General Surgery Costs

[bklase]

I belong to an HMO and am considering surgery via the House Ear Clinic.  Could someone give me an idea about the average anticipated costs involved with surgery and recovery?

Thanks so much.

[kristin]

hi. i'm not sure on the exact cost, but it shouldn't matter as long as you get pre-approval from your insurance. i called my insurance the day after i was dx'd to find out what was covered. they said that they would only pay for out-of-network procedures if they met 4 criteria..

1) couldn't be performed in-network (i live in kalispell, mt..easy one); 2) must be performed by a beech street physician (you can look this up online); 3) must be medically necessary; and 4) must be referred by an in-network physician.

i would get on them early and stay on them. fortunately for me, i work for medical billing and talk to my insurance at least once a week for my job...so i know the people there and haven't had a hard time getting pre-approval. talk to your referring docs too and have them write letters to your insurance stating that they prefer and recommend House.

well...i hope this helps! i plan to have it in writing when i go there (i'm scheduled on april 14th for middle fossa w/ dr brackmann and hitselberger at House for my 8 mm left AN) so that way they can't say no when the get the bill...

[bklase]

Thanks for the input...I'm trying to determine a ballpark dollar amount since most likely I will have to cover between 20-50% of the costs.  (I like to be fully prepared with few surprises).

[Becky]

Based on input to the original ANA Listserve, I have seen posts indicating insurance payouts (much less than the total charges) as low as $30,000.00; and figures as high as $148,000.00.  I think the average cost is about $70,000.00.  I believe GK treatment is about the same.  A lot depends your provider/carrier network, and possibly the location of the provider within the states.

Becky

[kristin]

ok..as you may know, i'm having middle fossa in two weeks at House. i received their fee schedule today:

test and examination in office: (abn & other hearing tests) $1020.00
combined surgeons fees: $35,000-$45,000
internist: $2344.00
anesthesiologist: $2704.00
hospitalization: $ as per hospital and ins
neurogergeon -initial exam: $433.00
facial nerve monitor: $2969.00

hmm..so that totals from $44,470-$54,470 not including the hospital fees....hope this helps.

[ecrmedia1]

      I had a large (4.5 cm) glomus jugulare tumor and a 2 cm carotid body tumor removed at the House Ear Clinic in June, 2004.  The surgery was complicated and involved.  Kristin had the fee schedule correct for the House Clinic.  My hospital fees were around $115,000.  The hospital will be St. Vincent, which is across the street from the House Ear Clinic.  They are wonderful.  I live in Florida and made the trip to LA for the procedure.   
      Also, St. Vincent Hospital has a guest house attached to it for the family of the patient to stay at extremely reasonable rates. 

[rntiggergirl]

Hi
I work in the insurance field. Be sure to check your insurance policy for you out of pocket maximum.  This is the maximum amount you will have to pay out and then the coverage goes to 100% for in network services. 

Hope this helps!!

Cheryl

[matti]

I had my surgery at Stanford in 1998 and the total cost was just over $110,000. That was for a 5 day stay, 2 of which were in ICU.

matti

[stein78]

I have seen $80,000+ worth of bills come in the mail after my surgery.  But just like rntiggergirl said, with all the tests and doctors visits I have done this year, I have paid quite a bit out of pocket.  I have now reached my peak of $2000 out of pocket for the year, all I had to pay for surgery was $768. 

[kristin]

it has been a HUGE headache for me and my insurance! i got everything pre-approved and in writing before i went to LA that my surgery would be paid at in-network benefit levels. (see above!) however, EVERY single claim that has come in has been processed as out-of-network. so everyday i've had to call my insurance and tell them to reprocess as in-network. i finally talked to someone w/ a brain yesterday and she is taking over all my claims and going to fix everything.

ps. my 4 day hospital stay (that includes surgery day) totaled $41,000. (this is not including any doc charges)

[pgold]

Has anybody had any experience with the insurer Mamsi regarding AN surgery costs?

[mshaybaler]

Has anyone used Medicare and AARP Suppliment for surgery cost at HEC and St. Vincent? If so how did they pay? I am 66 yrs. old and have been diagnosed with a 3 cm AN. I am waiting for the call from Dr. Brackman to tell me his opinion as to which type of treatment I need.

[Robquinn9]

Still tabulating (LOL), but I'd peg my wife's surgeries to be in the neighborhood of $45-50,000 (USD).

[Battyp]

It amazes me how different everyone's expenses are.  You would think it would pretty close to the same not 10's of thousands different.

I had my surgery in Fl and all said and done it was around 80,000 including a 5 days in ICU and doctors fees.  I paid about 1100.00 out of pocket. 
Ercmedia1 where in FL are you?  I'm on the east coast but had surgery on the west coast. 

[Joef]

I've seen 96,000$ in costs from St. V's .. but by wife as told me she's gotten seperate bills from Dr. Hits office ... that all total, this little 4cm ball of meat costs 170,000$ !!! (baha and local doctors) wish I still had it to sell on eBay