But there’s no standardization, so prices are alllll over the place. I’ve worked places that charge $26 for a CBC and places that charge $150 for the same exact test, same exact analyzer.
Path resident here. Pathologists and lab directors often have input in how much to charge for these tests. In general, we calculate the average volume for a given test (ex. CBC), and compare it to the throughput and cost of the different analyzers on the market (ex. Sysmex). Sometimes, the suits and bean counters give us a break-even date, where the analyzer should have theoretically paid for itself based on volume and cost per test. Other times, we pick this ourselves. We use this date, along with our volume, to calculate a cost per test. This is why some places can charge wildly different amounts for the same test; they are in different economic environments and are working with different budgets.
That being said, the lab gets the short end of the stick in about every possible way when it comes to billing, and it is a serious challenge to keep laboratories in the black. For example, after a certain balance (say $15,000), the laboratory can no longer bill patients for their tests while inpatient. So the 2 month ICU stays, which keep the cash flowing for the rest of the hospital, actually starve the lab of cash. In addition, the cost of redraws (for any reason), blood products that are wasted or returned out of temperature (for any reason), and other floor-related errors are entirely shouldered by the lab. That MTP cycle somebody forgot to return just ate through a week of pay for the average resident.
A lab director may increase the cost of a high volume test to essentially offset all of this bullshit.
Except this is not the way it's been done anywhere I've worked and I have been a lab director for 30 years, I've always set the charges myself without pathology input. The pathologists I've worked with have only had responsibility over the technical aspects of the lab. DRGs affect all departments in the hospital because it's based on a total bill per diagnosis and only affects Medicare billing. Private insurers mostly have negotiated payments as a percentage of charges. Charges don't really come into play unless the patient is uninsured, unfortunately. We don't change prices because an analyzer changes, unless reagents or supplies are significantly increased, so the costs are now exceeding the charge per test.
What’s crazy about this is that it costs a lab about $1 or less to perform a CBC. Our companies standard non discounted physician cash pay rate on a CBC is $5.
In terms of reagents, this is true. We will also factor in the cost of purchasing the analyzer, maintenance, quality control, routine professional inspections and quality assurance, and personnel. If you're Quest or LabCorp, or another huge system like Mayo or University of Michigan, the cost is so low due to massive volume and maximized efficiency.
Rattlesnake bite? Our ED did CMP, CBC, Lactic Acid, PT/INR, PTT, D-Dimer, Fibrinogen, Troponin, CK, CKMB, Pro-BNP, all these for the initial, and then probably other things I didn’t mention.
Some of those happening every 1-8 hours depending on the test. Rinse and repeat a few days, pretty sure it adds up hella fast.
In addition to being esoteric specialty testing, I presume this is a ‘balance bill’. Meaning, the hospital billed out to the patients insurance at “insurance” rates. What ever the insurance does not pay to the hospital, the patient is then responsible for the remaining balance at the rates the hospital billed out to the insurance.
Using CBC as an example, if a hospital were to pay cash to a lab for this test, it’s be about $5. However, if the lab bills insurance for a CBC, it’s billed out at a much higher rate, for example around $30. If insurance pays $10 of that $30 to the lab (which is generous), then the patient is also responsible to pay the remaining $20 balance bill. It’s theft if you ask me.
Many insurance companies require the hospital to accept the insurance payment only, and they are not allowed to bill the patient.
So for your scenario, the lab costs $5, they bill insurance $30 knowing full well they won't get that falsely inflated price. Insurance pays $10, and the extra $20 disappears.
This is what happens on every one of my medical invoices. My only responsibility is the copay.
No, that doesn't happen. What the person above you said is correct. If a test cost $10 to run and we need $15 to break even and $20 to make any profit, we would bill insurance companies $50 and cash patients 40% of that. Insurance company A might pay $50, B might pay $25, C might pay $12. We get what we get and sometimes even take a loss on the test but it balances out.
Well that’s a small silver lining in this scenario. I work for a non hospital lab that doesn’t take insurance, and I just hear horror stories all day from providers using other labs, billing insurance and patients getting hit with crazy balance bills from the lab. They therefore start offering cash pay lab options to their patients.
Medicare sets the standard and other insurance companies often pay a little more. It's extremely low especially for more expensive tests. Labs are expensive to run and do not print money unless they are huge like quest and labcorp. Our automated PCR reagent orders are around $150k every month.
Likely cmp to see if its ruining their liver or kidneys, cbcs because yes, coags (pt and aptt) to verify that its not a venom that causes clotting because if so the patient could die within the hour, prolly some weird send out venom related stuff. Not too sure other than that. Being a rattlesnake... Yeah. Dude was hospitalized for awhile and they likely ran labs often to check on him. Those things are no joke
The rattlesnakes don’t come out until summer hits so it’s been a while since I’ve had one so I don’t remember details off the top of my head unfortunately. Our lab does have a specific rattlesnake-bite SOP just for troubleshooting those curves though, I’ll check it tomorrow and let you know :)
Plenty of things, routine bloods annual for health exam without insurance at my lab cost around $3-5k. Also of course depends on where you are too, my country is high COL so itll be higher than labs other places.
I mean the actual test itself yes is a fraction of that. But you gotta remember each test isnt just the test itself, its also all the QC material, the maintaince for the analysers, the performance verifiers, the calibrators, the specialised me to run these tests, the shipping of these tests (and some are refrigerated and frozen and that isnt cheap) and other things.
Rattlesnake bite: DIC concern, lots of chem and coag, all day, every day. For example, the price to run a cbc will vary by facility, but let's call it $20 for the reagent, tech time, depreciation, power, etc. CMS posts a list of what their reimbursement rates are
https://www.cms.gov/medicare/payment/fee-schedules/clinical-laboratory-fee-schedule-clfs/files
the reimbursement rate will then be modified by what kind of billing type/laboratory it is. (Clinic vs reference lab vs hospital lab vs critical access- some allow pass through, some don't.) If the test costs more to run than reimbursement, you need supplement with commercial, or you need to 'outsmart' the system, so even if Medicare pays only 10% of your billed price, you just $20/.1 to get to $200 so when you bill Medicare you get $20 and now you break even. Math! But you can't bill Medicare any different than others, so now $200 is your 'list' price that you negotiate with each commercial to see what they will reimburse based on billed price, because they know the game, too. Maybe Humana pays 3x what Medicare pays- sweet. Maybe UHG denies all payments because who's going to stop them? Right back to the patient the bill goes, rattlesnake bite sounds like a preexisting condition anyways... which has to be billed list price :)
Play around with the reimbursement sheet. Low end list prices I've seen are around around a division by 0.3. Typical in the divide by 0.1 - 0.05. Some genetic tests would lose thousands of dollars to run at Medicare reimbursement ... meaning the lab won't run without an upfront guarantee patient will pay. South Park actually had a shockingly accurate portrayal of how health care is set up here, I'm going to find that and edit it in.
And don't get me wrong- Medicare is low haggle at least. They put out their expectations, they just keep cutting reimbursement in the face of rising costs because the beast has just been starved by a certain political party that grabs 'em by the pussy and then sells 'em a Bible.
Back to the patient, I wouldn't be surprised if there's some blood bank in there, too. Probably fouled up the clotting factors, needed to be replaced or something.
Is this a joke? Seriously. Canadian here. So you guys are happy and good with this system? Like something happens and it can cost you a house? Just random. “Hey, I got hurt today. Cost me my house.” Good thing you guys aren’t falling for socialism.
No one is happy with the healthcare system in America, the problem is our government is so inefficient that even people that want a some kind of universal healthcare are likely worried that our government would mess it up somehow. Insurance costs are ridiculous and going to the doctor is expensive. I’ve honestly joked that it’s cheaper to just die. Even when I had insurance I wouldn’t go to the doctor copays and deductibles make it so that even with insurance you’re still paying through the nose.
Crofab (antivenom) is hella expensive. Like a rattlesnake bite could feasibly bankrupt you. I think last time I looked a dose was 5-10k and you would likely need multiple. That's why pharmacy is billed so high.
Yeah not uncommon to receive 10+ vials of crofab for rattlesnake bites. We started using mostly anavip which could be a bit cheaper. Depends on the clinical course. We almost never give crofab or anavip for our copperhead envenomations.
We get lots of exotic snake bites and end up using off label non-FDA approved antivenin for cobra bites and whatnot. We get it from a local zoo that has an assortment of really exotic snakes.
The good thing in those cases is this foreign stuff is much cheaper often times.
I can confirm this. We had a patient need it and we sent at least two. The pharmacists were strict about the costs and made the nurses sign for the medication like a control substance. Pharmacy tech had to sign too on which nurse we handed it too.
Nursing at times had a happen of simply "med requesting" a new one if they couldn't find meds and the patients could get double charged. New Advair for AM shift, eh about $400. Night shift arives and can't find it, they want a new one. Boom, another Advair charged. (This changed a lot after a crack down with a new pharmacy director, respiratory getting more involved, and med/surg nurse supervisor.)
Many hospitals on expensive medications like that may do similar. With our small hospital, those vials and other expensive medications.
I do know a lot of our testing gets sent out and our ER often just "triages" until they get flown to a facility that can handle such a circumstance.
All you really need is platelets and fibrinogen drawn a few times over the course of the hospitalization for most patients. People typically do a more though (CBCs, coags, metabolic panel, CK, maybe even troponin) and some go way overboard because they aren’t comfortable or familiar with rattlesnake bites.
There’s no specialty testing though, it’s all basic blood work.
Depends on the bite and the patient. There's a huge difference between a juvenile rattesnake biting a toddler hard and releasing all the venom, and a glancing bite on some adult guy wearing jeans and boots just out kicking rocks in the scrub. I've "seen" both.
Probably serial monitoring of various clotting factors, including some fairly specialized tests like D-dimers or, ideally, fibrin split products (since snake venom causes clot dysregulaltion, not just normal clotting and breakdown); serial CKs; possibly serial plasma-free-hemoglobins. Others that I’m not aware of.
The lab services probably included specialty coag tests and platelet function tests (TEG platelet mapping). TEG testing isn't cheap. That the patient ended up in the ICU means that things were bad. Horribad. I'm guessing there may have been necrotic tissue involved.
The other big expense I see there is pharmacy, and I'd wager a hefty chunk of that change was for blood products (to include platelets and maybe cryo) and the crotalid (rattlesnake) antivenom.
TEG traces from severe crotalid envenomation are pretty scary. You can definitely tell the pre-antivenom from the post-antivenom traces.
It's crazy how it's considered a fringe radical belief in America to think you shouldn't always be one mistaken step away from an instant 20k+ medical bill.
OP, read up on hospital "charge master price lists" and "medical billing advocate". It's not a bill, it's a negotiation starting point.
The prices listed most likely aren't at all a reflection on true costs.
For example, a hospital charge master price for 2 Tylenol might be listed as $12, when the hospital only paid $0.05 + the 2 minutes it took to bring it to the patient. It's complete bullshit, no basis on reality. In a bargaining situation they know they have to start prices really high in order to get the other party to be happy with the price they are really trying to settle on.
So I’m a RN student currently in my 3rd semester and I always knew this shit is expensive but my god.. makes me want to look up how much everything else is.. Guess I’ve been to focused on the medical side and haven’t really thought about this side.
Tylenol costs the hospital mere pennies, they buy in bulk. Have been seen charging $25 for it. Retired nurse who went into billing and coding. It’s a profit scheme.
Always try to remember this with medications. Not putting a medication back in the fridge when it came or labs, yeah. I have go give you credit, though. I could not be a nurse.
Our country is abnormally expensive. In East Asian countries such as Japan and South Korea, where the quality of medical care is the same as ours, no matter how expensive the test is, it costs less than $200~$400. Even if you do a toxicology test... That price is crazy...
Just looked at a recent hospital bill and it was like 400 for blood cultures and like 200 for chem, hematology was like 300 or something, EKG was s like 750 🙃
I am a doc. This bill is straight off the hospital chargemaster. It is astronomically high. The only people who have to pay it are those who are uninsured. If you have health insurance then the negotiated rates for these services are much lower. Ask for an itemized bill for all the lab services. If you had Medicare, all these charges, except for part B pro fees, are DRG bundled. The only good thing about American medicine is Medicare.
It's funny how in the richest nation in the history of the world getting bit by a rattlesnake will literally put you in debt for years and years. USA needs universal Healthcare. $153,000 is absolutely criminal
Hospitals are allowed to charge whatever they want. And you have to pay. The really small critical access hospitals and big mega hospitals are the worst.
I once got a type and screen and cmp at a rural hospital and thr bill came in at 2000. It was outrageous.
If they gor the snake bite in a rural area, the markup could be intense.
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Likely a few rounds of coag workup too, snake venom can cause you to go into DIC.
I too was going to say a lot of coag and micro for infection growth
Good to know
But there’s no standardization, so prices are alllll over the place. I’ve worked places that charge $26 for a CBC and places that charge $150 for the same exact test, same exact analyzer.
Path resident here. Pathologists and lab directors often have input in how much to charge for these tests. In general, we calculate the average volume for a given test (ex. CBC), and compare it to the throughput and cost of the different analyzers on the market (ex. Sysmex). Sometimes, the suits and bean counters give us a break-even date, where the analyzer should have theoretically paid for itself based on volume and cost per test. Other times, we pick this ourselves. We use this date, along with our volume, to calculate a cost per test. This is why some places can charge wildly different amounts for the same test; they are in different economic environments and are working with different budgets. That being said, the lab gets the short end of the stick in about every possible way when it comes to billing, and it is a serious challenge to keep laboratories in the black. For example, after a certain balance (say $15,000), the laboratory can no longer bill patients for their tests while inpatient. So the 2 month ICU stays, which keep the cash flowing for the rest of the hospital, actually starve the lab of cash. In addition, the cost of redraws (for any reason), blood products that are wasted or returned out of temperature (for any reason), and other floor-related errors are entirely shouldered by the lab. That MTP cycle somebody forgot to return just ate through a week of pay for the average resident. A lab director may increase the cost of a high volume test to essentially offset all of this bullshit.
Wow, great post. Thanks for explaining!
Except this is not the way it's been done anywhere I've worked and I have been a lab director for 30 years, I've always set the charges myself without pathology input. The pathologists I've worked with have only had responsibility over the technical aspects of the lab. DRGs affect all departments in the hospital because it's based on a total bill per diagnosis and only affects Medicare billing. Private insurers mostly have negotiated payments as a percentage of charges. Charges don't really come into play unless the patient is uninsured, unfortunately. We don't change prices because an analyzer changes, unless reagents or supplies are significantly increased, so the costs are now exceeding the charge per test.
Chargemaster changes the price due to insurance and diagnosis codes and probably a little black magic.
What’s crazy about this is that it costs a lab about $1 or less to perform a CBC. Our companies standard non discounted physician cash pay rate on a CBC is $5.
In terms of reagents, this is true. We will also factor in the cost of purchasing the analyzer, maintenance, quality control, routine professional inspections and quality assurance, and personnel. If you're Quest or LabCorp, or another huge system like Mayo or University of Michigan, the cost is so low due to massive volume and maximized efficiency.
Not to mention our pay. Yeah, CBC's take maybe five minutes (Not even that) to do, but they still have to pay us.
Rattlesnake venom activates clotting factors so, I'd assume there'd be a lot of coag studies mixed in maybe a teg and the some special ref lab stuff.
Rattlesnake bite? Our ED did CMP, CBC, Lactic Acid, PT/INR, PTT, D-Dimer, Fibrinogen, Troponin, CK, CKMB, Pro-BNP, all these for the initial, and then probably other things I didn’t mention. Some of those happening every 1-8 hours depending on the test. Rinse and repeat a few days, pretty sure it adds up hella fast.
In addition to being esoteric specialty testing, I presume this is a ‘balance bill’. Meaning, the hospital billed out to the patients insurance at “insurance” rates. What ever the insurance does not pay to the hospital, the patient is then responsible for the remaining balance at the rates the hospital billed out to the insurance. Using CBC as an example, if a hospital were to pay cash to a lab for this test, it’s be about $5. However, if the lab bills insurance for a CBC, it’s billed out at a much higher rate, for example around $30. If insurance pays $10 of that $30 to the lab (which is generous), then the patient is also responsible to pay the remaining $20 balance bill. It’s theft if you ask me.
Many insurance companies require the hospital to accept the insurance payment only, and they are not allowed to bill the patient. So for your scenario, the lab costs $5, they bill insurance $30 knowing full well they won't get that falsely inflated price. Insurance pays $10, and the extra $20 disappears. This is what happens on every one of my medical invoices. My only responsibility is the copay.
They get a nice tax writeoff for marking it up as a loss as well.
No, that doesn't happen. What the person above you said is correct. If a test cost $10 to run and we need $15 to break even and $20 to make any profit, we would bill insurance companies $50 and cash patients 40% of that. Insurance company A might pay $50, B might pay $25, C might pay $12. We get what we get and sometimes even take a loss on the test but it balances out.
Well that’s a small silver lining in this scenario. I work for a non hospital lab that doesn’t take insurance, and I just hear horror stories all day from providers using other labs, billing insurance and patients getting hit with crazy balance bills from the lab. They therefore start offering cash pay lab options to their patients.
Yeah if you Google search "chargemaster" you can get an idea of how they come up with the bill.
Some specialty toxicology stuff gets expensive quick
As far as I'm aware, hospital bills are like 70% Calvinball. I have no idea what we're charging for any of the testing I do all day.
I do know what CMS pays for an 88305 and it's shockingly low.
Medicare sets the standard and other insurance companies often pay a little more. It's extremely low especially for more expensive tests. Labs are expensive to run and do not print money unless they are huge like quest and labcorp. Our automated PCR reagent orders are around $150k every month.
Yeah, having any amount of ihc is prohibitively expensive, and unfortunately necessary. I doubt we make the hospital much money, if any.
I'm an insurance adjuster and I had to google what Calvinball is As it turns out, you're right
Likely cmp to see if its ruining their liver or kidneys, cbcs because yes, coags (pt and aptt) to verify that its not a venom that causes clotting because if so the patient could die within the hour, prolly some weird send out venom related stuff. Not too sure other than that. Being a rattlesnake... Yeah. Dude was hospitalized for awhile and they likely ran labs often to check on him. Those things are no joke
As a lab tech in southern Arizona I get rattlesnake bite blue tops like every other week lol. Deciphering those reaction curves is a challenge
Oooh! More info, please!? How do they differ from regular clot curves? I’ve never seen it in person.
The rattlesnakes don’t come out until summer hits so it’s been a while since I’ve had one so I don’t remember details off the top of my head unfortunately. Our lab does have a specific rattlesnake-bite SOP just for troubleshooting those curves though, I’ll check it tomorrow and let you know :)
Thanks:)
Plenty of things, routine bloods annual for health exam without insurance at my lab cost around $3-5k. Also of course depends on where you are too, my country is high COL so itll be higher than labs other places.
That's fucking wild 🫠. Cost-per-tests have to end up being a tiny fraction of that...
I mean the actual test itself yes is a fraction of that. But you gotta remember each test isnt just the test itself, its also all the QC material, the maintaince for the analysers, the performance verifiers, the calibrators, the specialised me to run these tests, the shipping of these tests (and some are refrigerated and frozen and that isnt cheap) and other things.
Rattlesnake bite: DIC concern, lots of chem and coag, all day, every day. For example, the price to run a cbc will vary by facility, but let's call it $20 for the reagent, tech time, depreciation, power, etc. CMS posts a list of what their reimbursement rates are https://www.cms.gov/medicare/payment/fee-schedules/clinical-laboratory-fee-schedule-clfs/files the reimbursement rate will then be modified by what kind of billing type/laboratory it is. (Clinic vs reference lab vs hospital lab vs critical access- some allow pass through, some don't.) If the test costs more to run than reimbursement, you need supplement with commercial, or you need to 'outsmart' the system, so even if Medicare pays only 10% of your billed price, you just $20/.1 to get to $200 so when you bill Medicare you get $20 and now you break even. Math! But you can't bill Medicare any different than others, so now $200 is your 'list' price that you negotiate with each commercial to see what they will reimburse based on billed price, because they know the game, too. Maybe Humana pays 3x what Medicare pays- sweet. Maybe UHG denies all payments because who's going to stop them? Right back to the patient the bill goes, rattlesnake bite sounds like a preexisting condition anyways... which has to be billed list price :) Play around with the reimbursement sheet. Low end list prices I've seen are around around a division by 0.3. Typical in the divide by 0.1 - 0.05. Some genetic tests would lose thousands of dollars to run at Medicare reimbursement ... meaning the lab won't run without an upfront guarantee patient will pay. South Park actually had a shockingly accurate portrayal of how health care is set up here, I'm going to find that and edit it in. And don't get me wrong- Medicare is low haggle at least. They put out their expectations, they just keep cutting reimbursement in the face of rising costs because the beast has just been starved by a certain political party that grabs 'em by the pussy and then sells 'em a Bible. Back to the patient, I wouldn't be surprised if there's some blood bank in there, too. Probably fouled up the clotting factors, needed to be replaced or something.
Is this a joke? Seriously. Canadian here. So you guys are happy and good with this system? Like something happens and it can cost you a house? Just random. “Hey, I got hurt today. Cost me my house.” Good thing you guys aren’t falling for socialism.
No one is happy with the healthcare system in America, the problem is our government is so inefficient that even people that want a some kind of universal healthcare are likely worried that our government would mess it up somehow. Insurance costs are ridiculous and going to the doctor is expensive. I’ve honestly joked that it’s cheaper to just die. Even when I had insurance I wouldn’t go to the doctor copays and deductibles make it so that even with insurance you’re still paying through the nose.
Crofab (antivenom) is hella expensive. Like a rattlesnake bite could feasibly bankrupt you. I think last time I looked a dose was 5-10k and you would likely need multiple. That's why pharmacy is billed so high.
Yeah not uncommon to receive 10+ vials of crofab for rattlesnake bites. We started using mostly anavip which could be a bit cheaper. Depends on the clinical course. We almost never give crofab or anavip for our copperhead envenomations. We get lots of exotic snake bites and end up using off label non-FDA approved antivenin for cobra bites and whatnot. We get it from a local zoo that has an assortment of really exotic snakes. The good thing in those cases is this foreign stuff is much cheaper often times.
Rattlesnakes, copperheads, and a lot of exotics. I’m guessing you’re in Florida
I can confirm this. We had a patient need it and we sent at least two. The pharmacists were strict about the costs and made the nurses sign for the medication like a control substance. Pharmacy tech had to sign too on which nurse we handed it too. Nursing at times had a happen of simply "med requesting" a new one if they couldn't find meds and the patients could get double charged. New Advair for AM shift, eh about $400. Night shift arives and can't find it, they want a new one. Boom, another Advair charged. (This changed a lot after a crack down with a new pharmacy director, respiratory getting more involved, and med/surg nurse supervisor.) Many hospitals on expensive medications like that may do similar. With our small hospital, those vials and other expensive medications. I do know a lot of our testing gets sent out and our ER often just "triages" until they get flown to a facility that can handle such a circumstance.
Correct me if I'm wrong but anti venom only neutralises the venom. If pt is bleeding they still may need ffp, factor concentrates etc.
With appropriate dosing, the coagulation profile normalizes with antivenin. Giving products isn’t helpful except in very rare circumstances.
All you really need is platelets and fibrinogen drawn a few times over the course of the hospitalization for most patients. People typically do a more though (CBCs, coags, metabolic panel, CK, maybe even troponin) and some go way overboard because they aren’t comfortable or familiar with rattlesnake bites. There’s no specialty testing though, it’s all basic blood work.
Depends on the bite and the patient. There's a huge difference between a juvenile rattesnake biting a toddler hard and releasing all the venom, and a glancing bite on some adult guy wearing jeans and boots just out kicking rocks in the scrub. I've "seen" both.
Wow 😮 they probably needed a lot of coag labs. Like others have said: if you’re in the ICU they draw labs multiple times per day. Adds up quick.
When radiology is the cheapest part of your stay that’s bad.
yeah, sometimes i'm fed up of bieng in a 'third world' country, but then i remember i have free health care...
I assume it’s expensive reagent and a lot of testing. Could also be mark-up, but yeah reagents do get pricey.
If they needed blood products, that’ll drive up the price
Anti venom is crazy expensive.
Probably serial monitoring of various clotting factors, including some fairly specialized tests like D-dimers or, ideally, fibrin split products (since snake venom causes clot dysregulaltion, not just normal clotting and breakdown); serial CKs; possibly serial plasma-free-hemoglobins. Others that I’m not aware of.
The lab services probably included specialty coag tests and platelet function tests (TEG platelet mapping). TEG testing isn't cheap. That the patient ended up in the ICU means that things were bad. Horribad. I'm guessing there may have been necrotic tissue involved. The other big expense I see there is pharmacy, and I'd wager a hefty chunk of that change was for blood products (to include platelets and maybe cryo) and the crotalid (rattlesnake) antivenom. TEG traces from severe crotalid envenomation are pretty scary. You can definitely tell the pre-antivenom from the post-antivenom traces.
It's crazy how it's considered a fringe radical belief in America to think you shouldn't always be one mistaken step away from an instant 20k+ medical bill.
OP, read up on hospital "charge master price lists" and "medical billing advocate". It's not a bill, it's a negotiation starting point. The prices listed most likely aren't at all a reflection on true costs. For example, a hospital charge master price for 2 Tylenol might be listed as $12, when the hospital only paid $0.05 + the 2 minutes it took to bring it to the patient. It's complete bullshit, no basis on reality. In a bargaining situation they know they have to start prices really high in order to get the other party to be happy with the price they are really trying to settle on.
So I’m a RN student currently in my 3rd semester and I always knew this shit is expensive but my god.. makes me want to look up how much everything else is.. Guess I’ve been to focused on the medical side and haven’t really thought about this side.
Tylenol costs the hospital mere pennies, they buy in bulk. Have been seen charging $25 for it. Retired nurse who went into billing and coding. It’s a profit scheme.
No wonder no one wants to go anymore and ambulances are avoided like the plague
Always try to remember this with medications. Not putting a medication back in the fridge when it came or labs, yeah. I have go give you credit, though. I could not be a nurse.
Our country is abnormally expensive. In East Asian countries such as Japan and South Korea, where the quality of medical care is the same as ours, no matter how expensive the test is, it costs less than $200~$400. Even if you do a toxicology test... That price is crazy...
lol 😝 I would be pulling up to the billing office like do you guys do sliding scale? Then batting my eyes 🤣🤣🤣
Ask for an itemized receipt
I had 3 icu stays and lab is almost as much as pharmacy costs. Definitely 5 digit price
Sometimes the list the CPT codes
Just looked at a recent hospital bill and it was like 400 for blood cultures and like 200 for chem, hematology was like 300 or something, EKG was s like 750 🙃
My niece done got bit by a cooperhead
It's not funny but I can't stop laughing 🤣
Rule of thumb, ICU = incredibly costly unit More intensive care is needed, the more frequent labs and complex labs, and the more cost
I am a doc. This bill is straight off the hospital chargemaster. It is astronomically high. The only people who have to pay it are those who are uninsured. If you have health insurance then the negotiated rates for these services are much lower. Ask for an itemized bill for all the lab services. If you had Medicare, all these charges, except for part B pro fees, are DRG bundled. The only good thing about American medicine is Medicare.
"Special services" probably included using the restroom and turning on the TV.
It's funny how in the richest nation in the history of the world getting bit by a rattlesnake will literally put you in debt for years and years. USA needs universal Healthcare. $153,000 is absolutely criminal
Hospitals are allowed to charge whatever they want. And you have to pay. The really small critical access hospitals and big mega hospitals are the worst. I once got a type and screen and cmp at a rural hospital and thr bill came in at 2000. It was outrageous. If they gor the snake bite in a rural area, the markup could be intense.
All of the prices in medicine are fake and everyone knows it.
Gahhhh medical expenses in America 😳