Liars and profiteers.
I had anesthesia for a 12-minute endoscopy. The anesthesia itself was fine, the anesthesiologist was great, I didn't die or have any adverse reactions, etc.
HOWEVER. I received this very vague bill yesterday. Apparently, for my 12ish minutes of anesthesia, my insurance company was billed $1,960. My insurance company talked that down to $729.60, of which they paid 90%. This means my outstanding portion of the bill is $72.96.
This is all fine and good, and I get that in the United States healthcare costs are psychotically high, but I still thought it was bizarre for an anesthesiologist to charge this much money for 12ish minutes. I called York Anesthesiologists to ask the following questions:
1. What, exactly, am I paying for? Can I get an itemized invoice detailing the exact charges for each service I am being billed for?
2. If York Anesthesiologists can so readily knock $1,230.40 off the bill for the sake of my insurance company, do they want to go ahead and knock of the $72.96 that I owe? (Thought I might as well ask since surely they're still making a handsome profit.)
I spoke with two people at the office. The first one played dumb and acted like I was asking these impossible questions about the nature of being. The second guy was extremely huffy, kept loudly sighing and implying I was being deliberately difficult, and went out of his way to make me feel unwelcome and insulted. He eventually told me that his "hands were tied" and that he refused to tell me how much anything cost. He refused to send me an itemized invoice detailing charges for anesthesia and the anesthesiologist's time, etc. He then told me it was because of HIPAA and that part of HIPAA is to protect a doctor's privacy from patients knowing how much they charge for things??? Absolutely insane.
I ended the call and then called my insurance company. Get this: My insurance company actually AGREED that the charges were insanely high, and immediately informed me that HIPAA offers no such guarantee to a doctor's billing secrecy, and in fact guarantees a patient's right to a detailed invoicing of what they're being charged. My insurance company even offered to call York Anesthesiologists to tell them to knock it off. I'm not pursuing it because, after a little bit of research, I found out that anesthesiologists bill in "units," which doesn't provide any information on what you're actually paying for, just the time for the procedure. York used the code 00740, Anesthesia for Upper Endoscopy, which was not on the invoice they sent me but was provided to me by my insurance company. From the way I see it, this sort of coding allows anesthesiologists to comply with the body of HIPAA while still leaving the patient in the dark re: what they're being charged for. That's disappointing and about as American as things come, but the deliberately hostile, belittling, and duplicitous interaction I had with the two people on the phone has left a very sour taste in my mouth. I doubt you can avoid billing ambiguity like this in the United States, but I wanted to at least put the word out there that you *do* have a right to know how much you're being charged, even though apparently anesthesiologists have a pretty reliable way to obfuscate the process.
Lastly, to reiterate, the anesthesia and the anesthesiologist were fine. It's just psychotically expensive and deliberately vague. If I ever need an endoscopy again, I'm going to talk with my doctor about foregoing anesthesia (which is apparently possible) and doing my best to not choke on my own barf. I feel like York Anesthesiologists would bill you $500 to hit you on the head with a hammer and still go out of their way to be as snotty to you as possible for asking for a breakdown of the bill. read more