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Re: Charge for AVS

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Great post, a.

-Kip

>

> If anyone is going to have an AVS in the future I'm

> offering a few hints in hindsight. My first

> appointment for AVS had to be cancelled when U of M

> called me the day before to tell me that none of their

> doctors accepted my insurance, a Blue Cross PPO, and

> that I would be liable for all charges - first I'd

> ever heard of this. I knew I couldn't afford to pay

> so I cancelled and called Blue Cross. They told me

> that if my primary physician asked for a referral they

> would cover the procedure. My primary got one and the

> AVS was done in March. I called U of M the day before

> to make sure they had the referral information, which

> they did. Yesterday I got a statement from Blue Cross

> which showed they paid U of M $583 for the procedure.

> I also got a statement from U of M that I opened after

> that. I still can't believe it, they billed Blue

> Cross $13,866 for the AVS. Seeing how it took less

> than an hour to do and I laid in recovery for 2 hours

> afterward, this seems just a tad excessive to me. My

> son's hernia surgery cost less than this. There's a

> note on the statement that says " This amount has been

> billed to your insurance company. Amounts not paid by

> insurance companies may be rebilled to you. " If U of

> M bills me for $13,283 I'll either have to get an

> attorney or file for bankrupcy. In hindsight I

> realize I should have questioned U of M more, asked

> how much the procedure was going to cost and if they

> accepted whatever payment my insurance allows or if I

> was liable for any of the balance. This is the first

> time I've run into a situation where a doctor or

> hospital did not accept my insurance so I'll be a lot

> wiser in the future if this happens again. If anyone

> needs an AVS in the future all I can say is ask a lot

> of questions about costs, billing and insurance before

> hand.

>

> a

>

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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

>

> 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

> >

>

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Thanks for the info, Farah. When did you have your AVS done at Mayo?

I'd appreciate it if anyone else that's had one would post where and

when it was done and how much they charged. I'm going to start

accumulating info in case I have to get a lawyer and fight this. U of

M is evidently the only hospital in Michigan who does AVS and they

seem to be taking advantage of that fact. And the fact that of Jan 1

they quit accepting my insurance, I wonder how many other insurances

they quit accepting. Seems like that makes them the only game in town

and allows them to charge whatever they want.

a

>

> 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.

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I just realized this doesn't even include the

Radiologist's fee! Breakdown of charges:

TR-venous sampling w/o A (2) 3,058

Recovery phase 2, 2.0 hr 418

Mod sedation 30 minutes 200

Mod sedation add 15 min (2) 60

Lidocaine 2% 20 ml inj 12

Midazolam 1 mg inj 20

Visipaque LOCM 270 mg pe (100) 400

Cosyntropin per 0.25 mg 92

Heparin 1000 units 3

Sterile Water 5cc IV 10

Fentanyl 0.1 mg 2

Guide wire (2) 214

Sheath introducer 118

Catheter diagnostic (4) 352

Micropuncture set (2) 196

Lab - Renin 387

Lab - Cortisol, serum (12) 1,716

Lab - Aldosterone, serum (12) 2,736

Venous sampling S & I (2) 1,884

Venogram adrenal bilat S & I 1,020

Venography, renal unil S & I 968

TOTAL HOSPITAL CHARGES $13,866

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I just got back from seeing my primary, who I hadn't

seen since having the AVS. Good thing I asked for a

copy of the results since they didn't send him a copy,

despite me asking them to. I told him to guess what U

of M charged for the AVS. He guessed $2,500 and

almost fell over when I told him $13,866. The billing

thing keeps getting more and more weird. When I got

home another statement had come from Blue Cross. 3/27

is the date I had the AVS so these must be the amounts

they billed to Blue Cross. But NONE of these amounts

correspond to ANY of the charges on the statement they

sent me, anyone have any ideas why? I'm assuming the

first two charges must be for the bilateral venous

sampling, charge $3058 on statement sent to me. Quite

a difference in amounts.

Amt. Charged Amt. Allowed Amt. Paid

3/27/06 Surgery $495 224.58 224.58

2/27/06 Surgery 495 224.58 112.29B

2/27/06 Xray 293 90.08 90.98

2/27/06 Xray 263 89.66 89.66

2/27/06 Xray 130 32.96 32.96

2/27/06 Xray 130 32.96 32.96

TOTALS $1806 $695.72 $583.43

note at bottom-

B - This provider performed another surgery on this

day that's considered primary to this surgery. As a

result, we reduced our allowance for this secondary

surgery by half.

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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.

Re: Charge for AVS

I just got back from seeing my primary, who I hadn'tseen since having the AVS. Good thing I asked for acopy of the results since they didn't send him a copy,despite me asking them to. I told him to guess what Uof M charged for the AVS. He guessed $2,500 andalmost fell over when I told him $13,866. The billingthing keeps getting more and more weird. When I gothome another statement had come from Blue Cross. 3/27is the date I had the AVS so these must be the amountsthey billed to Blue Cross. But NONE of these amountscorrespond to ANY of the charges on the statement theysent me, anyone have any ideas why? I'm assuming thefirst two charges must be for the bilateral venoussampling, charge $3058 on statement sent to me. Quitea difference in amounts. Amt. Charged Amt. Allowed Amt. Paid3/27/06 Surgery $495 224.58 224.582/27/06 Surgery 495 224.58 112.29B2/27/06 Xray 293 90.08 90.982/27/06 Xray 263 89.66 89.662/27/06 Xray 130 32.96 32.962/27/06 Xray 130 32.96 32.96TOTALS $1806 $695.72 $583.43note at bottom-B - This provider performed another surgery on thisday that's considered primary to this surgery. As aresult, we reduced our allowance for this secondarysurgery by half.

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Or we should just say in the files to just go to Mayo Clinic and do

the AVS there. They have done enough procedures there that they know

what they are doing.

Dr. Grim by the way Dr. Stanson who did my AVS(and has done every

AVSs ever performed there and involved with well documented research

studies) gave me his contact information to give you. You can

contact him as he may be interested in our group. Hopefully someday

soon they will have another grant to do a follow up research.

Dr. Grim may I have the permission to email his contact info

directly to your personal email?

For anyone who is considering doing an AVS, you should really

consider doing so at Mayo Clinic. Not only they are well familiar

with PA, the clinic is an awsome experience. Hospital and nurses

were just amazing. Wish Stanford could learn a lesson or two in

management. Price is not bad if you need to fly you can fly to

Minneapolis and take a shuttle from the airport to mayo clinic for

$27.00(45 min drive). Or you can fly directly to Rochester(a bit

more expensive because only small plains fly there) and take a

shuttle from Rochester airport to mayo is $21.00.

Once you make an appointment they have a policy to get you in on

Monday and have you checked out by Friday(that is in my case if they

see that you need an AVS)AVS Results are available within 24 hours

(as compared to 2 weeks at UCSF)So you can kind of plan to stay

there a week.

Farah

>

>

> 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

>

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After two days I finally got in touch with someone at

U of M who sort of knew something about their

billing. First of all, I found out that the hospital

accepts my insurance, it's their physicians who don't.

I asked her about the bill for $13,866 that I received

and the diffent amounts billed to Blue Cross. She

said the charges that were already billed are the

physician's charges, the hospital charges have not

been submitted as yet. So Dr. Cho submitted a bill

for $1,806 and was paid $583.43 by my insurance

company. That seems like a pretty good salary for 1

hour of work to me but I guess I may owe him more. I

said I had some questions about the hospital charges

as there were a couple that seemed redundant to me.

She said the person I needed to speak with about that

was on vacation this week but she would leave a

message for her to call me back when she returns to

work. I then called Blue Cross and after 20 minutes

of punching numbers I finally got a real person. I

was able to verify that U of M Hospital participates

with my insurance and they have to accept whatever

payment they get from Blue Cross as payment in full. I

then said I believed that the bill they would be

getting from U of M might include some double charges.

I was curtly told that " Our people will review all

charges and payment will be made according to our

policies " . So much for that - health care is soooo

screwed up in this country. Thanks to all who sent

info on their AVS charges.

a

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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

>

> If anyone is going to have an AVS in the future I'm

> offering a few hints in hindsight. My first

> appointment for AVS had to be cancelled when U of M

> called me the day before to tell me that none of their

> doctors accepted my insurance, a Blue Cross PPO, and

> that I would be liable for all charges - first I'd

> ever heard of this. I knew I couldn't afford to pay

> so I cancelled and called Blue Cross. They told me

> that if my primary physician asked for a referral they

> would cover the procedure. My primary got one and the

> AVS was done in March. I called U of M the day before

> to make sure they had the referral information, which

> they did. Yesterday I got a statement from Blue Cross

> which showed they paid U of M $583 for the procedure.

> I also got a statement from U of M that I opened after

> that. I still can't believe it, they billed Blue

> Cross $13,866 for the AVS. Seeing how it took less

> than an hour to do and I laid in recovery for 2 hours

> afterward, this seems just a tad excessive to me. My

> son's hernia surgery cost less than this. There's a

> note on the statement that says " This amount has been

> billed to your insurance company. Amounts not paid by

> insurance companies may be rebilled to you. " If U of

> M bills me for $13,283 I'll either have to get an

> attorney or file for bankrupcy. In hindsight I

> realize I should have questioned U of M more, asked

> how much the procedure was going to cost and if they

> accepted whatever payment my insurance allows or if I

> was liable for any of the balance. This is the first

> time I've run into a situation where a doctor or

> hospital did not accept my insurance so I'll be a lot

> wiser in the future if this happens again. If anyone

> needs an AVS in the future all I can say is ask a lot

> of questions about costs, billing and insurance before

> hand.

>

> a

>

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Guest guest

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

>

> 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

>

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Guest guest

All of the insurance in the world isn't going to help if doctors are

too ignorant or careless to recognize a problem when they see it. I

have excellant insurance but I have been trying to find help for 6

years now. I thought almost from the beginning that this was a

hormone problem and went to an endocrinologist. No one referred me,

I just made an appointment. Unfortunately, I went to an

endocrinoligist who was an idiot. My bp was very high for 4 years

before someone finally recognized the problem and put me on Spiro.

That helped some but my bp was still way too high. How many years

has this taken off of my life? One problem is all of these studies

that say if both parents have hypertension, I have a 100% chance of

having it. I used to work with statistics and you can make them say

anything you want to. Most doctors assume that if they give you a bp

drug it will lower you bp. It is becoming obvious to me that this is

not realy a rare condition, yet it weems that only a handfull of

medical centers or universities in this country know how to diagnose

and treat it. What are they teaching medical students?

Fran

>

>

> 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

>

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