Cost range for AN removal by House?

[paul007ex]

I was recently diagnosed..wtihin the last week. It's supposed to be around 4 *5 *5 mm or so.. Very nervous. I'm 31.

Looked @ a bunch of options and the surgical method at HouseLabs seems most inviting. However, I've found very little that suggests what total cost with hospital stay ranges?

I realize it depends on insurance.. but what about some examples? I have Aetna PPO from Texas. I have no idea what their coverage is, but I do know that their "out of network" is 50%, or something to that effect..

I read a report about $30,000 average across all hospitals but that was a number of years ago..

Can someone share their cost experience with House, please?

[Jim Scott]

Hi, Paul ~

I can't offer you the fees for HEI because I didn't have my AN surgery there.  However, many of our members have used HEI and I'm sure they'll be along with some numbers for you.

FWIW: my bill from the hospital where I had my AN surgery came to approximately $65,000. My neurosurgeon's bill was a very reasonable $28,000. (for a 9-hour surgery using two neurosurgeons).  Other surgery-related expenses came to approximately $5,000. for a total of just under $100,000.  That was in 2006 in a New Haven, Connecticut facility.  Fortunately, once I met my $1,500. 'out-of-pocket' deductible, Blue Cross paid the rest of the bill. 

I assume HEI, being specialists, will charge more plus inflation will add to the total.  I suggest that you carefully check your policy to see exactly what is covered and at what percentage rate.  HEI may want some money upfront and you need to be prepared for that.

Jim

[jaylogs]

Four years ago, I had mine done at House and after all was said and done, it was over 100k. Thank goodness I had excellent insurance so it was very little out of pocket for me.
Jay

[kcarloy]

Call House directly, they will look into all of your costs with your insurance and give you the figures, its better than guessing!

[sdima2424]

has anyone had AN removal in NYU ?what was the surgeon cost ? if paying out of pocket 
 

[Patricks]

I had mine removed and a cross face nerve graph done in boston at mass general eye and ear infirmary.  After my 200 dollar deductible the rest was covered.  Thank God for insurance

[sharonov]

I had surgery at House last December, and am covered by Medicare + a supplement (Medicare pays 80%, the supplement 20%.)  I pay for the highest level of supplemental insurance, Medicare F.  At this point I don't know what I'll have to pay out of pocket, but here are some examples of bills that have so far been covered by Medicare.  Be aware that, 1. Medicare negotiates payments with medical suppliers and 2. The suppliers overcharge so that they'll get a reasonable reimbursement.  I checked before surgery to be sure they took Medicare, which pays less than many other insurance providers, and luckily they did.

St. vincent's Hospital:  Billed $160,000 (one day in ICU, 3 or 4 days in hospital--I honestly forget).  Medicare approved the whole amount but paid $22,400.  I don't get it, but won't call unless I get a bill!

One surgeon:  $40,000 bill - Medicare paid $3600.  I sure hope they give him more. 

Surgeon Two:  $27,000 bill-    "            "    $2800

Miscellaneous:  Pre-op Internist, Nerve Monitors, Internist Hospital Visits, Audiologist pre-test, etc. $8000 billed, much less paid
I still don't have a bill for anesthesiology.

Staying at Seton Hall after your surgery is relatively cheap at $85 a day for room only.

The world of medical insurance is extremely confusing, so perhaps I shouldn't even give you these figures, which could scare you.  That's why the suggestion someone made to phone House and St. Vincent's directly is a good one.  BTW, even if somehow I had to go into debt for this surgery it would be worth it.  I'm 74, an age where many doctors won't even do this surgery.  I had retro-sigmoid (the surgery most apt to cause complications) and two months after having my head cut open am 99% recovered with no headaches, a little bit of hearing left in my ear, no facial paralysis, and the same balance as before Dec. 12.  These guys know what they're doing.

[ANSydney]

Are you saying the bill was $160,000, but the insurance company "negotiated" it down to $22,400? And on top of this, one surgeon's bill was $40,000, and the insurance company "negotiated" it down to $3,600?

[sharonov]

I don't know how the amount got lowered.  I just know it was.  But that happens whenever I have a medical procedure or visit--the amount charged is way out of line; Medicare Then has a column "Medicare Approved" and another "Medicare paid Provider" which is usually 80 of the approved rate.  How they come up with the "Approved" amount is beyond my comprehension. 

[ANSydney]

If a surgeon got $3,600 for a day's work and could do this 250 times a year, it would amount to $900,000 per year. A good incentive to become a surgeon (not to mention the higher calling of saving/improving people's lives). If a surgeon got $22,400/day then it would amount to $5,600,000 per year. Now we can't all become great surgeons, but...

[alabamajane]

That's the way Blue Cross Blue Shield statements are also. ( and I would imagine most insurance companies),,

The doctors or hospital or lab etc  charge an amount and the insurance company has a fixed amount they will pay.  Then they pay usually 80% and patient 20%,,, or 70/30 whatever your policy allows.

I have always thought the amount doctors etc originally charge is the amount they " expect or hope" to get from patients or insurance companies,, the larger companies negotiate fees ahead of time as does Medicare. So doctors etc know that if they want to accept Medicare patients, this is what they will get paid,,,

Sad to say that if you don't have insurance, or good insurance, you may end up being billed the original rate,,, unless YOU negotiate with them. It pays to be your own best advocate in medical issues,,, from decision making all the way down to price of procedure,,,,,

My thoughts,,,,

[caryawilson]

ALL insurance companies negotiate the billing rates for in-network doctors. The negotiated rates are typically 8-15 times higher.l the the doctors "billing" rate. Hence, while a doctor may bill $100k, the contract rate may be around $10k. Therefore, If a doctor takes you as self pay, without insurance, you really need to understand the complete bill: surgeon(s), anesthesiologist, operating room, daily hospital rate.  The doctor "billing" rates are fictious, at best, and you need an insurance company to provide the contract rates and plan to spend your max out of pocket.

For example, I had a 14 hour surgery at John Hopkins and the insurance paid $60k for the operating room ONLY.  Each surgeon, (neurosurgeon, ENT) had their own bill and the anesthesiologist was another. For my initial surgery, this was over $100k

Unless you have debilitating symptoms, your tumor is small, and I would think watch and wait would be one approach. There have been a few studies posted on this site that indicate most tumors stop growing in five years, and you may not require any treatment..

Cary

[sdima2424]

 
hi , my surgeon has sued us for 80k after recieving 18k from out of network plain  need help

[ANSydney]

$98k x 250 operations per year = $24.5 million per annum. Something is wrong with this picture.

[james e]

Where are you in Texas? I had Aetna in Texas, lived in Austin at the time, and had surgery at Houston Methodist. Lots of great docs in the DFW area also. I just paid my deductible. I believe the total amount billed in 2010 was around $65,000.