Four wisdom teeth extracted-bill to my insurance co $12000+

Last month I took my son to an out patient surgery facility in a well known and highly respected hospital to have 4 wisdom teeth removed. I did this because he has other health problems that increase his risk during and after surgery. This was also done a couple years ago for the same reason but for bicuspids, prior to his braces going on. That bill was less than half this bill at the same facility.

Interestingly they billed it as "hospital incidentals" for every charge on the page. some of the charges were 5,000+, 2,000+,1500+,685, 589,437, and on sand on for a total of 15 charges that don't include the doctor or anesthetist fees. Those are between 2500 and 3000.

All this for an uneventful outpatient procedure that took an hour of OR time, recovery room time of less than an hour and step down unit of about an hour , possibly an hour and a half. Preop time was about 45 min to prep.

Needless to say our insurance company is requesting records for medical necessity. I can see why based on these charges. They covered the last extractions in the same facility because of the added health concerns and that was a more minor procedure than wisdom teeth.

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Universal health care needs to get moving and should include mental health.

Four extractions can be a serious procedure, so you did the right thing in taking him to a well-respected hospital. The bill is outrageous, obviously. Imagine if you didn't have insurance - they'd be expecting you to pay every penny out of your pocket. At least the insurance company will look into it.

The health care system in this country is in terrible shape. We need universal health care, including mental health care, and we need to stop these obscene profits on the part of a few sectors, at the expense of so many of us.

will graduate from college this year. 40% of college grads have no health coverage.

I would have thought it would be twice that. Perhaps some are still covered through the parents. I mean, how many jobs don't give it to you until your probationary period is over?

said that 60% of business offers health insurance, down from 66%. Most of my oldest sons friends have graduated in the past year, most aren't covered under their parents plan. but maybe they don't know about the COBRA law.

The student health insurance co here at UT Austin offers a post-graduate year of insurance to bridge the gap between school and employment.

to pay every penny. Medicare and insurance companies negotiate lower rates, but the "have nots" must pay full price. It's outrageous.

Since the large insurance companies get discounts on medical procedures for their clients
in return for agreeing to have clients seen through certain doctors and hospitals, and since Medicare and Medi-Cal are also discounted, how can you even know what the full price should be?

...Is because you are billed to make up for all the other people who didnt pay.

Its not about taking care of people, its about green paper with pictures of dead presidents on it. Its sad, really sad how our society is structured, its built around something that is actually meaningless and in the end accounts for nothing.

That's the whole point of having these off hospital treatment centers. They don't do charity care because they aren't attatched to an emergency room. The excessive charges were there for profit; even if that profit happened to be for somebody's salary for an otherwise non-profit operation.

The premise that somehow the growth in medical costs is due to improvements in care is crap. The medical establishment spends huge amounts of money trying to figure out how to seperate the insured class from the rest of us. They intend to treat the insured class at a healthy profit and the rest of us can die for all they care.

note the OP: out patient surgery facility in a well known and highly respected hospital.

as patients. Here in my city, there are exactly 2 hospitals that take uninsured patients for non life threatening illnesses. If you don't have insurance, you are turned away from every other hospital in town.

People who can't pay don't get health care at these kinds of places.

but nowadays it's very difficult to get admitted without insurance, unless it's a life-threatening emergency. What percentage of actual emergency room cases classify as such?

Face it--it's a good ol' boy (and girl) network who keep prices high, because they can. Because we need them. In many ways like the oil industry. What right do they have to charge *anyone* $5 for a couple of Tylenol or $75 for a goddam blanket, especially those who need it and have no real alternative but to pay it?

What I'm curious about is this: why isn't it competitive? Why isn't there a "discount" chain of qualified MDs which would make billions? The problem is not that it's about green paper (which is not at all meaningless) but that there's no free market and no competition.

Time to revisit the Sherman Act.

these kinds of prices...that along with the enormously outrageous drug prices...AND with so many on drugs that shouldn't be.

For example, our insurance was billed for a delivery room and hospital room. It was the same room. Many of the charges on the statement were way beyond my comprehension. Not that that takes much, mind you. But health care costs and coverage have got to be a primary concern with our new congress. In the worlds wealthiest nation, health care should be a right, rather than a financial burden.

teeth is so outrageous I think in most peoples mind. It might help illustrate the insanity again.

But I was born in the car on the way to the hospital. She had to fight to get it taken off the bill.

But she got a little excited when the cops showed up (she is Chinese and is constantly fearful of deportation even though she is legal). She told them that she felt a little dizzy.

So they called an ambulance, instead of me, to come get her. They took her to Marin General.

$26,400. And no insurance.

Two CAT scans
AIDS test
Pregnancy test
Observation
You name it

She was out of there in 2 hours.

significant surgeries due to that. i ended up with a settlement that covered that stuff.

Even though she was cited for excessive speed, her insurance company told me that they would fight me in court.

It would have cost me $50K to maybe get them to pay up.

So I took the path of least resistance.

was finding out the guy was underinsured. they then went to my insurance company with a letter from the guys company that said they acknowledged fault and paid to the limits of the guys policy(the minimum legally allowed). essentially an under insured case. My policy paid the balance(I have a high level) and they were then able to go back to the insurance pool and get reimbursed.
I still have trouble with the joint damaged and nerve that had to be moved.

He accidentally shot himself with his own handgun when his wife accidentally backed into him while he had it out. The bullet went right through the fat of his belly. He was taken to Emergency by ambulance and the ER took an MRI to make sure there were no stray bullet fragments left in his flesh. Basically, all they did was stitch him up, give him an MRI, give him a prescription for pain-killers, and send him home after about 3 hours there. The ambulance bill was another $1000, and the driver got lost on the freeway and took an extra 20 minutes to reach the ER. It wasn't a serious wound. The hospital bill alone was over $20 grand and my cousin had no insurance, unfortunately.

I am a hick from really rural Texas, and that story you told really takes me home.

"He accidentally shot himself with his own handgun when his wife accidentally backed into him while he had it out."

My evening is now complete.

...who neglects to give audible beeps while backing---ESPECIALLY if the man of the house "has it out."

This is what insurance is for.

But originally from Deep East Texas.

And I am moderately intoxicated.

I just performed a re-creation of that event and almost made my Canadian Sweetheart wet her pants.

She was saying, "Come on, it really isn't like that, is it?".

And I assured her that it was most certainly so.

That was a volatile mix...

Guns, women, cars...

...Sadly, I'm totally sober. Sitting here lurking and reading news and intermittently watching ESPN's coverage of the Australian Open.

Guns, woman, cars... What would the U.S. health and insurance industries be without 'em?

might as well be me.

Guns, women, cars, and unrequited love...

We will all sing the Blues...

Together, now..

1...., 2...., 3...

Jump..


When I asked her for water

She gave me gasoline

she backed into me without warning and...

You better take it from here.

And she left me that morning

I was showing heat

And she was just pissed off..

Gimme a ride to the hospital, Woman..

You done got me shot.

You done got me shot.

So fix it for the kids.

You know what I mean?

Help me, Mama..

I'm bleeding..

...I think you just might have the next big CW chart topper.

Call it Guns, Women, and Cars

Don't forget me when the royalties start pouring in.

wishing you had not have done me...

Leaving like that..

It was my pistol

And it was your sister

Why can't you have left it

Just swinging like that...

Your Daddy done told me..

That he could never have made up his mind


Nothing personal MJ24, just this life of mine.

Don't let the bedbugs bite.

Remember all of that cool stuff that our Mothers used to whisper in our ear(s)?

Sleep tight.

Man, I could go on and on....


The best music in the Country is every Tuesday night at Los Cabos II in downtown Denver.

Just in case you are interested.

The Piney Woods? Deep East Texas?

I'm movin up there, trying to get my act together to move to a very old house in a little bitty town.

As if EVERYONE jut has twenty grand laying around, in case of a rainy day.

I don't have $20 lying around this place.

Well, okay, I do. In CHANGE.

Christ on a fucking sidecar....

I have friends who are working hard on the Marin General Issue (if you haven't yet found anyone to complain to)

...Thay want you to PAY, PAY, PAY. But the moment you have a claim or need to us the insurance, they will refuse or try to not pay. Even though thats why we pay them, so we can us the insurance when we need to.

My mother, well my sister actually, was on my parents insurance when she was still at home. She had a little fender-bender, nothing major at all. My mother filed the claim to fix what little was broken and the insurance company dropped my paretns. Dropped over the only claim they had ever filed the entire 15years they had been with the same insurance company...

My parents andI both agree, Insurance is a fucking scam.

Hey, I changed fields so I could GET health insurance. I figured they were ONE company that had access!
I am just somewhat knowledgeable on homeowners and auto coverage (I don't do the health and life) and I do fight to try to keep people's premiums down.

It is a constant battle with the underwriters. Every day I am having to call and go to battle over one of our insureds.

Health care is as bad or worse then the drug companies.

its ludicrous, not to mention insane.

i supposedly had the most severe form of wrongly grown in wisdom teeth, requiring all 4 to be extracted in pieces over several hours, and there was no need for general aesthesia or an entire hospital

oral surgeons who do lots of wisdom teeth removals should have their own surgery centers for outpatient surgery

i think you were "sold" something that is not customary or medically necessary, but of course i was not there and i hope it is not so, because insurance coverage is going to be looking at what IS customary and medically necessary

i would fight this hard if it turns out you were deceived in order to inflate your bill, hard to tell from my distance, and all i know is what my dentist/oral surgeon told me about the severity of my procedure

general anesthesia always carries a serious risk and i have not heard of it being used even for serious wisdom tooth surgery without good reason

wonder if there are any oral surgeons here willing to put an oar in...

ah, re reading again, you went to an outpatient surgery center, yet they are billing as if you went to a full bore hospital -- i dunno, sounds a tad fishy to me

if your insurance co. pays, it's their problem, but if they kick up a fuss, you may need to start documenting what actually was done and where (sounds like you already are)

Hospital bills need to be audited a lot more carefully than they are.

We've all heard the stories: double billing, billing for services never received, etc.

And of course, the US needs a national health plan.

they ranged (here in cape Coral Florida)from $375.00 to $400.00...

My daughter had all four wisdom teeth out with general anesthesia--it was about $1500.00. Admittedly it was just at the oral surgeon's office but he is trained to do just about everything a hospital does. I guess she could have been called special needs since she has diabetes. We just went with it since I really like this guy.

We didn't have dental insurance so it wasn't covered. They actually have online dental "insurance" you can get ahead of time (basically you just pay for a list of names of dentists that agree to discount their prices to a certain amount per procedure). I really just wanted this particular oral surgeon.

I'm not fond of insurance companies but I can't say that I blame the insurance company for balking at this. Try to get the hospital and insurance company to duke it out and leave you out of it!

Root canals start at $800

I think it cost ME about $1400.00 but that was a long time ago (I won't tell but *hint* - over 20 years ago!).

ACK!!!

UNIVERSAL HEALTH CARE FOR ALL NOW!!!

Without insurance. We paid around $300 copay. Of course I was awake, but it was 2 hard tissue, two soft tissue extractions for my wisdom teeth. It was somewhat traumatic but I survived alright.

It did not FUNCTION - no power, nothing. They ended up using forceps and trying to bill us for the non-functioning instrument. A nurse that was there signed off on the fact that it did not work after 18 months of back and forth letters.

Besides I like to eat almost everything. Hope universal health care programs will offer some dental coverage if it's ever implemented. I'm in debt for about ever trying to pay for work already done. Sometimes I get tired of the salmon swim, but I prefer being in debt to gumming my food. eek.

indeed most of us live much better without them! too bad they can't be extracted with pliers! mine were so bad they <on second thought i'm redacting a truly gross and disgusting detail, just be glad they're all ok now>

I am not looking forward to it. Poor kid, poor wallet.

My daughter just had her 4 wisdom teeth removed. She had general anesthesia and the bill was $1140.
They cannot bill you because he is at increased risk. All that does is indicate that they need to basically pay closer attention to certain things...but it shouldn't increase your bill unless he actually suffered complications.
I wish you luck fighting this bill. It is insanely outrageous.

and my portion was 480 and the bill was around 3-4000. California area

for a total of about $65,000.

If you have any medicare/medicaid or other federal insurance report this to the (aaaaaaaaauuuuuuuuugggggggggh) attorney general's office.......


$12K is excessive unless there were very unusual medical issues....

No complications or incidents during the time he was there. we wanted to make sure his diabetic issues and risk factors were in good hands with people who knew how to adjust his insulin and glucose if needed. Oral surgeons so often will do the procedure in their on site surgical unit without an anesthetist and without much experience with type 1's and less with insulin pumps. Not to mention if anything were to go wrong his health would be at even greater risk due to the diabetes issue. the facility was designated as ambulatory surgery for outpatients though it is on the second floor of a hospital. this was the case two yeas ago for the same thing(different teeth)and the bill was less than half this. Under 6000 but over 4000 can't recall the exact amount.

died in '84.

In any event this should have been covered by Medicare...

DIABETICS ARE COVERED UNDER MEDICARE!!!!!!!!!!!!!!!
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!


Call An attorney.........

These costs are covered by Medicare/medicaid...........

This is a statutory requirement..........

Been There Done That.............

That may be solely a Medicare thing (over age 55 or whatever), not a Medicaid thing that would be applicable to a child/minor. I know from brutal experience that it's almost impossible for a middle-middle-class special-needs kid to get Medicaid, at least everywhere our family has lived.

We've been trying for years to get Medicaid for our 7-year-old heart patient, immunocompromised, formula-fed, dysphagic, dyspraxic, developmentally-delayed, veteran-of-nine-heart-surgeries son (2 open-hearts and 7 angioplasties, plus a Ladd procedure). So far, no dice, unless I take a job as a janitor and we live in a cardboard box for 6 months first. We're currently on pins and needles awaiting news on the outcome of our latest appeal for CAP MR/DD...

For many/most special-needs kids in middle-class families, THERE IS NO SAFETY NET, unless you are poor--at least in any state where I've ever lived...

here in the Philippines

and ya cant beat nitrous.

You may have to pay a small print fee (likely not but I'm mentioning this just in case), but you can call the billing department as request a full itemized bill be mailed to you. This will label each and every medication and fee involved during you son's care. You can then cross reference this bill with your doctor's orders (request the surgical records as well). Be prepared to have to challenge some charges. If possible, enlist your referring dentist's or oral surgeon's aid to determine which are legitimate charges and which are not...

It could be that some charges from another patient were mistakenly placed on your son's running chart and this is your best way to determine if this has happened. This almost happened on one of my son's outpatient stays, though it would have been an error in the negative. A couple of hospitals/surgery centers we've been to had a system where stickers with a numerical code are attached to hospital equipment. The stickers are transferred to the running chart and are then submitted to billing for tallying and processing for submission to the patient and the insurer. Well, a nurse almost forgot to place two of the charge stickers onto my son's chart (we'd been talking intensively about Colin's after care needs) and I stopped her in the hall when I realized she'd left behind the stickers....

The label of "hospital incidentals" is not acceptable for submission to your insurance processor. They will demand a properly coded bill. As your current bill is written, the insurer will likely delay paying any charges until the proper customary costs for such a surgery are reflected by the final bill. Meanwhile, you're left to panic over the thought of receiving even more inflated bills...

Hope this helps you out, and best of luck resolving this problem. And yes, I definitely think those charges are inflated horribly for an uncomplicated out-patient oral surgery... Heck, my son's cardiac catheterizations cost (overnight stay, complicated by pre-existing issues) less than half that bill!

billing office tomorrow once my son says they can discuss my bill with me for him. He is 18 so they require permission from him. We have college tuition and yes the possibility that i could get stuck with some of this now has crossed my mind.

they need to present an itemized bill.

All the stockrooms in our hospital have huge "did you scan" signs..at times a list of "scan rates" comparing hospital departments scan stats.
Why the big deal? So we can get every penny from people's insurance/Medicare.
Some of the chargeable items:
Bedpans/urinals/diapers(baby sized and adult sized)
Lotions/Shampoo
Medical tape
Admit kit (water jug, box of tissues, water basin)
Blue Pads to put on the bed to prevent sheet soilage
Container to empty foley catheters into
Basically ANY supply we bring into one's room get scanned...
Pulse oximeter machine to measure one's oxygen level ($200 PER DAY while it is at the bedside)

Up until a while ago our facility used to let patients bring their own medicines from home instead of getting them dispen$ed from our in house pharmacy. But that changed--no med dispensing means no $$..so now they just can use their home med that the hospital doesn't have in stock (which is very rare).

we have become a third-world nation in less than a generation

Ain't capitalism great!

both the healthcare and pharmceutical industries are bleeding this nation dry . . . while reaping unheard of profits and dispensing obscene executive salaries and benefits . . . they should all be prosecuted for racketeering . . .

That say it all, I think.

This is exactly the kind of thing that drops off completely if you don't have insurance, because you can't afford to pay for it any more, dental work and routine dental care. With increasing price-gouging on everything, and flat earnings, fixed incomes or etc., you can try to take care of your own health, but the actual check-ups and work are beyond most people's reach, increasingly. I wonder what the statistics are, on numbers of people who used to go to the dentist regularly, but since Bush, deregulation, etc., have stopped. It is a cost you cannot manage, maybe ever again.

This reminds me of something I heard just recently, when Sen. Ted Kennedy gave a speech at the National Press Club, that was broadcast on C-SPAN. Referring to the situation of the insurance industry, right near the end of the question-and-answer part, Kennedy described the pattern they have had for the past several years now: fewer and fewer people in this country are insured, more people being cut off as an earned benefit or priced out of it, and at the same time, the number of lawyers employed by the insurance industry has skyrocketed. I forgot the numbers, but there are huge departments full of lawyers at each corporation now, as more people are losing their coverage, and Kennedy said, that is exactly why they are there--their whole purpose is to try to find loopholes to avoid paying claims, and to cut people off who are using insurance enough so that they are not profitable to the corporation. Insurance is for investors to make profits off of, not for policy-holders to turn to when they need it.

I had my wisdom teeth taken out by a Navy dentist, wide awake in a dentist's chair on a destroyer tender. No anesthetic except 13 shots of Novacaine (12 initially, then a booster when it started to wear off too soon). They had to knock the top ones out with a chisel, they were so impacted. Afterward, they gave me some Motrin and a chit for a day off work, and light duty for a couple days after that.

Healed right up, though, just a little infection on the bottom two and no dry socket.

insurance actually ends up paying . . . and how much your next premiums go up. A person can't afford to be sick or hurting anymore.

My husband is disabled and had all his teeth removed. He has a morphine pump (similar to the pump your son uses)high blood pressure and can have muscle spasms in the chair. Like your son, he has to be monitored completely and have a crash cart located somewhere in the doc's office. A few of his surgeries our dentist had to cut down on his jaw bone. Brutal but necessary.

Full price...3 grand and that is without insurance. He just had this done a few years ago.

Might want to find a "good" dentist and steer away from the oral surgeons if you can. Or hey, fly out here to my house and meet my dentist. Even out of pocket would be cheaper in the long run.

The base price the independent practicing orthodontist charged was 250 for each wisdom tooth above the gums. For teeth below the gums, the charge was around 300 or a little higher.

I don't know what this hospital you went to is, but I can tell you they fucking ripped you off. 3,000 per teeth--that's fucking ridiculous.

just be glad they aren't telling you all the surgeries are "cosmetic"

For $ 90.

It was a two minute procedure.

Two years ago, when I found that the polyp had grown back, the doctor who had bought the older retired doctor's practice insisted I have the polyp removed at the local hospital's outpatient
surgery center

The cost if I had agreed?

$ 2,000.

Even though at the time I had insurance, I refused. It took a week to find a doctor who didn't have some contractual agreement to bring me into the outpatient surgery center.

Finally found another doctor who did the two minute procedure, and of course it cost more ($ 400) but the other price was TOTALLY highway robbery.

The doctors can charge what they like; insurance companies can and do pay far less, and the doctor can't do a damn thing about it. this is why many docs are leaving the profession, if they can.

OUT OF HEALTH CARE.

I am losing a tooth soon. it is infected.(not in pain thankfully) Medical assistance will not pay for a root canal.I could only get one round of antibiotics because medical assistance won't pay for the full course I need and I can't afford to pay for two zithromax packs. So I'm getting it yanked out soon IF med assist sends a FAX to the dentist the ONE that accepts MA out here...A tooth that could be saved yanked because of someones greed.It's thankfully not a front tooth, but it is a tooth I eat with.

And it makes me pissed. This should not be,,yet stupids still say America is no much better than other countries I doubt it. In the netherlands I would not be having to save up and ask my mom for my transgender surgery and my tooth would be fine, and I would not be fighting the bullshit and going through hideous stress and tons of red tape while getting jerked around to get ANY kind of health help in OTHER countries that CARE about what _all_ (that means including the POOREST) their citizens quality of life is like.

hospitals and health insurance co's should definately not have STOCKHOLDERS. That's just assinine.

trying to find out how much it is going to cost me out of pocket to head into the afterhours clinic for something as simple as access to an anti-viral/bacterial prescription.

If this is in the several hundreds of dollars, I am forced to deal with the illness, which is beginning to really kick my butt.

for gall bladder issues. I was sent home and told I would need to have it removed soon, which I did a few weeks later. But just for the three hours it was $8000, half of which was covered by insurance.

with pliers and charged me $10 for each tooth. Things have really gotten over the top these days, haven't they?

around $500 and we only had to pay 20%, but it wasn't anything extraordinary...that dentist just yanked 'em out.

but some folks have to have more work done because there are veins in the way or other problems.

I also remember that the dentist gave my husband a mega prescription for percoset (which neither of us can take)...and when my husband told him it was too much...he told him..."well keep them for the little lady in case it is that time of the month"...

:eyes:

Medicaid. I think you will see the fees for those oral surgery procedures drop to something more reasonable. They told me to take aspirin if there was any pain. No neat drugs for me.

paid for by insurance.

she was intubated, and had basically one nurse devoted to her care for the first five days.

she was also one of the lucky ones because she was born premature but not really premature...by preemie standards she was a little moose...at 6lbs 5 oz....her lungs weren't finished baking when she was born.

I talked to one mom in my unit who had her baby there for 6 months...her bill to that day ( he was still to be there another month after our conversation) was $700,000...Right now we have a baby in there that has been in the ICU side for 8 months. I cannot imagine what the bill is right now cuz he has been in the actual ICU side for th whole time and not just the stepdown ICU section.
The "$700,000" mom told me that another couple with a baby in the main ICU had already blown by their $1 million insurance cap.
I believe Medicaid kicks in at some point, no matter what the parents financial status..something about the babies being preemie..before a certain gestational age I have Medicaid starts to pay part of the bill?

Medicaid in some states (and very few at that) will help pay expenses if a child has a disability (no matter the parental income). However, in cases where insurance runs out it is up to the parents.

Autistic children for instance in PA receive medical, therapeutic and mental health through medicaid. However not all autistic children qualify. Those who aren't quite autistic enough...get nothing.

If your child is currently in the NICU, I would talk to the billing department right away and contact your child's caseworker (if the hospital has assigned your child one.)

My bill without insurance was $1200. that included everything and i had all 4 cut out.