Wednesday, October 14, 2009

Somebody help me to understand.

Ok... so I'm moving off of COBRA back to my employer's health plan. It's the same coverage, I just am no longer paying as much for the coverage since I am again "gainfully" (right) employed. For another reason not related to this post, I needed to log into my insurance provider's web site to verify that I still will be covered during the brief transition. I managed to get the web site to work long enough for me to pull up an EOB (explanation of benefits).

Now I have no wish for ANY government agency to tell me what coverage I shall have. I have no wish for any president of any party to tell me how good I can have it. I do, however, think there must be some way to regulate costs.

I know... big wish... I want big brother to leave me alone, but I want big brother to watch over me.

I looked over my EOB, and wondered why so many folks blame big insurance for the medical crisis we have. Perhaps some smart person can explain the following to me...

In August, I visited the Infusion Center of my local "not for profit" hospital three times.
I was treated twice to a cocktail of the nastiest tasting shit you can imagine.
Once I was dealt the "skip a turn" card.

My insurance carrier was asked to pay for the following items.

3 blood tests... 3 CBC and 1 CA-199. Payment asked for by " not for profit ", $69.00
2 treatments of Zofran and Gemzar. Payment asked for by " not for profit ", $1166.00
3 times sitting in the funky looking recliner to have my work done. Payment asked for by " not for profit ", $16083.95.
Total requested by "not for profit" $17,318.95.

In all fairness, I should mention that the "sitting" fee includes (based on my best guess) the following:

Being barely greeted by a receptionist at the infusion center. She doesn't even open the window at the counter or mention my name, just a nod of her head.
Being escorted by an RN from the waiting area to be weighed.
Being weighed by the RN.
Being escorted to my "funky chair".
Having a catheter put in by RN.
Blood drawn from catheter by RN.
Blood taken by RN to lab.
Blood checked in lab (separate bill here folks).
Results picked up from fax by RN.
Stats taken by RN (BP and temp).
Pump first IV into me (Zofran).
Pump second IV into me (Gemzar).
Whip out catheter.
Bandage me up.
Send me to receptionist who barely has time to set my appointment.
Walk out fancy door at the front.
Total time spent 1.5 to 3 hours.

I am guessing that they probably have some form of malpractice insurance to cover the work of the RN.

17,000 dollars for that?

Can someone tell me what I'm missing here? My best guess is I've paid for all the furniture in the center twice. I've probably paid the wages for the RN working on me at least 6 times. That leaves about 10 grand for the one month. (I've been at this for 3 now). Am I helping with the new remodel too?

Just one final note at the end of this rant...

I am SO grateful that I have my own insurance to help me with this. While insurance companies gamble that you won't get sick and you gamble that you will... I DID... so I'm freaking lucky again.

I wonder how long I have until my max life benefit hits... at this rate it won't be long.

Perhaps I need to ask to just stand during my treatments? Maybe I can get a discounted rate for not sitting in that expensive chair? I mean ... common... I ask $20 an hour to fix a computer and people call me a criminal. They ask $1925.00 per hour and my insurance company just sends a check???

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