A friend cut his hand (crotch of the thumb and forefinger) with a carpet knife at work a few weeks back. He has no insurance and no workers comp. He also doesn’t have a car or a drivers license. It was a four block walk to Miami Valley Hospital emergency room- and about a mile to the closest “doc in a box/ urgent care” at the corner of Patterson and Stewart (if it’s still there).
He opted to go to MVH. It was a six hour visit. The bill from the doc came yesterday (there may still be one from the hospital).
- Repair simple S to 2.5 cm $258
- Extended exam $277
- Total: $535
The invoice listed a woman as the care provider- yet, the only woman he saw was a billing clerk. The guy who sewed him up- only took 10 minutes to scrub it out, numb it and throw three quick stitches in.
When I was in the Army, our Special Forces medics routinely would take care of issues like this. Total training was completed in under a year and a half (this includes how to jump out of airplanes, shooting exotic weapons while rappelling out of helos and knowing how to camp with the best of them). We even had medics doing vasectomies with a doctors supervision.
Somehow, our medical system has become as broken as our financial system.
There is no reason for three stitches to cost $535 or for treatment to take 6 hours. Even at $250 an hour, with a half hour minimum charge- this shouldn’t be more than $125 plus some silk and supplies costing less than $25.
Can anyone defend these practices? Can anyone tell me why a doctor can’t set a rate before working on a patient? How can we consider ourselves leaders of the free world when in any other industrialized country this would be taken care of by universal health care coverage?
The bad news is- since the bill is so incredibly high, it’s unlikely that my friend will be able to pay (the bill is double his weekly pay), so we’ll all be told that we have to pay higher premiums to cover his lack of coverage. And this is how a “free market system” works?
[UPDATE: Feb 14, 2009]The hospital bill came-
$39.38 for “Medical surgical supplies and devices- General
$249 for Emergency Room- General
$600 for Emergency Room- Other ER
Total, in addition to the $535 above- another $888.38
Total for 3 stitches: $1423.38 or $474.46 per stitch.
It’s time to start talking about taxing MVH for their property. If this is a “public service” I’ll be damned- it’s more like a robbery.
The day after Christmas, my 7 year old son fell in the kitchen and busted his chin It was bad enough to require stitches. We took him to the ER. They took his vitals, cleaned the wound, and gave him 4 stitches. Total bill $1,935.90, and that may not even include the Doctor’s fee.
GENERAL MEDICAL SERVICES – $98.72
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SUPPLIES – $294.16
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SUPPLIES – $21.44
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EMERGENCY ROOM – $403.63
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EMERGENCY ROOM – $1117.95
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Totals – $1935.90
Can someone tell me how to immigrate to Iceland or Norway?
Can someone tell me how to immigrate to Iceland or Norway?
For Iceland the first step is to learn Icelandic, as you’ll have to be able to pass a language test:
http://www.ehow.com/facts_5150933_icelandic-immigration-laws.html
Learning Norwegian is also necessary if you choose to emigrate to Norway. http://www.mynorway.co.uk/norway_top_10_tips.html also has the useful tip that you should emigrate during the summer.
Gangi þér vel! or Lykke til!
All comments and ideas were interesting. Everyone must be young. Medicare tells hospitals and doctors what they will allow, which is much less than what is charged. Then they pay that reasonable amount. Your secondary insurance picks up the rest, usually very little compared to what they would pay if they were the primary insurance billed. But when they are primary, they adjust charges and pay less than what was charged and you the insured pay less usually 20% of what the insurance allowed. · Why does our system not include a self pay allowance on charges? · Why should a person pay more than insurance and/or Medicare? · Why should a person and insurance pay more than Medicare? · Doctors and nurses are invaluable, hospitals and offices have to be maintained and supplies are expenses, so how does the insurance company fit in? (They provide no medical service except to deny procedures.) The current health care bill will not help this. Doctors need to take back their own business and be capitalists. Insurance companies need to find a new business. Prescription insurance the same. (Pills cost whatever they cost to make and a reasonable amount for expenses and profit and set time for patent names.) I aggress with Chris and Brian for the most extent. Why did President Obama increase the number of insurance companies and decide they should keep making money as a middle man? Why help them, which is what mandatory insurance will do? Why not look into why Medicare and insurance companies get lower costs than the self pay citizen? We need honest congressmen/senators and legislative people. In our system that is only accomplished at the poles. Why do we vote for the least upsetting of the candidates’? Why do we the people just not vote, no one in these offices? Canidates should have to audition. They should get to state their goals, how to achieve them and where they stand on major issues. NO party info. Then people should vote bases on which candidate is going to do the most for the people. Middle men (lobbyist, insurances, whatever) should be… Read more »
This is a very good thread about a very big problem. My perspective is the doctor who puts in the stitches. I do this every day. My colleagues and I have been demonized in these posts. The posts accuse my colleagues of greed, insensitivity, incompetence, etc. I did read most of the posts. There is a lot of misinformation and misunderstanding. The posts by the medical billers and nurses are good and true but may be difficult to understand to many, kind of like explaning the economy. The most interesting issue is the wide variation in bills. This is largely due to which hospital chain runs the ER. The doctors and nurses are not the problem. They are employees. If ER people seem insensitive they have to be to some extent. They encounter misery 8-12 hours per day. Daily, they can expect to come to work to clean up orifices & excrement, get spit on, fight with schizophenics , see dead people, let people die, get exposed to communicable diseases, get stuck by dirty needles sometimes, and then after getting stuck by the needle they are expected to smile at the next person, and probably most likely they will. They do not make out the bills. They are not the demons. The hospital chain executives have become very clever and bold at marking up consumables, ( gauze, solution, meds), adding a usage fee for the item, and redefining procedures. They have the time to do this, thats all they do. The mark-up is what gets the cost of three stitches over $500. Compare your medical bill to a online catalog for medical products, Moore Medical for example. The products are very very cheap wholesale. The mark-up is 10-100 fold. They also can charge a usage for certain things. Like if the IV needle costs them $ 2, they charge $50, and then $75 for putting it in. Technically, there is a lot of double charging for usage services. Doctors offices buy these same materials at the same cost and do the same procedures but are prohibited by law for charging for them or their use in most cases. Doing so is called unbundling, and that gets you… Read more »
Thanks for the detailed explanatoin doc.
I recently got a ridiculous 811$ bill on a ER visit for what’s diagnosed as acute diagnostics by nurse on duty. Nothing was done (not even a physician inspecting me) but a prescription antibiotic and the general triage. Ridiculous. Had I been smart, I would have got the EDTR.
It’s acute bronchitis btw1
My sister who is visiting me from Sri Lanka tried to dodge an attack by my pet conure (who takes an aversion to most of our house guests) Anyhow when my sister dived she hit and split the corner of her eyebrow. She was bleeding and we were worried and I decide to check online to get details on how to get to the local ER and the costs (Since she is visiting and didn’t consider taking travel insurance). I had no idea about the cost of the ER room, so I called ahead at the number given on the website to find out what we had to do and how much it would cost without insurance. I was basically told they couldn’t give me a figure prior to treatment. I asked to be put through to billing and was told they couldn’t advise me prior to seeing a doctor. Basically I was expected to take my sister to get the stitches with no clue as to how much we would be expected to pay. I prefer the upfront “menu” of prices someone suggested. After all this is a service and we need to know ahead what we are paying for. After reading your first few posts: Me and my sister decided that NO we don’t need to go to ER, no we don’t need to see even a nurse. We’ll just treat it ourselves!!! Thank you very much!! Back in Sri Lanka we would have been able to walk into any clinic or the equivalent of the ER, and it would have only cost $5.00 . The U.S has an amazing state of the art medicare but unfortunately it does not seem to be getting through to it’s citizens. And after all you are paying your taxes, this is your fundamental right to care!! I had previously had a thyroidectomy performed and was just too happy to have the ordeal over with to even consider negotiating the fees, despite being a poor student at that point. But now looking at all the posts I think I will pay extra… Read more »
Wow…we have the same discussion about every topic.
Robert talks about the best way to fix the problem. The Davids become outraged and claim that “it has all been tried before and everyone died. Everyone was too stupid to understand that they shouldn’t buy from snake-oil salesmen.”
Robert clarifies his point and talks about how it wasn’t truly a free market then either and that the issues would still be taken care of by a right’s respecting government. I.E. Snake-oil salesmen are defrauding people and should be rightly apprehended by the law enforcement agency. However, because the law enforcement agency is too incompetent to do their jobs, the government blames capitalism and greed and claims that we must have more and bigger government.
The Davids ignore that government’s inability to protect private property rights and their citizens from fraud was the cause of the problem initially and make fun of Robert.
Ice writes a well reasoned and poetic defense of freedom and receives thumbs ups based on the wonderful command of the language regardless of the majority of the people hating his underlying message, which is often the same as Robert’s; though more poetic and less academically rigorous.
Lastly someone jumps in and says something amazingly stupid like…”you are paying taxes, this is your fundamental right to care!!!”
I make fun of everyone and complement Robert and Ice and am roundly booed; receiving many thumbs downs.
Did I miss anything?
Just saw this BoingBoing post and had to share:
Ayn Rand took government assistance while decrying others who did the same
See the costs graphically:
http://www.medicalbillingandcoding.org/medical-costs-1/
Well, well, well………….. Canadian ER and ICU doc here. Fees are set by the state here, so apart from rare occasions, docs/nurses/hospitals can only bill what the government allows them to ! Same goes for medications ! The private insurance only covers for ”extras” such as having a private hospital room, physiotherapy, renting a wheelchair at home, etc.
Healthcare in Canada costs almost half per capita of what you guys pay in the US. And we have all around better health markers (vaccination, life expectancy, child mortality, nutrition, etc). You just can’t have it both ways. You either have more government control on costs/less influence of HMOs and the pharmas = lower costs/better coverage for the poor OR the system as you have it with ridiculous charges !!!!!!!!!!!!!!!!!
I don’t know about most doctors, but the Plastic Surgeon who was in the hospital when we brought our son in for stitches from a soccer injury charged us $7,011.00 for 35 minutes of sewing my kid’s eyebrow.
I am being SUED by a Plastic Surgeon for $6,011.50! Our insurance company, which we pay A LOT of money to, paid their “usual and customary” price of about $1,000.00 to the physician. The Emergency Room accepted the insurance company fee along with our copay.
So, it is not the Hospital or ER in this matter. It is a greedy, insane Plastic Surgeon who actually believes he is worth about $12,000 and hour for stitches! There was no nose job, eye lift or tummy tuck involved. Really, over $7,000 for stitches!!!
This quack actually told me that he could “charge whatever he wants, this is Bergen County, I can charge Manhattan prices”……tell me there is nothing wrong with this picture.
Until my case is finished, I will not reveal this asses name, but I will when a judge kicks his ass out of the court room.
I agree that seems like a lot, but think off how much it cost for a new car. What about plumbing or car repair? I dont enjoy getting robbed by these folks either. Lets face it, people expect health care to be free. Why is that? I need a car to go to work , as bad as someone needs a few stitches. Quite honestly , the laceration would heal, maybe scarred, but it will heal. My car wont just heal and I can resume using it. So in a sense , they have me strapped much worse than health care. I mean we are not talking about cardiac cath, or open heart or liver transplant. We are talking about cuts and scrapes.
Wow I never realized how lucky we are I am so grateful to be Canadian.
The stitches are too damn high!
Also, I hope he was working in a self employed kind of way and doesn’t have an employer who is getting away cheap by not paying workers comp.
We live in the bay area. my son recently tripped and cut the area right next to his eye…we took him to the ER and it required 5 stitches maybe (2 internal, 3 external….or something like that). We just got the bill from the ER and it was $6000. this seems insanely high for a few stitches???? I have FOUR BOYS….i’m sure we’ll have a few more ER visits for stitches in our lives….maybe i should figure out how to do it myself?????
Sorry to hear that Kendra. Examine your bill carefully. Dont pay it. Which hospital? It is hard to be prepared for this.
Dr. Guy,
My 5 year old son fell on an escalator in a mall. He has 5 stitches in his knee, right on top where the kneecap is. He has a line of 3 stitches in one place and 2 in another. He went to Nationwide Children’s Hospital Close to Home Urgent Care Facility in Dublin Ohio. We do not live in Ohio, he was there visting family. How much should 5 stitches on the knee be?? I am wondering where to start and what to do to negotiate the bill. I have not gotten the bill yet, but I am really not looking forward to it. We have insurace but is a high deductible plan. Nothing gets paid for until a $5000 deductible is paid. Please let me know what I should pay and how to negotiate this. Thanks.
First thing dont worry about the bill. Second dont pay anything now. Third your insurance will negotiate out a lot of the padding. The easiest is to offer to pay the ER bill cash at 5 cents on the dollar unless that seems way to low in your case. The doctor’s charge should be about $200. The Hospital (ER) bill should be about $350 but is probable $3500. Pay the doctor bill but offer 75% of it or no go. the longer the hospital remains unpaid the more likely theywill accept a low offer. Dont let it go to collections, then the negotiation is no possible. Examione the itemized statement carefully. See if every thing was done. Ask was this necessary? and that? I dont remember him getting that. If you have insurance you are already ahead of the game. Probably not much. If it is over $ 500 then fight it
[…] unless you have a 2nd mortgage available. You can read a few examples of similar incidents here, here, here, here and here. Many of the same problems popped up in each event: “Am I in or […]
A year and a half ago I got a really bad cut in my hand from a broken peice of glass. A piece broke off in the wound so I headed to the ER for stitches. Six x-rays, a fishing expedition in my hand to remove the piece of glass and five stiches later all I was required by my insurance to pay was the $100 co-pay. Now fast forward to a week ago…. My son had his first playoff baseball game so we went a little early for warm ups. We were the first ones there and he asked me to have a catch with him. He caught me off guard with a throw and nailed me square in my bottom lip HARD. Split it pretty good. I got it to stop bleeding and applied ice until my parents got there. My mom is a nurse and thought I should go to the hospital. I needless to say, didn’t want to miss my son’s playoff game so I stayed and then went after. I lucked out because the buttlerfly held it together pretty well and it started to heal on its own. I went to the ER was given a guaze pad with saline to dab on my lip, the doctor numbed me and did two stitches. My employer moved to a high deductible insurance so I can’t wait to see the bill under the new plan. I’ll post when it arrives…unless of course the site of the bill gives me a coronary : (
The bill will be higher than $100. There is a tendency of people to go to ERs for minor things, thinking they will be treated fairly. The bill will likley be $1000 with a $200 copay. If your deducible is $500 or $1000 there will be more out-of pocket. The good thing is you had an insurance plan. Regardless of the deducible the bill will be reduced by the plans contract with the hospital. Still faster and cheaper and likely better work done at a private doctor’s office.
I recently cut my elbow hitting a sharp object. I went to my doctor, she gave a Tetanus shot (she said it will cost me far less than having it at the hospital) and asked me to go the ER immediately. I was taken into the ER, the guy there wasn’t even a doctor, he was a PAC, someone who is not a doctor but is qualified to do stitches. He just looked at my elbow for a second and said I will need 4-5 stiches. I was placed on a bed in the hallway, the nurse gave a numbing shot, squirted a cleaning solution, cleaned the wound and the guy put 4 stiches, nurse dressed it up and I was out in 20 minutes from the time I walked in. I got the bill from the hospital. $150 for cleaning supplies, $450 for ER facility use, $460 for treatment of artificial wounds. Then I got a bill from the provider – $270 for ER use and $570 for treatment of artificial wounds. I am self-employed and have a health insurance with high deductible. After insurance discounts and exclusions between the hospital and the provider my out of pocket for 20 minutes of service is $1800. I am fighting the hospital and the provider for both charging me ER use and stitches. I am OK if the ER is charging for using their facility but they didn’t put the stitches and don’t understand why they would charge me for it. Similarly why would the doctor charge me for ER use when the ER is charging me. The hospitals have these days contracted pretty much everything to outside providers instead employing doctors and both are double charging for everything. Last year my wife was hospitalized for a gall bladder surgery and between the doctors, hospital, labs, my physicians etc. the bill came to $35,000 for 2 days in the hospital. Luckily my insurance only covered $21,000. I had to pay $5000 out of my pocket and the insurance paid the rest – since I knew I was going to pay 5K anyway I didn’t bother back then, I looked at the… Read more »
To NUSC,
Sounds very typical. Where are you located? Unfortunately, most people will google “how much stitches cost” after they have been to the ER (makes sense). If you read the long post above there is good advice. Some people will take the advice, manage to avoid the ER and call a private doc. At one point on this thread, there were many many accounts of incidents like yours. They revealed the disturbing truth about ERs. They were deleted I suppose to save space on the thread; the most egregious should be replaced so that more people can see you are not alone. These ridiculous bills are not being investigated and challenged officially as they should. Instead we just get higher insurance premiums to pay them. I think it is extortion; and the insurance that covers it is a “protection racket” (google it). Now Obamacare has increased our premiums so that the habitually uninsured will be covered by law and can get their medical bills paid by those of us who are insured. I have ( “had” now) a high deductible like you. I got “The Letter” yesterday that said my plan was now obsolete and by Jan 1st, 2014 I had to choose from the insurance exchange at the new rates. My $2000 deductible plan is going from $220/month to $819. Wow what a deal! Now all you have to do to get your stitches paid for by my increased premium, is sign up for insurance from your Iphone on your way to the ER, or work less, under the table, or not at all so you qualify for free insurance.
No comments have been deleted.
Thanks for the correction, David. I guess those posts are on a side thread.
Guy- the comments split pages at 50- there is another page- see the back arrow previous comments.
My bill for 6 stitches and a tetinus shot at an urgent care was $1200 and took 4 hours. I thought I got the shaft but after reading these horror stories I feel like mine was a bargain!!
The New York Times just wrote a long story on the ridiculous cost of stitches:
Appreciate you guys sharing.
It’ s down right robbery!
My son’s 3 stitches cost ~$1800 in CA.
The Dr and the Facility bill separately, and I seriously thought I was double billed.
Where is the oversight on this? How can these Dr’s and Hospitals charge whatever they feel like.
If you don’t pay they send you to collections.
10 min of work by the Dr for ~$900 after waiting for 3 hrs.
another ~$900 for the facility.
I never agreed to such rates.
Can you say class action law suit … sign me up!
Well, thank you to everyone for making me understand how much my bill of my 3 stitches will be… God, this is crazy! It is so unfair to be in the midle of all this, first I got injured while I was walking to come back home by a broken bottle that went beyond my shoes, than all the story with the hospital. I’m coming form a Europian country and I am not familiar with the hospitals rates here in US. Now, I am blaming myself that I didn’t take the flight to go directly to my country, and for sure the cost including everything will be less than 2 hours spending in the emergency room here. Can someone give to me an advice, how to manage this situation? Thank you!
hana, i’m not and expert, but i would try to avoid an emergency room if possible, and find a doctor or urgent care center to take care of the wound. the ERs send you home with crazy high bills.
Did you already go and get treated at an ER? What hospital, what city? It is very important where you are as to what your options are. It is difficult to be prepared if you are from another country. Sometimes your country’s consulate will pay the bill if there is national health insurance in your country. Tell the hospital to bill the Embassy. It will throw them off for awhile. Dont pay the bill, let embassy process it. Dont give a credit card number or any thing they could charge against. The law says they must treat all emergencies whether or not you can not or refuse to pay. American doctors and hospitals almost never expect to get paid by a foreigner or a foreign country. The bills are not realistic. just go and get treated and dont worry about it.
Thank you, guys for trying to help me out! Well, I’m not as a visitor here. I’m leaving in Philadelphia for about two years, but I didn’t have to deal with this kind of issue before. I went to hospital one day after I got injured, because I knew that they charge a lot. First I went to a clinic as a walking, and the doctor form there sent me to the hospital emergency room (Methosdist Hospital), as he thought it was a deep wound. After I went to the hospita. They just gave to me antibiotics, because it was over 24 hours so they couldn’t touch me as they fear an infection, and asked me to go for a check up after 3 days. I went the day they said, where the ER of that day decided that it was better to get stiches as my wound needed a lot of time to heal and it was still open. Probably, I shouldnt let her to do the stitches…my mistake. Now I have another appointment for removing the stitches, which I’m not sure to go or not, because I’m fearing a lot about the expenses. This is pretty much what happened… :(
I was interested in reading your story because like you, i was completely floored by the bill that i received from the plastic surgeon who put 4 yes only 4 stitches in my daughter’s forehead.
My daughter was running in the hall at school and ran into the door knob. I am a nurse so as i saw her forehead, i knew we needed stitches, it was a pretty good blunt trauma to her forehead. We were first seen by the ER doc who decided she was not going to stitch my daughter’s head up because she felt the wound was too deep. So, we waited almost 5 hours in the ER for the plastic surgeon who we did NOT request to come treat my daughter. He came, stitched her up and left. Total time: 15 minutes. (No exaggeration) being in the medical field, i knew that the bill was coming, i knew it was going to be a little bit higher being that she was treated by a plastic surgeon, i NEVER expected the bill that I received…….. Total cost: 4 stitches, 15 minutes of time: $15,250!!!!!!!! I almost fainted, honestly! I thought he might have gotten the bills mixed up, maybe i received the bill for the pt that he was with while we waited for 5 hours. Unbelievable!! My insurance company only paid $1250 which is what they feel is a substantial amount for the treatment. I am now left to fight this astronomical bill, plead with the insurance company to cover the cost of what I feel from a doctor who feels that his 15 minutes of time is worth $15,250. I am almost sad to say that I am part of this medical world in our country!!!
Are you sure the bill was from the plastic surgeon? That sounds more like the hospital bill. Either way it is unrealistic. Your insurance will assign you a copay and deductible both of which you are legally obligatd to pay. Your responsibilty for the uncovered charges depend upon whether the hospital and doctor were “in-network” meaning “contracted”. If they are then uncovered charges are not collectible because they are contracted to accept an assigned amount. Most hospitals are in-network and you are safe. An exception is usually the county general hospital because often people must go there and there is little need for general hospitals to have to attract customers by advertizing they are in-network. It is less likely that the plastic surgeon is in-network. It that case the bill is legally collectible. It is unlikley that the surgeon would try to use legal maneuvers to collect that amount, it would be bad PR. If they do then you can fight it by complaining to the hospital medical staff, the news, newspaper, etc. If it went to court you would use the defense that you were not informed of the charges before you agreed to the service. If it goes to collections you would use the same argument to the credit bureaus in a well written short rebuttal letter. If this happened to me I would not pay the bill at all.
Medical tape-its a strong sticky tape that I used to close my sons wounds.Once he got hit in the forehead with a rock and other time he fell in the bath tub and got another gash to his forehead.He was about 4 years old at the time.He healed up just fine.Im a nurse so I felt like I could take care of it at home and after reading these posts im glad I did
Two stitches in Texas for what the insurance was billed and what we were due to pay was over $4,000! And then they send us a second bill for the doctor’s fees on top of that! We negotiated a rate of $500 to settle everything after the insurance paid their portion, and they wrote a second bill from a different company for the doctor’s fee the same day we negotiated the settlement. The insurance paid twice for the same procedure because one was coded facility fee and one was coded doctor’s fee. Sound a bit slimy to me. And we wonder why insurance premiums are so high, the insurance is paying twice for the same procedure.
Next time call a plastic surgeon directly !! about $100 a stitch & they know what they are doing!!