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Re: Bayonne: Man astounded by bill for 4 stitches at ‘most expensive hospital in America’
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Just can't stay away
 
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Double checked my in-network hospitals after this story.
Posted on: 2014/2/26 15:25
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Re: Bayonne: Man astounded by bill for 4 stitches at ‘most expensive hospital in America’
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Home away from home
 
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I have Aetna, too, and noticed that there aren't very many hospitals in northern NJ in network. Billing shenanigans may have something to do with it. A couple years ago, I had to have surgery. Thank goodness it wasn't an emergency, so I chose to have it done at NYU Langone. It couldn't have gone more smoothly. I think the only bills I saw were $200 for my share of the anesthesiologist's services, and a little bit here and there for lab tests. Aetna forbids balance billing - i.e., hospitals and doctors can't come after you for the difference between their contracted rate and their list price. A couple of coworkers have had surgery at hospitals around here and ran into balance billing, which took months to fight/untangle. Thank goodness most major NYC hospitals are in network. I kind of shudder to think what my bills would look like if I had a life-threatening emergency and couldn't make it across the river.
Posted on: 2014/2/26 15:02
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Re: Bayonne: Man astounded by bill for 4 stitches at ‘most expensive hospital in America’
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Home away from home
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JCMC billing practices are criminal.
A few years ago, I was smart enough to get a copy of my medical record from a 9 day hospital stay soon after I left. Several months later, I requested an itemized bill. I compared the bill against my record and found numerous examples of them billing for procedures that were neither ordered nor done. I notified my insurance company--who ignored me and paid their 75% of the negotiated price without question. I had also notified the billing office. Months later, when the leftover $12K bill came to me (when my grad student stipend was $18K/year), I took it up with the billing office directly. I showed them the evidence, and the guy was like "hmmm. Your copy of the medical record doesn't look like mine." My response "If you guys altered my medical record--particularly to make it match the bill--then you violated state and federal law." He agreed. Rather than reimbursing the insurance company, he subtracted the cost of those procedures from my bill and (no joke) sent me a handwritten, undated, unsigned note with my new, much lower balance and a message to go to the charity care office. I have no idea if JCMC is in my network now. I will never step foot in there again. The level of incompetence in the billing office made perfect sense after the level of incompetence of the doctors assigned to my case.
Posted on: 2014/2/26 14:39
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Re: Bayonne: Man astounded by bill for 4 stitches at ‘most expensive hospital in America’
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About a year or so ago Aetna struck off most of JCMC-affiliated doctors from it's in-network. JCMC itself isn't an in-network hospital. Palisades and Newark's Beth Israel seem to be the closest large in-network NJ hospitals. Anyone have any insights as to why? Is JCMC adopting Bayonne's predatory billing practices? Or has Hudson County just got cooties?
http://www.aetna.com/docfind/home.do
Posted on: 2014/2/26 3:09
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Re: Bayonne: Man astounded by bill for 4 stitches at ‘most expensive hospital in America’
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Home away from home
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There isn't a doctor in America making $15/hr on anything. The way much of this works is that the insurance company has a pre-agreed upon price that they pay per procedure. That is why there is different costs per insurance plan. It is also why a doctor will only take certain plans from a provider.
Posted on: 2014/2/26 0:06
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Dos A Cero
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Re: Bayonne: Man astounded by bill for 4 stitches at ‘most expensive hospital in America’
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Home away from home
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I think it would have been in the $20K with anesthesiologist. I received a similar bill for a thumb stitch situation in Hoboken. Not before they turned me away in emergency saying I was okay before x-rays only to learn I had to return in an emergency situation again because it was broken and they failed to identify that - by then a bone infection kicked in.
Posted on: 2014/2/25 23:39
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Re: Bayonne: Man astounded by bill for 4 stitches at ‘most expensive hospital in America’
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Just can't stay away
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$14K for stitches is outrageous. But, I think there might be more to the story.
My guess is that the kid had to be sedated because of the location of the cut and his age. Most 3 year olds I know would not sit still for 1 stitch to the chin let alone 4. Pinning down a freaked out kid isn't a good option. If there was an anesthesiologist involved the cost would be much higher. Also they would be in the ER much longer than if it was just 4 stitches. About 5 years a friend got stitches in the ER, the total was ~$1400. I think that's stitoo higll h. Moral of the story is if you need a cut stitched up and the bleeding has stopped call your doctor or find an urgent care center in your network. Save the ER for life threatening situations.
Posted on: 2014/2/25 22:53
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Re: Bayonne: Man astounded by bill for 4 stitches at ‘most expensive hospital in America’
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You are right. Part of the insane bureaucracy of health insurance is that the hospital or doctor always bills much higher than they expect to be paid. The insurance then essentially negotiates what they will reimburse. I've had bills for say $1200 where the insurance negotiated it down much lower e.g. $700 or something. Medicare/medicaid has negotiating power to get lower costs per procedure but in some cases this means reimbursements so low doctors in small practices actually lose money, or make something insane like $15/hr. A standardized billing procedure that neither short shrifts providers or patients is sorely needed.
Posted on: 2014/2/25 22:46
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Re: Bayonne: Man astounded by bill for 4 stitches at ‘most expensive hospital in America’
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This is depressing. We are held hostage by the PATH. And we can be at the mercy of Carepoint.
Time to move, except my job is at JSQ.
Posted on: 2014/2/25 22:30
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Re: Bayonne: Man astounded by bill for 4 stitches at ‘most expensive hospital in America’
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Home away from home
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It seems astonishing that there's nothing regulating hospitals from simply pulling prices out of their buttholes. Could you imagine a car collision insurer sitting still for this? "hey uh, that tail light is gonna cost you $12,000".
How is it that the trillion dollar private health insurance industry hasn't developed a comprehensive and universal schedule of charges the way Medicare has? Hey, I'd even say to adjust it for local cost of living so it's higher here than in Mississippi. But this is insane, and will go on as long as they can simply pass the costs on.
Posted on: 2014/2/25 21:57
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Re: Bayonne: Man astounded by bill for 4 stitches at ‘most expensive hospital in America’
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Wow - $14,000 for four stitches sounds like a lot - I'd like to see the itemized bill and see what they charged for (plastic surgery, x-rays, anesthesia, etc.).
I would like to see a side by side comparison of what JCMC would charge in a similar case. I'm certain the father was thinking only of his son's well being when he rushed him to the local hospital rather than see if it was "in" or "out" of network. Head cuts can bleed profusely and if he banged his head hard, perhaps there was a concern of a concussion, too.
Posted on: 2014/2/25 21:43
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Re: Bayonne: Man astounded by bill for 4 stitches at ‘most expensive hospital in America’
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Carepoint also owns Christ Hospital and Hoboken University Medical Center (old St. Mary's Hospital)
See CarePoint Health brings together three Hudson County hospitals: Bayonne Medical Center, Christ Hospital in Jersey City; and Hoboken University Medical Center. http://www.carepointhealth.org/our-hospitals/ Sort of scary. Must say, I called an ambulance (JCMC) for a friend during the blizzard, they came quickly and were wonderful. I would be extremely upset if they changed ambulance providers to McCabe.
Posted on: 2014/2/25 21:17
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Re: Bayonne: Man astounded by bill for 4 stitches at ‘most expensive hospital in America’
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It's good that his bill got reduced in the end, but why wouldn't you be aware of what hospitals around you were in network? Especially if you have kids.
Posted on: 2014/2/25 20:53
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Bayonne: Man astounded by bill for 4 stitches at ‘most expensive hospital in America’
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Home away from home
Joined:
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Man astounded by bill for 4 stitches at ?most expensive hospital in America?
Read more: http://pix11.com/2014/02/25/man-astou ... in-america/#ixzz2uMsWIZYI
Posted on: 2014/2/25 20:33
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