I just got a bill from the home health agency that shipped my supplies. There were a total of 4 shipments (one a week for 4 weeks). Each shipment included 7 bags of rocephin, pre-filled syringes of saline and heparin, tubing, and supplies for a once-weekly bandage change and a once-weekly blood draw (lab fees for blood tests were billed separately).
The total bill for these 4 shipments was $14,437. That comes to over $3600 per shipment, $516 a day. Does that sound out of line?
I initially asked the case manager how much it was going to cost, and she said about $100 a day. Never having been through this before, it didn't occur to me to get that in writing.
Blue Cross is to pay 90%, leaving me with 10%. But I was expecting to pay 10% of a much smaller bill.
Peggy
Posted by beachcomber (Member # 5320) on :
Hi:
Yup, sounds about right. IV Rocephin + supplies + weekly visits for bandage change cost me $3600 per week.
Be glad insurance is covering any of it. Hang in there.
Posted by lou (Member # 81) on :
Sorry, I don't agree. This sounds way out of line. I think you should call around to other suppliers and get quotes. They don't all charge the same amount. Very nice if ins will pay but sometimes they fink out after charges are incurred. If this happens, you do not want to be left holding a bag that is larger than necessary. And even if ins starts to pay, huge amounts like this are going to make them rethink paying.
There are also outfits that will ship from elsewhere.
Rocephin generic now costs less than $400 a month and one bag of saline costs about $10. Saline and heparin flushes can run $1 apiece. Tubing is under $10 and can be used more than one day. Dressing changes, etc can't give you an estimate for since it depends on what kind of infusion device you have. Then, there will some labor involved in putting the drug into the saline bag, unless they are using the screw on type that even a patient can do safely.
Posted by lou (Member # 81) on :
Most lyme docs don't care where a patient gets his or her meds. You don't need anyone's OK on checking prices elsewhere. And if you find someone, you can have them transfer the prescription for you.
This price is so outrageous that I would call and point out to them the discrepancy. Ask if this is a billing error. And if they say no, tell them you will do no further business with them and will spread the word to other patients.
Check around too with support groups in MD and the metro DC area. They may be able to put you onto a more reasonable source for infusion supplies.
Posted by nannie (Member # 5250) on :
This is definately high...it almost sounds like your insurance company is upping the bill so that your 10% share covers most of the cost.
IS the BC a nonprofit or a public company?
Posted by digirl02 (Member # 7177) on :
Peggy Way to high. I had no insurance and paid $528.00 per week and about $46.00 for the weekly home nurse.. Can you contact the pharmacy and talk to billing manager. I agree this is has definitely got to be a mistake.
Posted by Peggy in Maryland (Member # 10480) on :
I'm not on rocephin anymore; I did it only one month because Blue Cross refused to pay for more. Now I can see why.
What's really bizarre is that I expected them to pay the provider a percentage of "reasonable & customary." Instead, they're paying 90% of the total billed amount, without making any adjustments! This leaves me liable for 10% of the fully billed amount.
My husband called the home health agency to ask for an itemized bill, to see exactly what this $14,000+ was for. They admitted they inflated it because they expected an adjustment.
The next step is to call Blue Cross and ask "what were you thinking?!"