Pay the Fiddler
I mentioned I would share itemized lists of all the costs associated with my ACL reconstruction and menisci repair surgery, once I obtained that information. Well, I don’t have itemized lists (yet!), but here are some of the figures that have shown up on my healthcare accounts due to the diagnostic (MRI, x-ray), surgical, and rehabilitation aspects of my knee injury. You might want to sit down, first. Thankfully, these are raw numbers — eg. what healthcare providers billed my insurance, not out-of-pocket expenses we have had to pay outright (unless otherwise noted!) In general, we’re responsible for 10% of all health care services rendered, and we’re still waiting on paperwork for those bills to arrive! Thankfully, there is also a maximum cap on the total out-of-pocket expenses incurred in a plan period (see, now I’m talking like they do!), so it helps to minimize one’s total exposure to exorbitant healthcare costs.
- Knee Injury Diagnosis & Referral on 1/13:
— OFC/OUTPT VISIT E&M NEW LOW-MO: $93.00 - MRI on 1/18:
– MR IMAG ANY JNT LOW EXTREM: $950.00 - Diagnostic Visit with Orthopedic Specialist/Surgeon (OS) on 1/24*:
– OFC/OUTPT VISIT E&M NEW LOW-MO: $172.83
– RADIOLOGIC EXAM KNEE; COMPLETE: $134.46
* Our $1,500 deductible paid $99.71 of this visit. - Day of Surgery (2/4)
– FULL DEDUCTIBLE DUE, PRE-OP: $1,400.29 OUT-OF-POCKET! - Day of Surgery (2/4) – Pre-Op Nurse:
– BLOOD COUNT; COMPLETE AUTOMATIC: $14.00
– URINE PREGNANCY TEST VISUAL CO: $10.00 {They check, even if your period is at the time of surgery.}
– UA DIP STICK/TABLET REAGENT; A: $10.00 {Part of the PG test; that, or I got an oil change!} - Day of Surgery (2/4) – Attending Nurse in O.R. (I think):
– ARTHSCPY AIDED ACL REPAIR/AUG: $3835.91
– BONE GRAFT ANY DONOR AREA; MAJ: $2142.89 - Day of Surgery (2/4) – My Orthopedic Surgeon (OS), aka the “Big Kahuna”:
– ARTHSCPY AIDED ACL REPAIR/AUG: $5114.55
– ARTHROSCOPY KNEE; W/MENISCUS REPAIR: $3588.77
– BONE GRAFT ANY DONOR AREA; MAJ: $2857.18
(It’s timely to note that there appears to be a huge “game” between the medical profession and insurance, in that both of the “Bone Graft” line items were marked as “DECLINED” by my insurance. It’s like the insurance co. is saying, “Boys, we know during her knee surgery you took a little bone graft, but you don’t get to bill for that separately!” No one’s hassled me, yet, so I assume this is Standard Operating Procedure.) - Day of Surgery (2/4) – Cryo Cuff Setup/Rental:
– WATER CIRCULATING COLD PAD WIT: $480.00
– DME SUP/ACCESS/SRV-COMPON/OTH: $50.00 {“Accessories”: Igloo cooler, water pump & hose)
– DME DEL SET UP&/DISPNS SRVC CM : $125.00 {“Delivery & Setup”… in my hospital room, while I was hopped up on Demerol!} - Day of Surgery (2/4) – CPM Setup/Rental (2 weeks):
– PASSIVE MOTION EXERCISE DEVICE: $720.00 - 1st PT Session/Evaluation on 2/7:
– APPLICATION MODAL 1/MORE AREAS: $22.00 {Icing and stretching}
– THERAP PROC 1/> AREAS EA 15 MI: $140.00 {Physical Therapy exercises/guidance} - 1st Post-Op Checkup with OS on 2/14:
– RADIOLOGIC EXAMINATION KNEE; O: $139.87 {More x-rays, now showing 3 screws in my leg!} - PT Sessions (Ongoing, weekly charges):
– APPLICATION MODAL 1/MORE AREAS: $22.00
– THERAP PROC 1/> AREAS EA 15 MI: $140.00
TOTAL BILLED AS OF LAST WEEK: $22,162.75
TOTAL OUT-OF-POCKET SO FAR: $1,500 (Deductible)
And that, my friends, are just the charges that have “hit” so far. For instance, it doesn’t include the $900+ hinged ACL brace I now wear daily, nor my second OS checkup this Friday, and PT sessions that will remain three days a week for some time yet! Thank God for health insurance!
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