatever. I’m tires I’ve been here too long so I sign and I leave. Now I’ve got the bill, 1,560 dollars. AMERICAN DOLLARS. WHAT THE FUCK. EKG AND BLOOD TEST? BOTCH I DIDNT EVEN PISS IN A CUP. I DIDNT EVEN GET A CUP. I WISH I USED THE BATHROOM THERE AJD STOLE THEIR SOAP. oh guys that’s with insurance. Without it’s over 9k. Is that normal. I feel like I’ve been scammed. I’m gonna call in the morning. What the fuck.

So a few weeks back during a work trip i contracted a pretty bad sore throat, i couldnt talk well and couldnt really breath out of my nose. I worked night shift during that trip and ended up going to the local medical emergency room. (Small town with one medical center. I called and asked for clinic hours and the told me to just come in)

So i did. They took some information and a swab to see if it was strep, they then took me to another room and placed an intravenous line into my wrist. They gave me two injections of saline and took some blood as well as steroids to help with the swelling.

The on site doctor stated that he wanted to do an CT scan 'Just to be on the safe side' but i politely declined and explained that i will be paying out of pocket. He understood and didnt push me on it further, at the time i was already stressed about how much the cost was going to be.

The swelling went down and they sent me on my way saying that the billing dept isnt open on weekends and they will reach out to me with the bill soon and to come back if my condition gets any worse. This was on a saturday (i think)

Fast foward to this morning, ive just woken up to a text with an invoice link stating that my bill is over $1,100 USD!

Is there anything i should do before i agree to that amount and start paying it. I know the medical industry is savage but eleven-hundered seems a little rediculous for what they did just to send me on my way in 40 mins.

The image is of the full invoice (that for some reason isnt itemised) is included.

Any help or just being pointed in the right direction would be amazing. Also let me know if you need any further information.

Thanks for your time <3

I haven’t gotten the full bill yet but according to my insurance, just the room for the surgery center is $34,000. It was an outpatient surgery and I was in the room for maybe 3 hours! Is that normal amount? This did not include the surgery or anesthesia. I already got the bill for those. This was literally for just the room. My husband has surgery a few years ago on his nose and it was only $12,000. I’m just shocked at this cost.

Long time lurker, first time poster.

When our first child was born, we gave mom’s insurance (through her parents) and baby was eligible for Medicaid. We never got a bill.

With our second child, we did the same thing, but baby wasn’t eligible for Medicaid. After mom’s insurance denied the claim, we had to put on dad’s high deductible plan. Now we have a 5k bill that they’re not budging on. (Even though the itemized bill was for 11k and insurance paid 25k after a mysterious “adjustment.”)

We applied for charity care and have yet to hear back. But I’m afraid our assets (retirement account and cash/investments for a down payment) will disqualify us.

Any advice would be appreciated.

First time in the US healthcare system. I have insurance:

I went to a primary care physician to check a suspicious object under my skin (a growth/tumor).

So the doctor recommended an ultrasound and asked me if I want that. I asked, is it covered by my insurance, and he said yes. So I said okay. Then he recommended and asked if I wanted blood tests (which in my head is to check the tumor), the again, I asked - is it covered by insurance, and he said: “yes, it is routine” and so I said okay not knowing that by saying “yea it is routine” he means it is a routine check and not related to the tumor…

Now turns out, the blood test they made will not be covered by my insurance because it is “routine” and not medically needed….. and i got a $1,200 lab test bill (the doctor included everything in the test)

Clearly I wouldn’t have done it if i knew it was just “routine” not actually needed!! And if I knew i will need to pay! I explicitly asked my doctor and was under the impression that: 1. it is needed for the clear tumor diagnosis i came to check - why would i want blood test just because

1. I explicitly asked if it is covered and the doctor (or PA) said yes! Why would you he say yes when it turns out it wasnt?!?

I genuinely feel i got scammed. I felt like the doctor/PA sold me the blood test and handed me it as a responsibility under wrong impression!

What should I do? Is it my fault? Maybe it’s cultural differences that I over trusted him? He told me I recommend blood test and that it is covered I said yes :((

In Alabama. This seems really weird. Why was there a delay? Is there any time period limit for the patient to receive a bill?

Can I just get one big hospital bill instead of every other week some random email saying I owe this and that.

Thought I paid for everything since my child was born back in august then the past 2 weeks i get a 1300 bill for apparently his care in the NICU and a 300 for more anastecia...... why is it so hard to give me a number all at once and how am I suppose to know my debt is over with

Hi!

I got some treatment and appointments in-network but my insurance rejected the claims. They obviously rejected them a few months after the fact (because why make life easy if they can make it hard?) so by the time I got the bills I was away.

The bills were sent to collections. The hospital doesn’t want to file with the insurance again to get it covered and insurance is saying that the treatment code doesn’t match the diagnosis code so they won’t cover it.

I am stressed out of my mind having this in collections and getting reminders of how much I owe constantly. If I pay the hospital directly, what’s the most discount I can negotiate realistically?

I look forward to hearing from anyone with knowledge/experience.

Thank you so much!

Thank you everyone. I had hernia surgery. No complications. Nurse kept telling me I would go to a room in an hour, then another hour, then she told me that I was staying in recovery all night due to lack of empty regular rooms. The hospital then billed me 14000 for the stay in recovery room. Have spoken with insurance company; no help. Any advice I would appreciate.

Had a minor surgery recently and went online to pay since I had seen a trickle of bills coming in via mail for the pre surgery tests- But when I went on a saw that what must be the total cost of the surgery- $13k was there on top of the other bills. I received my pre authorization confirmation from my insurance so the only thing I can think is that the whole balance was just posted to my account in the interim before the insurance pays, even though it has been three weeks. Is this at all normal? I am certainly calling tomorrow, just wanted more information since I am panicking right now.

I had cardiac ablation almost 2 months ago and I just got the bill 😳😳😳

Several phone calls and upon arriving I was told how much is expected to be paid. It was fine because FSA had enough to cover it. Unfortunately when arriving and getting signed in, I forgot the fsa card to pay it. They said it was fine, they'll just send the bill so I know where to send the payment.

Well today I got the bill and I'm really confused. It's way more than what I was quoted. It was suppose to be just over 2k but now it's over 30k. This was not expected 😕 BTW I have really good insurance through hubby's employment.

What should I do?

located in Houston TX

UPDATE!

Called the hospital to ask why it went from $2k to $31k. They said to call the insurance because it's on their end.

So I called the hospital, and I didn't even finish telling her the whole issue before she put me on hold. She got me on a three-way call with the hospital. She was like uhhh it's all in network. What's the deal!? The hospital was not keeping up with the records and claims between insurance and hospital apparently so they had to make some adjustments, and now I have a new bill otw.

I'm so glad we didn't have the card upon arrival of the surgery because we would've overpaid by 1k! Won't woot! By bill went from 2k to 31k to 1k!

Thank goodness she was on my side, and I questioned the bill. Hubby and I were not prepared to have to pay all that after just getting a new ac installed in the house.

One week before my due date I went to the hospital thinking I was in labor. It was during business hours, so we went straight to the Labor and Delivery unit. Once there, I was brought to a triage room and hooked up to a fetal monitor. They determined pretty quickly I probably wasn't in labor, but my total stay was about 2 hours; they kept me to track the fetal monitor for a bit, and then had me walk around for 30mins before sending me home to make sure labor wasn't progressing.

My bill for this visit (after insurance) was nearly $2000!!! The two charges listed were "Fetal Monitoring" for about $700 (which makes sense, I suppose), but the rest was listed simply as "ER VISIT LVL 4".

I did not set foot in the ER at any point, and I wasn't even admitted to the L&D floor; I never went past the triage room. I did not get an IV, they did not take blood, they did not use a monitor to track contractions, and even though they collected a urine sample the nurses mentioned they probably didn't need it. I also did not see a hospital physician.

When I called the billing department to ask why it was listed as an ER visit and that I would like a further itemized bill, she put me on hold to research. Eventually she came back saying, "this kind of visit to L&D is always coded as an ER LEVEL 4". She wasn't able to access more specifics regarding my bill, and she did not seem able to refer me to someone with more access.

Is there no way to get concrete, specific information about my bill? Is this actually standard practice for hospitals to charge L&D visits as ER??? This bill is half of what my actual overnight hospital stay and birth cost when I had the baby 10 days later.

Bonus question: I received a substantial bill from my OB doctor for this visit as well. I know the nurses consulted her regarding how to proceed with me, but, despite being told she would come by to see me, she never did. Is there any point trying to get a reduced bill for not ever having seen the doctor?