The woman in this story had a quick, simple outpatient procedure on her knee that took 20 minutes, and she was billed over $87,000 by the outpatient surgery center. And Blue Shield paid $84,000 of it. The woman was told to send that to the surgery center, she refused, and filed a complaint.
Now, Blue Shield isn't going to win either way--if they paid it, why did they pay so much, if they hadn't paid it, people would have complained that it wasn't paid. But that aspect isn't the focus of the article. What is, is how outrageous these costs are, and certain types of care centers are getting away with it. Now they are all claiming it was a mistake, how could a such a charge been generated, etc. And everyone will be more careful in the future. Blue Shield was obligated to pay it based on the contract they had with the woman's employer, the Long Beach school district. HHhmmmm.
But what if the woman in this story hadn't complained? Somehow I don't think the surgery center would have been too upset at the 'overpayment.'
We had a similar ridiculous set of charges and care in my family. My boyfriend's son was hit a couple of months when a car turned in front of his motorcycle. He ended up okay, better than his lap top did, but was taken as a precaution by ambulance to a local trauma center. I saw him an hour or so after, and he looked fine. Remember, I was an emergency nurse for many years. Long story short, he was there 3 hours, had 2 CT scans that really didn't seem necessary since he wasn't bleeding, wasn't knocked out his blood pressure etc. was fine. He walked out. Then the $40,000 bill came. Yup, $40,000. Talk about overkill.....