Zurik: ‘Absolutely ridiculous’ medical bills show critical need for transparency
NEW ORLEANS (WVUE) - If you buy a TV, a car, a bag of groceries, you know the cost before you check out. But in healthcare, the prices remain hidden - until now.
We've spent two months pricing common procedures across the metro area. And hundreds of FOX 8 viewers have helped gather information.we want prices you have on any procedure. right now... We definitely are looking for colonoscopy costs. if you've had that... Please send in your costs.
"I've got pages and pages that will shock you," one consumer tells us in a phone message.
Those pages refer to the sort of paperwork that should easily outline the cost of your healthcare coverage. For many in the metro area, though, the answers remain hidden in a complex language of letters and numbers.
"It's absolutely ridiculous," says another person.
"They charged me $2,300 to put two drops of deadener in my eyes," another consumer says.
We received dozens of such voicemails, many with serious accusations.
"I feel like they're ripping people off by double charging," one local resident tells us.
"Their billing is very suspicious," says another.
We heard stories of helplessness in these voicemails, and of heartache.
"I don't know if my call is going to make any difference," a woman tells us.
The cost of healthcare cripples many people in metro New Orleans. And many have a hard time understanding why those bills are so high.
Mitch Brandon, a U.S. Army veteran living on the North Shore, is just one of them.
"Most of my family's served in the military, in some form," he tells us. "This is the greatest country on earth, without a doubt. And to protect our freedoms and what we have, our way of life, is just important."
Brandon is almost 20 years removed from his five-year Army stint. But some recent aches forced him to make a trip to the Veterans Administration.
"A lot of back pain, stiffness, really impact my way of life," Brandon says.
The VA directed him to Lakeview Regional Medical Center for two MRI's.
"Six, seven months later, when the billing started, I got a bill in the mail for the MRI," he says. "$8,066.24. I was quite surprised by the amount, how large it was."
The VA hasn't said it will pay the bill. But the hospital wants its money right now; a collections officer even called him.
"I think, in hindsight, if it were my responsibility and we're going to pay for it, I would obviously like to know what the charges are up front before I just go and get an MRI," Brandon tells us. "I had no idea it would cost that much."
Often, the sticker shock of a bill like this is only a starting point - these prices can be negotiated down. But no one at the VA told that to Brandon.
He says he's still hopeful the VA will pick up the bill; he just hopes taxpayers won't be forced to pay that much.
"My biggest concern was that, knowing that this was provided by the VA or a program of the VA, through the Veterans Choice Program - my biggest concern was that they would not be charging a private insurer perhaps this much," Brandon says. "And they could be potentially taking advantage of a government program and the VA program, and it could potentially compromise other veterans, current and future veterans from getting care."
FOX 8 News, along with our partners at NOLA.com | The Times-Picayune and Clear Health Costs, have spent the past two months working to bring transparency to healthcare pricing in the metro area. We've created a database of prices.
Right now, Lakeview Regional Medical Center in Covington is asking Mitch Brandon to pay $4,000 for each MRI. But our database shows that the same MRI's, just a two-minute drive away at Medical Center Diagnostics, cost $350 with cash, off insurance.
Examples like this stand out in our research. Prices for many procedures, like an MRI, can vary widely.
"It's happening more and more," says Shea Soll.
Soll owns and manages Doctor's Imaging in Metairie. His clinic is just a short drive, a few turns away from East Jefferson Hospital.
Soll says he knows of someone who went to East Jeff for an MRI. He says Blue Cross Blue Shield allows East Jeff to charge patients using insurance $825 for an MRI of the knee. For that same procedure at his clinic, the allowable Blue Cross insurance fee is just $476.
"The insurance companies will typically give in for higher rates on the imaging services, in order to secure lower fees for more intensive-type services," Soll explains. "When an insurance company is negotiating with a non-hospital provider for imaging services, that's the only thing they're negotiating. So, they play hard ball and the insurance companies essentially tell you what the rate is going to be. And you can accept it or not."
That means facilities with the same equipment, employing radiologists with the same qualifications, could have starkly different prices.
"I think price absolutely matters," Soll tells us. "And I think patients should be oriented to, looking into whether or not they can get the same service at a lower cost, given it's a financial burden on them and their families.
Another FOX 8 viewer received a breast MRI at Thibodaux Regional Medical Center. The insurance company covered $1,181.57. The viewer and patient paid a $506.39 copay and an additional $1,071.33 for the MRI not covered by insurance. Down the road at Leonard Chabert Hospital in Houma, they tell us the cash price for the same procedure is $157.87.
Another Thibodaux Regional Medical Center customer paid $1,590.83 for a brain MRI. At Leonard Chabert Hospital, the same procedure costs $578.
A shoulder MRI cost another viewer $748 at Ochsner in LaPlace, using Aetna Insurance. A few miles away at Doctors Imaging, the cash price for the same procedure is $495.
"The state of healthcare basically, Lee, needs a total revision," says Dr. Rob Muller, a North Shore gynecologist.
Muller showed us a recent lab bill for his annual blood work, performed by Quest Diagnostics. It includes a nearly $850 charge for the removal of tissue.
"I had no surgery," Muller tells us. "I did not have a pathology specimen. I did not have anything done other than routine blood work."
In other words, the bill claims they cut a tissue sample from him; he insists they did not. One way or the other, they charged him $850 for it.
Muller called and Quest removed the charge.
"Very, very few people are catching them," Muller says of apparent billing errors. "I think a lot of this problem deals with, especially, the elderly, who are on Medicare and supplemental insurances. And it's very difficult because, if you got Bill A and Bill B concurrently, at the same time, it'd be easy to do. But when you get Bill A and then you don't get Bill B four to five months later, it's hard for them to remember and to correlate whatever happened at that particular time. I think a lot of people are paying these bills."
Another FOX 8 viewer told us by email, "I'm very unhappy" - his bi-annual trip to the doctor used to cost him $146, blood test included. But after his doctor retired, he gave someone else a try - and that leap of faith cost him plenty money. His $146 bi-annual visit shot up to $440.
As we inspected his bills, we noticed the increase resulted from pricier blood work. In the past, his doctor sent him to Quest Diagnostics; the tests cost him $27.91. The new doctor sent him to East Jeff's lab, where the same tests cost $284.40.
The viewer told us he's "changing" his primary care physician.
"I'm fed up," says Dave deBronkart. He's a cancer survivor and a patients advocate, traveling the world to speak about the rising cost of healthcare.
"There's not a thing I can do to control health costs and be responsible about my spending, if I can't see the freaking information," deBronkart insists.
He says projects like our investigation will help crack the code of medical billing practices, because patients will be empowered with information to help unmask the secrecy of healthcare costs.
"There's nothing magic," he says. "There's no rocket science about this. We just need to treat our healthcare billing the same way we treat any other bill in life."
The pages of paperwork health insurers send out can be complex. But deBronkart warns, "There is no excuse for sending us a bill and charging us, even if it's through an insurance company, with things where a knowledgeable person cannot tell whether what you're getting billed for actually happened, much less whether it's a reasonable price. There's no excuse for it."
DeBronkart says there's no excuse for inflated prices, either. "I think it's outrageous," he says.
Hundreds of people have already contributed to our database, arming our community with information.
Our database reveals, for instance, how a Hammond resident likely paid too much for an ultrasound at North Oaks Medical Center for an ultrasound. Humana charged her $865, but the same procedure can easily be found at several locations for under $200.
Experts say sharing information may be the only way to reduce prices by empowering yourself with information, and using it to help crack the code on rising healthcare costs.
In the meantime, our lines continue to ring as healthcare consumers call to share their concerns, to seek help in understanding their high medical bills.
"They charged me $250, just to walk through the door," one says.
"I looked at the bill and I thought, what are all these charges?" another viewer says. "That five minutes cost $60 for walking on a treadmill."
A few of the providers and insurance companies mentioned here offered written statements to our requests for comment. But none were able to give specifics about the points we raise in our story.
Remember: we want you to join our investigation. Please contribute your prices, your stories to our database.
We want to see the prices you have to pay on any procedure.
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