Guest guest Posted April 23, 2006 Report Share Posted April 23, 2006 It is hard to believe that this amount was billed. Someone must have billed for 2 AVS as they did before and after ACTH. I have never heard of such an amount. Fill a protest immediately with them and with BCBS. Please get all the details and keep us posted. Something is very wrong. Write to your state board of health as well. Does anyone else have charges for their study? I must admit I do not know the charges or how much one is charged but will check into it here in Milwaukee. May your pressure be low! CE Grim, BS(Chem/Math), MS(Biochem), MD. Board Certified in Internal Medicine, Geriatrics and Hypertension Former Epidemiologic Intelligence Services Officer (Lt. Comdr.), CDC Specializing in Difficult to Manage High Blood Pressure Clinical Professor of Medicine, Medical College of Wisconsin Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 23, 2006 Report Share Posted April 23, 2006 I don't recall how much mine cost, but if it helps I had it done at St. Lukes - I was referred there by an endo in Waukesha who made it sound like they are the only hospital in Milwaukee that does AVS. Re: Re: Charge for AVS hyperaldosteronism > It is hard to believe that this amount was billed. Someone must > have billed > for 2 AVS as they did before and after ACTH. I have never heard > of such an > amount. Fill a protest immediately with them and with BCBS. > Please get > all the details and keep us posted. Something is very wrong. > Write to your > state board of health as well. > > Does anyone else have charges for their study? I must admit I do > not know > the charges or how much one is charged but will check into it here > in > Milwaukee. > > > > May your pressure be low! > > CE Grim, BS(Chem/Math), MS(Biochem), MD. > Board Certified in Internal Medicine, Geriatrics and Hypertension > Former Epidemiologic Intelligence Services Officer (Lt. Comdr.), CDC > Specializing in Difficult to Manage High Blood Pressure > Clinical Professor of Medicine, Medical College of Wisconsin > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 2006 Report Share Posted April 24, 2006 In a message dated 4/24/06 9:49:11 AM, shahall@... writes: Venous sampling S & I (2) 1,884 Venogram adrenal bilat S & I 1,020 Venography, renal unil S & I 968 This should be part of the first charge. Someone is ripping someone off. I would see if there is a TV guy who investigates this sort of thing. The assay cost was doubled by doing before and after ACTH sampling which is not what I do as currrent evidence is that you do not need to do before and after. The charge for renin also seems excessive for one assay. Plus you can see how those who make catheters and wires are ripping us off. It would be reasonable to get a discount when you do 12 samples at once as they are all run by a machine. We need to shop for labs that will do that. May your pressure be low! CE Grim, BS(Chem/Math), MS(Biochem), MD. Board Certified in Internal Medicine, Geriatrics and Hypertension Former Epidemiologic Intelligence Services Officer (Lt. Comdr.), CDC Specializing in Difficult to Manage High Blood Pressure Clinical Professor of Medicine, Medical College of Wisconsin Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 2006 Report Share Posted April 24, 2006 I have double checked with our Xray people here and it looks like they double billed as the first item includes the last 3 items. The comment was that most places dont do many of these so it was likely a coding error but as UM must do these every week I would think they should know it is not billed this way. Indeed this would be illegal billing for Medicare. Also contact your insurance company and tell them it looks like double billing and UM Hosp. Now! May your pressure be low! CE Grim, BS(Chem/Math), MS(Biochem), MD. Board Certified in Internal Medicine, Geriatrics and Hypertension Former Epidemiologic Intelligence Services Officer (Lt. Comdr.), CDC Specializing in Difficult to Manage High Blood Pressure Clinical Professor of Medicine, Medical College of Wisconsin Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 2006 Report Share Posted April 24, 2006 In a message dated 4/24/06 9:37:39 AM, shahall@... writes: I had two AVS's done: > The first one at UC San Francisco(which the doctor did not do right) > cost me over $6,000( I have a break down of what the charges were > of), from the hospital which did not include the radiologist's fee). > His charge was something like $600 for one gland, $750 for another > gland and since he did the before and after ACTH, he double charged > for each sample he took. UCSF hospital told me that the ACTH is > costing them $500.00(so almost $10K all together) at UCSF. Though my > insurance did not cover all I got stuck with paying the balance they > did not deserve to get since they didn't do it right. This is highway robbery it seems to me. No wonder our health care system is going broke at these charges. Someone must be in bed with those who put together these changes. The time from sampling one side and then the other can be as little as 2 minutes. May your pressure be low! CE Grim, BS(Chem/Math), MS(Biochem), MD. Board Certified in Internal Medicine, Geriatrics and Hypertension Former Epidemiologic Intelligence Services Officer (Lt. Comdr.), CDC Specializing in Difficult to Manage High Blood Pressure Clinical Professor of Medicine, Medical College of Wisconsin Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 2006 Report Share Posted April 24, 2006 In a message dated 4/24/06 1:35:42 AM, farahbar@... writes: I had two AVS's done: The first one at UC San Francisco(which the doctor did not do right) cost me over $6,000( I have a break down of what the charges were of), from the hospital which did not include the radiologist's fee). His charge was something like $600 for one gland, $750 for another gland and since he did the before and after ACTH, he double charged for each sample he took. UCSF hospital told me that the ACTH is costing them $500.00(so almost $10K all together) at UCSF. Though my insurance did not cover all I got stuck with paying the balance they did not deserve to get since they didn't do it right. The second one was done at Mayo Clinic and the charge of everything including 6 hours at hospital was about $5000.00 Farah Sounds like Mayo is the place to go. You will save enough to cover the flight and hotel and then some. May your pressure be low! CE Grim, BS(Chem/Math), MS(Biochem), MD. Board Certified in Internal Medicine, Geriatrics and Hypertension Former Epidemiologic Intelligence Services Officer (Lt. Comdr.), CDC Specializing in Difficult to Manage High Blood Pressure Clinical Professor of Medicine, Medical College of Wisconsin Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 2006 Report Share Posted April 24, 2006 The do have the most experience in the area. At one time we have an expert with excellent "hands" who could usually get both sides but he moved away. May your pressure be low! CE Grim, BS(Chem/Math), MS(Biochem), MD. Board Certified in Internal Medicine, Geriatrics and Hypertension Former Epidemiologic Intelligence Services Officer (Lt. Comdr.), CDC Specializing in Difficult to Manage High Blood Pressure Clinical Professor of Medicine, Medical College of Wisconsin Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 25, 2006 Report Share Posted April 25, 2006 In a message dated 4/24/06 11:12:50 PM, garypatton@... writes: my first AVS at OHSU (oregon) looks like sticker price was $17915. after network discounts etc... it ended up around 14000. these billings are so vague it's difficult to determine. my 2nd AVS which went bad and I spent the night in the hospital cost 9388. Guess they felt sorry for me. I think we need to post a summary of this discussion in our files. The title should be: Warning. The cost of AVS may be very expensive so be sure it is done right and by someone who has done a number of them as you dont want to have to pay for it twice. May your pressure be low! CE Grim, BS(Chem/Math), MS(Biochem), MD. Board Certified in Internal Medicine, Geriatrics and Hypertension Former Epidemiologic Intelligence Services Officer (Lt. Comdr.), CDC Specializing in Difficult to Manage High Blood Pressure Clinical Professor of Medicine, Medical College of Wisconsin Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 25, 2006 Report Share Posted April 25, 2006 Just be certain they do ACTH before the sampling. It will save about $4,000 it look like and if you only need one it will save you another 10,000 it sounds like. May your pressure be low! CE Grim, BS(Chem/Math), MS(Biochem), MD. Board Certified in Internal Medicine, Geriatrics and Hypertension Former Epidemiologic Intelligence Services Officer (Lt. Comdr.), CDC Specializing in Difficult to Manage High Blood Pressure Clinical Professor of Medicine, Medical College of Wisconsin Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 25, 2006 Report Share Posted April 25, 2006 In a message dated 4/25/06 3:49:42 PM, frand.2@... writes: Dr. Grim, Medicine in this country is all about making money, it is not about patient care. I have the bill from my octreotide scan last fall. They billed the insurance $4038. My insurance allowed $2363.10 and they paid the hospital 2,126.80 and I had to pay $236.30. Since the hospital was a preferred provider, they had to drop the remaining charges. Of course there was a later bill for the doctor who, I guess, reviewed the scan because I never heard of him. Imagine someone who doesn't have insurance, they will be billed for the whole amount. If you have never seen the movie, "The Doctor", you should try to find it. It is about a surgeon who gets cancer and suddenly becomes a patient and finds out how patients are treated. It should be mandatoroy for every doctor, nurse and receptionist to see it at least once a year. Fran But as another mentioned there is no free market forces here. When we turn out so many specialists and not enough well trained Internists the speicalist still have to "live" so they do lots of stuff that many not be clearly indicated and they do speicailities because they pay so much more. May your pressure be low! CE Grim, BS(Chem/Math), MS(Biochem), MD. Board Certified in Internal Medicine, Geriatrics and Hypertension Former Epidemiologic Intelligence Services Officer (Lt. Comdr.), CDC Specializing in Difficult to Manage High Blood Pressure Clinical Professor of Medicine, Medical College of Wisconsin Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 25, 2006 Report Share Posted April 25, 2006 Yes I would like to talk with him. May your pressure be low! CE Grim, BS(Chem/Math), MS(Biochem), MD. Board Certified in Internal Medicine, Geriatrics and Hypertension Former Epidemiologic Intelligence Services Officer (Lt. Comdr.), CDC Specializing in Difficult to Manage High Blood Pressure Clinical Professor of Medicine, Medical College of Wisconsin Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 25, 2006 Report Share Posted April 25, 2006 keep us posted when you figure this out. May your pressure be low! CE Grim, BS(Chem/Math), MS(Biochem), MD. Board Certified in Internal Medicine, Geriatrics and Hypertension Former Epidemiologic Intelligence Services Officer (Lt. Comdr.), CDC Specializing in Difficult to Manage High Blood Pressure Clinical Professor of Medicine, Medical College of Wisconsin Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 25, 2006 Report Share Posted April 25, 2006 I have no complaints about the procedure itself or my experience at U of M. Their staff was courteous, friendly and professional. Dr. Cho does all the AVS at U of M and has done over 600 or 800, can't remember which. I talked to him beforehand and he answered all my questions. They procedure itself took less than an hour. It's just this billing mess that's turned into a nightmare. But after reading 's post about a $17,915 bill my $13,866 bill doesn't look as bad as it did. That's a sad thing to have to say, isn't it? a > I think we need to post a summary of this > discussion in our files. The > title should be: > Warning. The cost of AVS may be very expensive so > be sure it is done right > and by someone who has done a number of them as you > dont want to have to pay > for it twice. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 25, 2006 Report Share Posted April 25, 2006 Fran, I've had hot flashes and heart-pounding nightsweats periodically for years but thought it was a menopausal thing, now you've got me wondering. I was apprehensive about the AVS for the same reason, lying on my back for an extended period. I have never been comfortable lying on my back. I'm a stomach sleeper and wake up if I turn on my back during the night. But honestly, my AVS was a piece of cake. After reading other stories here I realize they're not all like that, but mine was. My procedure went like this: An IV was started before the procedure which stayed in until I was discharged. The Dr. came in and talked to me beforehand. He explained the AVS to me, risks involved, possible complications, etc, and answered my questions. I was taken to the procedure room and hooked up to BP monitor and pulse oximeter and oxygen was applied via nasal cannula. A small dose of Versed and Fentanyl was given IV. I was awake and alert throughout the procedure but felt quite calm. My right groin was shaved and prepped and a local anesthesia was injected. It stings but is not painful. I felt some pressure as the catheter was introduced into the vein but again, no pain. I was able to see the monitor and watched the entire procedure on it. I felt one twinge of discomfort as the guidewire was advanced at one point, but this passed very quickly. After the samples were taken the catheter was removed, pressure was applied to the site for 10 minutes then a bandaid was applied. Somebody at some point (I think it may have been my Endo) had told me that I would have to lie 4-6 hours flat on my back afterward so I was pleasantly surprised when the nurse told me it would be 2 hours. She said the 4-6 hours is for an arterial poke like a cardiac cath, AVS is a venous poke. So I watched TV for 2 hours and went home. You cannot drive yourself due to the sedation. They told me to expect my groin to be a little sore the next day but mine wasn't at all. The worst part of the whole thing was the apprehension. My procedure was schedule for 9:30 and they didn't take me into the room until 11:45, so I had myself pretty worked up by then. And like you, I went undiagnosed for years so I can definitely sympathize. I have bilateral adenomas and was hoping that just one side was functional, I could have one adrenal taken out and be " fixed " . No such luck, the AVS showed bilateral hyperfunction. But just the fact that I now know what is wrong with me has given me some peace of mind. I don't know how to put it, other than I have a feeling a validation now. I actually have a condition that has a name and so many of those annoying symptoms that I've complained of through the years were not in my head but caused by the PA. I realize now that the frequent palpitations that I had throughout the years were due to hypokalemia and that I'm probably lucky I didn't drop dead. I know now that I don't have an overactive bladder because I have to get up 2-3 times a night and why the Detrol I was prescribed didn't help at all. My BP is sooo much better since I was diagnosed and my spiro doubled, usually 130's over 70's. Worrying about the bill for the AVS probably hasn't helped it any Keep your chin up and try not to worry too much about the AVS. I'll be rooting for you. a --- pagirl1946 <frand.2@...> wrote: > a, > > Thanks for the info, I don't check this web site > often and just got > in to see if anyone could give me any info on AVS. > I am waiting for > results of a saline supression test to come back and > my Dr. said that > if it is positive, he will schedule me for AVS. My > biggest fear of > the procedure is laying on my back for a long time. > I have terrible > hot flashes from this thing and most of the heat is > in my back. I > can feel it moving from the back of my head down my > back. During > the " hot flash " my heart pounds. Sometimes it wakes > me up during the > night and what wakes me is the sound of the blood > gushing thru my > head. It is horrible. The best way to relieve it > is to get off of > my back and get under a fan. I have Blue Cross > Standard option. My > insurance pays 80% of " customary and reasonable " > charges. It is my > understanding that the preferred providers agree to > reduce the charge > to what is customary and reasonable and I only pay > 20% of that. There > is also a catostrophic limit or something like that. > I will probably > have the money to pay whatever I owe. My concern is > getting this > tumor/adnoma out before I die. I am really > beginning to feel that I > won't make it. These doctors only care about > research and could care > less if the patient dies. Dr. Grim, please do not > make any comments > to this message, I do not want to hear from you. > Doctors have > ignored my condition for years and when I finally > got referred to > someone who can help me, he had to start all over > again. He took me > off of spiro to run a test and told me to go back on > it as soon as I > did the test. Then a few days later, he called me > and said he wanted > to do the saline supression test. I hit the roof > and told him to get > his act together. Nothing else helps my bp and most > drugs I have > tried make it go higher so I am only taking the beta > blocker that I > have been taking for years and 1/4 tab of Maxzide. > It seems to me > that anything that takes sodium out of my body > drives my bp extremely > high. I am just getting along the best I can with > bp around 168/85 > most of the time but sometimes jumping higher. I > only check it once > a day so I can reassure myself it isn't too bad. I > worry with every > pain I have in either my chest or my head. I have > some questions > about the AVS. Did you put you to sleep to do it? > Did you have an > IV during it and afterward? Were you able to drive > home afterwards? > The saline they gave me during my last test was at > room temp so it > made me cold and the hot flashes I had were mild. > That was a big > relief. > > Fran Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 25, 2006 Report Share Posted April 25, 2006 Think about the 25 million in the US without insurance. They will be billed the full amount. May your pressure be low! CE Grim, BS(Chem/Math), MS(Biochem), MD. Board Certified in Internal Medicine, Geriatrics and Hypertension Former Epidemiologic Intelligence Services Officer (Lt. Comdr.), CDC Specializing in Difficult to Manage High Blood Pressure Clinical Professor of Medicine, Medical College of Wisconsin Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2006 Report Share Posted April 26, 2006 In a message dated 4/26/06 7:20:03 AM, shahall@... writes: That makes sense, doesn't it? People who can't afford to pay for health insurance are charged even more exorbitant rates. Good article I just read this morning says that about 45.8 million Americans did not have health insurance in 2004. It's like we're a third-world country. The problem is us tax payers pay for the majority of their care and it is almost always late in the game so it costs a lot more. This is the reason most health economists recommend universal insurance so we stop the strokes etc before they happen. A major cost to the health care bill is the complications of poorly or untreated HTN. May your pressure be low! CE Grim, BS(Chem/Math), MS(Biochem), MD. Board Certified in Internal Medicine, Geriatrics and Hypertension Former Epidemiologic Intelligence Services Officer (Lt. Comdr.), CDC Specializing in Difficult to Manage High Blood Pressure Clinical Professor of Medicine, Medical College of Wisconsin Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2006 Report Share Posted April 26, 2006 That makes sense, doesn't it? People who can't afford to pay for health insurance are charged even more exorbitant rates. Good article I just read this morning says that about 45.8 million Americans did not have health insurance in 2004. It's like we're a third-world country. http://news./s/ap/20060426/ap_on_he_me/uninsured_americans --- lowerbp2@... wrote: > Think about the 25 million in the US without > insurance. They will be billed > the full amount. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2006 Report Share Posted April 26, 2006 Every med student learns about this disease, but dont understand statistics. May your pressure be low! CE Grim, BS(Chem/Math), MS(Biochem), MD. Board Certified in Internal Medicine, Geriatrics and Hypertension Former Epidemiologic Intelligence Services Officer (Lt. Comdr.), CDC Specializing in Difficult to Manage High Blood Pressure Clinical Professor of Medicine, Medical College of Wisconsin Quote Link to comment Share on other sites More sharing options...
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