In 1968 I broke my elbow, bad compound fracture with the bone coming through the skin, The total cost was under 350.oo us dollars... We had no insurance and It was repaired in our local doctors office. I knew this doc well because he was the only doc I had ever met although this was my first time to his office because he made house calls, I remember my dad asking the doc if he could spread the payments out over a few months, he agreed and they shook hands and off we went..... That was then.... this is now... I found this story,



Just the fact that it adds another layer of bureaucracy means it will undoubtedly cost more. And the fact that that bureaucracy will be making the decisions, instead of your Dr. is the worst part. At least, with current plans, we get GOOD care.

Since writing about the convoluted medical insurance and hospital statements and bills arriving in my mailbox, I haven't received anymore! But today my insurance company's automated attendent was actually working, so I was able to get an update on all of the claims processed so far.

First, to recap, I broke my arm while visiting my sister in Bluffton, SC on April 5, 2009. The next morning, I went to the ER at Hilton Head Regional Medical Center, after first checking with my insurance company to make sure we were going to a "preferred provider."



When I returned home to Wake Forest, I saw an orthopeadic doctor and was scheduled for surgery April 13, 2009 for the implant of a plate and screws, like a little "inside cast," my doctor explained.

I didn't react well when I heard I needed surgery. I told the orthopeadic doctor that the E.R. doctor had said my bones looked aligned, and he didn't think I would need "intervention."

My orthopeadic doctor said, "That's why he is an E.R. doctor."

According to my insurance company, two claims have been filed for the emergency room visit, and five for the surgery. Since the amounts on the claims do not match up to the bills I've received, I still have a lot of homework to do, but I know the price of fixing my left arm is over $20,000.

Here's the breakdown.





The Health Care Value Chain: Producers, Purchasers, and Providers

The Health Care Value Chain: Producers, Purchasers, and Providers

Amazon Price: $34.33
List Price: $80.00



Hilton Head E.R.

•One Claim for $37 - paid by insurance - amount I owe $0!
•Second Claim for $684 - also paid by insurance - amount I owe $0!

This totals to a bit more than the $535.77 "estimate" Hilton Head provided to me before I left their Cast Room and handed over $164.29 up front. But then I have this bill from Hilton Head for $2,285.50. The first time I called Hilton head, they said the insurance company did not cover the bill. Today, the insurance company said had that amount had not been filed. I called Hilton Head again, and they said the claim was rejected. It sounds like they had a typo in my Patient ID.

Okay. Mistakes happen. But let's see...My correct name is on all of the paper work from both the hospital and the insurance company. Apparently 2 out of 3 claims had the correct ID. No one on either side of this equation could match up my records and figure this out?

Hilton Head is going to resubmit, and they gave me the claim number that was originally rejected, so I'll be calling the insurance company back to tackle this from both sides.

Rex Hospital - Raleigh, NC








On to the surgery bills....recall from my previous hub that the "Patient Summary of Services" from Rex totalled $19,762.95. That's the only statement from Rex I've received so far, though they warned me that some "Professional Services" might not be included.

I was relieved to hear that the $19,762.95 claim was paid - I owe $0 on that one.

Three other claims were filed and paid in full in the amounts of $1535.50, $999.00 and $228.43. I have no idea what services racked up these charges. But on a fifth claim, for $850, I apparently owe $135.80. So I asked the insurance company to explain that claim to me. It turns out to be for a medical device called a TENS Unit.

I'm saying it out loud, right here on the internet, I AM NOT PAYING THAT $135.80! You can read why in my next hub.



To sum up, the total to fix my broken arm is now $26,382.38 - not including the prescription pain meds. My co-pay on prescriptions is generally pretty good, so I only spent about $30 out of pocket. I don't have the reciepts, however, to see what the total really was.

And let's not forget, my doctor initially wanted me to have physical therapy. I've managed to get lots better without it, but at my last checkup, he mentioned it again, that I should just let him know if I think I might need physical therapy. Wonder what that would add to the total bill?

A few years ago, I was left with an unexpected medical bill when the provider explained to me that my insurance company had not approved their rate increases. I almost felt a little sorry for them. Almost. Not anymore.

Many people seem to be of the opinion that hospitals and other medical providers charge less to individual's who do not have insurance than they charge the insurance companies for those who do have coverage. I've realized in the midst of this mess that it is probably the opposite.



The nice lady from the insurance company explained to me today, using one of my claims as an example, that "Prefered Providers" are contracted to accept certain (lower) amounts from the insurance company than what actually appears on the bill. The insurance company only paid Hilton Head $289 of the $638.00 for "general ER services," but I still owe $0 on that particular claim.

Why the big numbers? If providers can agree to the insurance company's rates, why pad them for our statements?

So my $26,000 arm really didn't cost anyone that much. I strongly suspect my arm didn't cost more than a couple of thousand, total, to fix. And t***hfully, if these things were more reasonably priced, maybe most of us wouldn't need health insurance at all!

Please tell me, how could socialized medicine be any worse than this mess we currently call the healthcare industry?

In 1968 I broke my elbow, bad compound fracture with the bone coming through the skin, The total cost was under 350.oo us dollars... We had no insurance and It was repaired in our local doctors office. I knew this doc well because he was the only doc I had ever met although this was my first time to his office because he made house calls, I remember my dad asking the doc if he could spread the payments out over a few months, he agreed and they shook hands and off we went..... That was then.... this is now... I found this story,



Since writing about the convoluted medical insurance and hospital statements and bills arriving in my mailbox, I haven't received anymore! But today my insurance company's automated attendent was actually working, so I was able to get an update on all of the claims processed so far.

First, to recap, I broke my arm while visiting my sister in Bluffton, SC on April 5, 2009. The next morning, I went to the ER at Hilton Head Regional Medical Center, after first checking with my insurance company to make sure we were going to a "preferred provider."



When I returned home to Wake Forest, I saw an orthopeadic doctor and was scheduled for surgery April 13, 2009 for the implant of a plate and screws, like a little "inside cast," my doctor explained.

I didn't react well when I heard I needed surgery. I told the orthopeadic doctor that the E.R. doctor had said my bones looked aligned, and he didn't think I would need "intervention."

My orthopeadic doctor said, "That's why he is an E.R. doctor."

According to my insurance company, two claims have been filed for the emergency room visit, and five for the surgery. Since the amounts on the claims do not match up to the bills I've received, I still have a lot of homework to do, but I know the price of fixing my left arm is over $20,000.

Here's the breakdown.





The Health Care Value Chain: Producers, Purchasers, and Providers

The Health Care Value Chain: Producers, Purchasers, and Providers

Amazon Price: $34.33
List Price: $80.00



Hilton Head E.R.

•One Claim for $37 - paid by insurance - amount I owe $0!
•Second Claim for $684 - also paid by insurance - amount I owe $0!

This totals to a bit more than the $535.77 "estimate" Hilton Head provided to me before I left their Cast Room and handed over $164.29 up front. But then I have this bill from Hilton Head for $2,285.50. The first time I called Hilton head, they said the insurance company did not cover the bill. Today, the insurance company said had that amount had not been filed. I called Hilton Head again, and they said the claim was rejected. It sounds like they had a typo in my Patient ID.

Okay. Mistakes happen. But let's see...My correct name is on all of the paper work from both the hospital and the insurance company. Apparently 2 out of 3 claims had the correct ID. No one on either side of this equation could match up my records and figure this out?

Hilton Head is going to resubmit, and they gave me the claim number that was originally rejected, so I'll be calling the insurance company back to tackle this from both sides.

Rex Hospital - Raleigh, NC








On to the surgery bills....recall from my previous hub that the "Patient Summary of Services" from Rex totalled $19,762.95. That's the only statement from Rex I've received so far, though they warned me that some "Professional Services" might not be included.

I was relieved to hear that the $19,762.95 claim was paid - I owe $0 on that one.

Three other claims were filed and paid in full in the amounts of $1535.50, $999.00 and $228.43. I have no idea what services racked up these charges. But on a fifth claim, for $850, I apparently owe $135.80. So I asked the insurance company to explain that claim to me. It turns out to be for a medical device called a TENS Unit.

I'm saying it out loud, right here on the internet, I AM NOT PAYING THAT $135.80! You can read why in my next hub.



To sum up, the total to fix my broken arm is now $26,382.38 - not including the prescription pain meds. My co-pay on prescriptions is generally pretty good, so I only spent about $30 out of pocket. I don't have the reciepts, however, to see what the total really was.

And let's not forget, my doctor initially wanted me to have physical therapy. I've managed to get lots better without it, but at my last checkup, he mentioned it again, that I should just let him know if I think I might need physical therapy. Wonder what that would add to the total bill?

A few years ago, I was left with an unexpected medical bill when the provider explained to me that my insurance company had not approved their rate increases. I almost felt a little sorry for them. Almost. Not anymore.

Many people seem to be of the opinion that hospitals and other medical providers charge less to individual's who do not have insurance than they charge the insurance companies for those who do have coverage. I've realized in the midst of this mess that it is probably the opposite.



The nice lady from the insurance company explained to me today, using one of my claims as an example, that "Prefered Providers" are contracted to accept certain (lower) amounts from the insurance company than what actually appears on the bill. The insurance company only paid Hilton Head $289 of the $638.00 for "general ER services," but I still owe $0 on that particular claim.

Why the big numbers? If providers can agree to the insurance company's rates, why pad them for our statements?

So my $26,000 arm really didn't cost anyone that much. I strongly suspect my arm didn't cost more than a couple of thousand, total, to fix. And t***hfully, if these things were more reasonably priced, maybe most of us wouldn't need health insurance at all!

Please tell me, how could socialized medicine be any worse than this mess we currently call the healthcare industry?

Three solid replies... right on target.. is it possible our health care problem could be as simple as common logic? Why is it such a big deal to cross state lines for health care to begin with? Cant there be a private company that provides health insurance that's non profit? ... For the people by the people. Why cant we just all kick in say.... 100 bucks a head per month into a pool and pay out as needed? We would not have to show billions of dollars of profit or pay dividends... just doctor bills and employee's to run the company. I know this seems too simple to be allowed... but why? 300,000,000 x 100 per month could cover some bills.... I know the for profit insurance companies may not like this simple plan but it is free market capitalism and wouldn't take up 2000 plus pages of total crap.... Next crazy topic... if your auto mechanic padded your repair bill just like a hospital or some doctors would you pay it... if you were billed 200 dollars for a 2 dollar spark plug what would you do? sorry for the crazy rant... its been a tough day.