Haemo Costs

[Bear]

I remember seeing somewhere on here recently, young ReRun mentioned some astronomical figures for cost of dialysis.
Friday, I was looking @ the Geelong Hospital (Vic., Aus.) cost analysis figs for IN-center-versus-Home/Home Nocturnal dx.
IT seems to work out @ around $33K (Aus.dollars - about 60cU.S) for In-center; $30K for Home (5-6nights. 3-4 nights that I do, obviously cheaper). So about $600p.w. ($400U.S.)....somewhat lower than I expected, but nowhere near the $1500 for 3 x 5 you have to pay if you go
elsewhere for treatment (i.e. travelling o/s)
This seems to confirm what I've thought before - about hospitals charging more when recovering from insurance cos./ medical benefit funds, which then causes on-going cost increases...
....I'll have to find the URL, so I'll follow this up with it in a mo.
    ...and here it is  :-

  http://www.nocturnaldialysis.org/geelong_experience.htm

[Rerun]

Bear please tell me what 600p.w. means and is that per month?  So, $400 US dollars per month?

That is what it SHOULD be.  What the hell is this game they are playing with figures here in the US?  To see who can charge the most? 

What is funny is for February, The "submitted charges" were $40,246.15.  Now that includes everything for dialysis plus epoigen. 

My insurance plan allows for payment $4,648.32.  My co-pay is $516.48 which Medicare will pick up.  My question to my insurance company and DaVita is "who the hell is going to pay the other $35,000?"  They may as well just submit 2 billion dollars because my insurance is only going to pay $4,648.32! 

There answer was it is "contracting or something, I don't really understand."   WTF  Find me someone who "DOES" understand!
No one understands because it is a crock of BS.   

[Bear]

I thought those abbrevs. were common use....oh well
p.w. =  per week ;  p.m. = per month ; p.a. = per annum (year)
so it ws $600 per week in Australian = about $400 per week in Uncle Sam's Greenbacks
Did you look @ the Geelong site. btw???  IT has amounts for pharmacology. plus "bricks & mortar"
(i.e. clinics), nurse costs etc.

[ahamner]

My insurance plan allows for payment $4,648.32.  My co-pay is $516.48 which Medicare will pick up.  My question to my insurance company and DaVita is "who the hell is going to pay the other $35,000?"  They may as well just submit 2 billion dollars because my insurance is only going to pay $4,648.32! 

There answer was it is "contracting or something, I don't really understand."

As I understand it the term is "contractual adjustment".  That is the amount of the difference between the submitted charge and the eligible charge with the contacted providers.  In this case your insurance carrier and Medicare.  Health care providers agree to accept the eligible charges in full payment for the services provided and write off any difference rather than charge the patient.

[Epoman]

My insurance plan allows for payment $4,648.32.  My co-pay is $516.48 which Medicare will pick up.  My question to my insurance company and DaVita is "who the hell is going to pay the other $35,000?"  They may as well just submit 2 billion dollars because my insurance is only going to pay $4,648.32! 

There answer was it is "contracting or something, I don't really understand."

As I understand it the term is "contractual adjustment".  That is the amount of the difference between the submitted charge and the eligible charge with the contacted providers.  In this case your insurance carrier and Medicare.  Health care providers agree to accept the eligible charges in full payment for the services provided and write off any difference rather than charge the patient.

 

Please see this thread to learn how to "quote" someone.

http://ihatedialysis.com/forum/index.php?topic=463.0

- Epoman

[Rerun]

So, the providers are escalating, animating, exaggerating, whatever term you want to use (lying) so they can write off HUGE amounts for tax breaks?  That is FRAUD!

[ahamner]

 

Please see this thread to learn how to "quote" someone.

http://ihatedialysis.com/forum/index.php?topic=463.0

- Epoman

Thanks, I'm new here and learning! Hope this works right.

[Rerun]

 

Please see this thread to learn how to "quote" someone.

http://ihatedialysis.com/forum/index.php?topic=463.0

- Epoman

Thanks, I'm new here and learning! Hope this works right.

Nice Try!   

[Rerun]

Now back to Hemo Costs........ I have decided that I am worth more alive than I am dead.  So, CHARGE whatever you want!   

[kitkatz]

Me too. At least now I can make part of the house payment and the medicare copay.

[Black]

So, the providers are escalating, animating, exaggerating, whatever term you want to use (lying) so they can write off HUGE amounts for tax breaks?  That is FRAUD!

I just figured that out myself a few years ago when my parents reached 65 and became eligible for Medicare.  I was stunned that it is legal.  Similar thing w/ the credit card companies.  They spread their credit cards around to everyone who will accept one -- use the no pay and late pay as an excuse to raise interest rates (and also to justify the high interest when Congress gets involved) -- and then the icing on the cake, they write them off as a loss on their taxes!  I guess Medicare has been taking lessons.

[Bajanne]

Well, it has finally happened.  I told you in another post dealing with the cost of dialysis, that it is free here, but the hospital had been recently given to a statutory board to run, and that would mean that eventually we would have to pay.
During Wednesday's dialysis, a lady with an official looking clipboard woke me (yes!!) and asked me if I still have insurance.  She said I had to come into the office because my insurance would now have to pay for my dialysis.
I spoke with my supervisor and she said that a session in our hospital costs US$500 (our legal tender here is the US dollar) for visitors and that would be what the insurance would have to pay.  I can't imagine that dialysis is now costing about $6000 per month!!!
I am only hoping that the insurance pays the full cost. If not, I will be in the soup!

[Hawkeye]

I spoke with my supervisor and she said that a session in our hospital costs US$500 (our legal tender here is the US dollar) for visitors and that would be what the insurance would have to pay.  I can't imagine that dialysis is now costing about $6000 per month!!!
I am only hoping that the insurance pays the full cost. If not, I will be in the soup!

In my neck of the woods, clinics get roughly $300 U.S. per treatment.  That then has to be split up between employee wages, machine repair costs, dialysis supplies (everything used during the treatment), rent or mortgage, and facility maintenance.  That's not a lot to go around.  It makes it very difficult to provide extra amenities to the patients.  We currently have satelite TV for the patients (all chairs have their own TV w/headphones) with 26 channels to choose from and a DVD player hooked to the TV system as well.  Beyond that we have little contests that we run every few months for best KT/V or fewest missed treatments.  The prizes are nothing huge ($25 Amercian Express gift certificates), but the patients seem to like it.  The thing is that it all cost money.  There have been several times when we have been in the hole at the end of the month, and the company has to eat those extra costs.  But that's just what has to be done to care for the patients in a proper manner, and give them some extras so they don't completely dread coming every other day.  What is paid out by the patient treatments goes back into the patients care, not padding pockets.  At least in my clinics case, I can't speak for any other entity that also gets paid from the insurance companies for your care.

[Black]

In my neck of the woods, clinics get roughly $300 U.S. per treatment.  That then has to be split up between employee wages, machine repair costs, dialysis supplies (everything used during the treatment), rent or mortgage, and facility maintenance.  That's not a lot to go around.  It makes it very difficult to provide extra amenities to the patients.  We currently have satelite TV for the patients (all chairs have their own TV w/headphones) with 26 channels to choose from and a DVD player hooked to the TV system as well.  Beyond that we have little contests that we run every few months for best KT/V or fewest missed treatments.  The prizes are nothing huge ($25 Amercian Express gift certificates), but the patients seem to like it.  The thing is that it all cost money.  There have been several times when we have been in the hole at the end of the month, and the company has to eat those extra costs.  But that's just what has to be done to care for the patients in a proper manner, and give them some extras so they don't completely dread coming every other day.  What is paid out by the patient treatments goes back into the patients care, not padding pockets.  At least in my clinics case, I can't speak for any other entity that also gets paid from the insurance companies for your care.

Is your center trying to get more patients out of the clinic and doing dialysis at home to lower their overhead?

[Hawkeye]

Is your center trying to get more patients out of the clinic and doing dialysis at home to lower their overhead?

We do have a Home Hemo and a PD program in full effect, but they are budgeted separately.

[Panda_9]

I'm surprised that anyone could even afford to pay for dialysis. If I had to pay Id be dead 

[angieskidney]

I'm surprised that anyone could even afford to pay for dialysis. If I had to pay Id be dead

me too lol! I am glad that in my country I don't have to worry about the cost to just frickan live

[jbeany]

You're not safe even if you have private insurance.  Many of them have fine print somewhere that gives a lifetime total for benefits paid out.  It's a huge number, and most people will never get close.  But those of us with transplant surgery and ever increasing dialysis costs may get there a lot sooner than we realize.  My mother was warned when her liver failed - her life time total on the insurance she had was something like 2 million.  Sounds like plenty, but when you start taking it out in chunks for things like emergency helicopter transport, or even ambulance rides around here where most of the ambulance lines no longer accept BCBS, it disappears fast.  My husband had to have an emergency transport to a downstate hospital a few years ago when he cut off his fingers with a buzz saw.  BCBS paid about $6000 - we had to come up with the other $5000.  They were supposed to send us by helicopter, but there wasn't one available at the time.  I don't even want to think about how much that would have cost.