On 9/9/2024 I stopped in Amarillo to get week-old stitches out at an ER facility .. got the bill today: $20,000+

[Bo Zarts]

On Labor Day, 9/2/2024, I had busted my upper lip in a fall at the lookout tower in the Idaho wilderness. Went to the ER in a small town in the Idaho panhandle, where a moonlighting doc from Coeur d'Alene put eight sutures in my lip. When I told him that I'd be leaving to drive back home to SC on the 4th, he said to stop at an urgent care or ER anywhere along the route after about seven days to get the stitches out. The Idaho doc said that most facilities don't even charge to remove stitches.

So I planned my driving so that I could be at a urgent care facility in Amarillo, Texas, bright and early on Monday morning, 9/9/2024. I now know that what I thought was an urgent care facility was actually an ER associated with the medical center on the west side of Amarillo. It was within easy walking distance of the hotel where I spent that Sunday night.

The Amarillo ER doc asked me if the ER in ST. Maries, Idaho, had done a head CT scan. They had not. He ordered a CT scan, that was done right there in the ER facility. Results: NEGATIVE.

Then the Amarillo ER doc refused to remove the eight sutures because of encrusted blood in my mustache. He instructed me to soak it as I continued my drive, and to stop at an urgent care clinic somewhere down the road in a couple of days. The Amarillo ER had my Medicare and insurance info, and checked me out with no balance due.

So I stopped at an urgent care in Gainesville, Texas. They would not remove the sutures because they said it would require numbing, which they didn't do. Same with urgent care in Dennison, Texas. I did not get the sutures removed until I got to an ER in Monroe, Louisiana, on Wednesday, 9/11/24!

The nurses at St. Francis Hospital in Monroe absolutely could not believe that the doc in Amarillo would not remove the sutures. Or that two urgent care facilities wouldn't remove them. I had waited in the St. Francis ER no more than about ten minutes before getting called back to a nurses station, where it took a nurse all of about 60 seconds to remove the stitches .. without me feeling a thing. The charge by the St. Francis ER? ZERO!

So today, Monday April 28, a bill shows up in the mail from the Amarillo ER. The total for all services was over $20,000! Fortunately, Medicare and my insurance paid all but about $140 of it.

What a rip-off of the system! The doc in Amarillo ordered a head CT scan that I did not need (no symptoms, no pain, etc), and then would not remove the sutures!

BTW: The doc in St. Maries, Idaho, did not think .. based on his examination and my history .. that any CT or MR imaging was necessary. And Medicare and my insurance covered 100% of the ER visit in St. Maries.

[Bernardo de La Paz]

1. I had a general anesthesia operation a few years ago. Never saw a bill, not a cent.

Canada.

Not the 51st state. Never the 51st state.

[Jim__]

10. Socialism! Socialism! Thank god we don't have that in the US.

[Katnip.]

60. My father had a nearly year long hospital stay

Cost: Whatever I paid for the food I brought him as the hospital food was unpalatable to him.

Actual hospital cost: 0$

He had a major, risky surgery and so many scans and procedures.

[Ms. Toad]

2. Let me guess . . .

You have a Medicare Advantage plan, which limits your medical access to in-network facilities - aside from emergencies (the original visit).

[CountAllVotes]

3. K&R

& recommend.

[Heidi]

4. Kick!

[Ritabert]

5. Outrageous.

[Meowmee]

6. First I advise to never go to an er for something like this

They are all known to charge a fortune for nothing here.
Second, did Medicare really pay that? They usually only pay a fraction of what is billed. The
vast overcharging by these places is part of the whole obscene system here. We need control on all costs immediately. You are lucky they covered a large portion or all of it.

As for the ct scan it probably was not needed, but it should not cost the overinflated price they charged you. It would never cost that much at radiology facility not attached to an er/hospital. On the other hand if you had had a head injury as well, which can happen and can be serious, at least you know now everything is ok, hopefully. 😁

[JCMach1]

11. The distinction between urgent and non hospital ER is sometimes blurry

They also we will sometimes give you woefully inadequate information about what is covered.

Why we need a medical truth in billing law in this country...

[Meowmee]

14. We also need control of all costs, but yes truth in billing is desperately needed also 😁

[progressoid]

15. Sounds like someone is milking the Medicare system

I know a retired Doc here who is swimming in money from gaming the system. He's now in his 80s and has his name on a couple buildings.

I went to him once about 40 years ago. He was an average Doctor, but he was good at playing the game.

[Meowmee]

17. Medicare is the only thing that put in price controls but I believe W or Bush

Stopped them from having price controls on drugs. We need price controls on everything.

[JCMach1]

38. Most countries have price controls, Americans get hosed

at all levels on this while pharma milks the cash cow.

On edit. Of course not just pharma. The rest of billing is due to our F'd up system

[Meowmee]

56. Price control everything and put everyone on salary period

Canada does not have pharmicare, when they get that it will be better and you won't have to depend on which province you are in for coverage of certain things. Still their prices are much lower in general than here.

[Jim__]

7. Medicare and your insurance paid for it? The full amount? Or, do they pay a discounted fee?

I believe Medicare and insurance companies don't actually pay those astronomical fees. They have the power to refuse to pay them. It's uninsured people that get stuck with those ridiculous bills. I really hope they didn't pay that full charge.

[Wonder Why]

20. You are very correct. If a place accepts Medicare assignment, they know how much

they are really going to get. I've, in the past posted numbers of what the places billed and what Medicare paid. Medicare's 80% will probably be a couple of hundred dollars and the insurance company will be happy to pay the rest for about $50 or so. I've seen numbers like that. It's so nice to get my Medicare/Medigap notice that I will not have to pay anything.

It's only the uninsured/uninsured that owe that kind of money and end up in bankruptcy. And those that can't afford it at ll, well what do those facilities care abut "human chattel"? Let them eat cake.

[Ms. Toad]

58. Unless it is a Medicare Advantage plan -

outside of your geographical area.

For a non-emergency situation, it may not pay anything outside of the network. There are some limits on what you can be charged, depending on whether the provider accepts Medicare (from the amount Medicare would have paid - to unlimited).

[Joinfortmill]

39. This is true. The entire system needs fixing

[dsc]

8. Last Christmas I was visiting my brother when my sister got an earring stuck in her ear

so on Christmas day she had to find a place to remove it. She is on Medicare and Medicaid due to disability. We went to two different Urgent cares, one was closed another was open but didn't take her insurance (but did take Medicare just not Medicaid with Medicare). So we went to an ER run by the same company as the urgent care which didn't take her insurance. It did for the ER. So God alone knows what the less than 2 minute procedure cost the state. Major scam.

[UpInArms]

9. Amarillo

is located right next to Borger …

the asshole of the world … they will insert the enema tube there

[Ponietz]

13. Full of Republicans on SSI

Methane central. Oil wells, feed lots, gas station convenience stores, churches and a profoundly ignorant hubris that believes they’re God’s gift to the planet. No problem a gun can’t fix.

[Sneederbunk]

12. Your first mistake: Entering Texas.

[Iamscrewed]

16. S.O.S.

Same old criminal level shit.

[Old Crank]

18. Couldn't take suturers out with out numbing!!!!!

What a crock.

I bit sutures out of a cut on my lip. (they bothered be and I ended up worrying the threads bare until they fell out.) No pain. I have never had numbing for sutures. Snip and pull, out they come.
On a related note, I have had 3 pairs of pins in my hands over the years. They got pulled without numbing. The 2 in the little finger were a quick ouch. The 2 pairs in my hands just felt a bit funny. The pair in my right hand I pulled them out while my doctor videoed.

Ordering a scan well after the fact is just a cash grab. I've heard horrible stories from some places in Texas where the doctors groupls own the medical practices and hospitals. Order everything they can to grab cash.

[Mblaze]

19. Sounds like waste, fraud and abuse

By that Texas ER.

[Brenda]

21. Lookit that! Best Health Care in the World!

NOT. The CT scan is a real money maker for the medical industrial complex. They take millions of unnecessary CT's and MRI's to pay for the machines and make a good profit on top.

After a major high speed car wreck in Georgia (not my fault) that totaled my car, I had trouble breathing and my chest hurt after the air bag hit me (well saved my life, too). The cops actually asked if I wanted an ambulance and it was like "dude, I don't have a car" so yeah. It drove me less than a mile to a hospital and charged me $400.

They took an X-ray of my chest. Got a bill from a doctor in Connecticut about 6 months later. He had "read" my X-ray remotely. I think the bill was about $2,000.

Insurance paid for the X-ray but I had to pay ambulance.

[NNadir]

22. I had an automobile accident after which i was having chest pains.

They took me in an ambulance to the local ER.

I sat two hours before they got around to giving me an EKG. They did a CT scan about two hours later to see if I had internal injuries.

Happily the chest pains proved to be bruising from the air bag, which was good because they told me they had no beds in the hospital.

They sent me home after about 8 hours, most of which involved waiting around.

The bill came to my house. $95,000 dollars!

Fortunately, or unfortunately since my car was destroyed and I did have pain, the other cars insurance company was on the hook since the young woman I hit ran a stop sign.

The hospital in question is about a mile and a half from my home. I told my wife if I ever have another emergency I want to be taken to the hospital about 15 miles away.

[SunSeeker]

33. Wow, a CT and ELG do not cost $95k. That is theft. nt

[Tarzanrock]

23. Find a Qi Tam trial lawyer ...

... and bring a whistleblower Qi Tam lawsuit against that Texas hospital for Medicare Fraud. You're quite likely not the only one whom they have used to defraud the Federal government and Medicare.

[Silent Type]

40. Won't do any good. Doctors and hospitals charge astronomical fees because in the 1970s Medicare and other insurers

pretty much paid what doctors and hospitals charged.

Docs and hospitals learned to charge more every year because they too are greedy just like insurers. Then, Medicare and insurers went to fee schedules. Docs and Hospitals still charge amounts they know they won't receive.

In fact, on something like this even if you don't have insurance, one would probably negotiate the $20K down to several hundred dollars because that's about the best docs and hospitals are going to get from most insurance plans.

There is no fraud for charging Medicare or insurers a bizzillion dollars, as long as they don't go after the patient for the difference between Medicare's -- or other insurer's -- Allowed Amount and the astronomical/fictitious charge.

[FakeNoose]

24. I'm wondering if you could have refused the CT scan?

My experience of how things happen in the ER are negligible. I don't think I've been to an ER since I was in 2nd grade. But it seems to me that the CT scan and MR images could have been postponed until you had a chance to confer with your "regular" doctor. That would have avoided at least some of the charges, I'm guessing.

Just because you didn't shell out the money from your own pocket, doesn't mean the charges are fair or even accurate.

[markodochartaigh]

41. Sure, patients can refuse any treatment, except

certain psychiatric treatments under certain conditions.

But few patients are experts in the type of injury or disease process that they have. And even if the patient is a doctor they generally prefer not to diagnose or treat themselves.

Patients should be given all of the information about their injury or disease process and allowed to make their choice. But their
choice shouldn't be influenced by misinformation given by a provider influenced by the profit motive.

[Crunchy Frog]

44. The thing about getting a CT scan a week after a potential head injury,

is that if it was something significant and CT worthy, you would already be dead or in a coma, and not in the middle of a drive from Idaho to SC.

[markodochartaigh]

48. Thank you for your opinion, doctor.

Since I'm not a doctor, just a registered nurse with four decades of experience, much of it in trauma, I will seek a second opinion.

[Martin68]

25. What a horror story!

[Attilatheblond]

26. It's NOT patients who do Medicare fraud, it's the BIG MEDICAL CORPORATIONS doing the fraud

Firmly believe many, or most of corporate medical care providers put their people under orders to run up the tab. And one of the biggest fraudsters, who ran a facility owned by the Frist family (one of whom was a US Senator) is Rick Scott, former FL governor and current US Senator.

[DENVERPOPS]

27. I have noticed an increasing amount

of Dr.'s, ER's, etc doing all they can to add stuff on to increase their bottom lines, or the Corporations that own them adding on stuff.
It was bad the past years, but it is becoming common practice from what I can see........
The other thing I have seen, is even your regular Dr.'s billing for their full amount, after it was supposed to be covered by Medicare if they accepted medicare........When I have called, they ALWAYS say: "Oh we made a mistake"......my guess is they plan on a certain number of people that will just go ahead and pay it.

Same with them billing Medicare using a more expensive procedure code, and description of what they did, in hopes that it will just go through......

The Senator in Florida was CEO of a firm that corruptly billed Medicare for 1.4 Billion........He made a ton of money off the corruption, the firm paid the fine, and the people in Florida even voted him in as a Senator....

The entire Medical Industry and Pharmaceutical Industry has become a Humongous Criminal Enterprise................and it will only get worse with Trump/Musk destroying Medicare and Medicaid, and the Medical Insurance Corporations trying to get out of paying for anything.....

[leftyladyfrommo]

54. Veterinary medicine has gotten the same way. nt

[DENVERPOPS]

57. For many more years

VCA and then they sold it for 6.7 BILLION to MARS Corporation (yes the candy people)

Prices skyrocketed under VCA, didn't think MARS could raise them any higher, and of course they did.


PS....Kevin Fitzgerald just came out with a book about his life.......everyone who loves pets, and every new vet should read it.!!!!!
He wrote it himself, he is a really great writer.

"IT STARTED WITH A TURTLE"

He has taken incredible care of six generations of our dogs.........an incredibly excellent vet, and great person.....

Any one who watched Emergency Vets will recognize him immediately. Fantastic and Colorful guy......

Covers his veterinarian stuff, His years as a Bouncer at all big name group's concerts back in the early 70's, his college years, his stand up comedy, etc.....

[senseandsensibility]

28. I am glad that most of it is covered by Medicare

and that you weren't hit with the bill, but this overbilling to Medicare weakens the system. Bernie was always right that we need single payer.

[Warpy]

29. Get an itemized bill

because that's higher than getting most of them put in. Are you sure that's not the case, that this bill was for getting them in?

If not, it might be time to pay a lawyer a retainer fee to look the itemized bill over. There is usually a listing for those who specialize in medical fraud and malpractice. A retainer that triggers a nasty letter from a lawyer can save you money.

[LovelyStuff]

30. Moral of the story . . .

Don't stop in Texas! If you can avoid it, don't try to get anything medical done in Texas. Whee hoo, what a rip-off.

[multigraincracker]

31. My old horse doc was great for stuff like that.

Never a charge. I miss that old guy.

[mamacita75]

32. Amarillo

Speaking of Amarillo, we crossed the border from NM at the end of January this year and the sign at the state line said "You are a felon"
quite a welcome.

[Vinca]

34. That's outrageous. For future reference, it's easy to remove your own stitches.

Alcohol, a cotton ball, tweezers and fingernail scissors. Snip next to the skin and pull.

[barbtries]

35. outrageous.

absolutely and utterly.

[Joinfortmill]

36. UnFing believable

[wolfie001]

37. It's quite OK when racist redneck republican doctors rip off Medicare and US taxpayers

The whole sordid story is a warning to stay out of states run by republicans.

[BigMin28]

51. Republican

politician the used to be CEO of a health insurance company that committed the largest Medicare fraud in US history. Did he go to jail? No, he got elected Senator.

[Crunchy Frog]

42. Sounds like Medicare fraud on their part.

Do an unnecessary procedure and then charge an outrageous amount for it, knowing Medicare will cover it.

[Silent Type]

49. Medicare will cover the service. But they'll pay less than $500 and the ER has to write-off the remainder.

If the sutures were removed by the physician who did the suturing, there is usually no charge unless there is a complication.

If he had gone to another physician's office -- rather than ER -- for the suture removal, Medicare would have allowed roughly $60 at best. That office might have charged thousands of dollars, but all they'd end up with is $60.

[ProfessorGAC]

43. My Recent Experience Supports This

I had a post in the Lounge about getting a ring cut off because tendinitis made it impossible to get off for an MRI.
A local jewelry store cut it for free, in about a minute & a half.
Out of curiosity, I called the hospital to see if they get get if off because I couldn't.
They said yes, so I asked about the cost. They said insurance would cover it, but I insisted on knowing the cost.EIGHT HUNDRED DOLLARS!
For something a jewelry store did for free.

[pansypoo53219]

45. medical industrial complex.

[markodochartaigh]

47. We do not have a health care system.

We have a profit making system which produces as much profit as possible while producing as little health care as possible as a byproduct.

[markodochartaigh]

46. I started my nursing career in

Amarillo in 1983 and my sister, who is a nurse practitioner, is still there. The whole area is a study of what you get when an authoritarian zeitgeist governs a society.

But, there is a point in your experience of which everyone should be aware. Many little doc-in-the-boxes have been bought up by hospitals and so they can charge emergency room type fees. There should be a sign or notice near the entrance. I'm sure that this varies by state, Florida's law, HB 1157, was passed in 2021. Especially in towns like Amarillo, where there are basically only two hospital corporation systems for hundreds of miles in any direction, the need to keep profits rising has driven the corporations to explore ever more inventive means of profit making.

[Ponietz]

55. Enshittification contaminates every crevice of this broken world

[John Farmer]

50. When I needed sutures taken out in 1963

my parents sent me over to the neighbor who was a psychiatrist. After rummaging around in his junk drawer for an Excito Knife and pair of needle-nosed pliers he took care of it in less than a minute.

[CousinIT]

52. "wealthcare" - gotta keep those billionaires CEOS in gilded houses and yachts and keep stockholders happy. nt

[Turbineguy]

53. The CT scan was obviously to see if you were pregnant.

Taking out the stitches might make you pregnant.

No Doctors in Texas were arrested as a result of your visit.

I know more about medicine than those making laws in Texas.

[live love laugh]

59. October '24 in Athens Greece my Dr. bill $150 for meds and visit.