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Shoulder surgery cost...bananas.

Posted on 2/19/24 at 10:42 am
Posted by PCRammer
1725 Slough Avenue in Scranton, PA
Member since Jan 2014
1446 posts
Posted on 2/19/24 at 10:42 am
So I had a labrum tear and bicep tenodesis (relocation of the bicep tendon) fixed last week at the Andrews Institute (Dr. James Andrews' facility) in Gulf Breeze Fl. Operation lasted 70 minutes. Guess how much the claim that went to my insurance company was.

If your guess was 12K for the use of the surgery center + 73K for the surgery you get a cookie. I have not seen the anesthesiologist cost yet but im sure that'll put me over 90K.

I mean what are we even doing here with health care costs...
Posted by SulphursFinest
Lafayette
Member since Jan 2015
8694 posts
Posted on 2/19/24 at 10:43 am to
American the beautiful
Posted by Bjorn Cyborg
Member since Sep 2016
26465 posts
Posted on 2/19/24 at 10:43 am to
You don't pay for the surgery, you pay for the doctor to leave.
Posted by LSUnation78
Northshore
Member since Aug 2012
12033 posts
Posted on 2/19/24 at 10:43 am to
Another one who doesn’t understand how medical billing works.


Posted by beerJeep
Louisiana
Member since Nov 2016
34885 posts
Posted on 2/19/24 at 10:44 am to
Cheap.

Quick.

Good.

Pick 2.
Posted by CocomoLSU
Inside your dome.
Member since Feb 2004
150428 posts
Posted on 2/19/24 at 10:45 am to
quote:

labrum tear

I have this as well. Contemplating on if I want to get it fixed or not.
This post was edited on 2/19/24 at 10:46 am
Posted by The Torch
DFW The Dub
Member since Aug 2014
19200 posts
Posted on 2/19/24 at 10:46 am to
You have to pay for the 10 Obamas that went through the ER and never paid their bill.

Baw
This post was edited on 2/19/24 at 10:47 am
Posted by PCRammer
1725 Slough Avenue in Scranton, PA
Member since Jan 2014
1446 posts
Posted on 2/19/24 at 10:48 am to
quote:


Shoulder surgery cost...bananas.
Another one who doesn’t understand how medical billing works.

I mean does any normal person? I get that will be negotiated down between the ins company and the Dr/surgery center but the fact it even starts that high is ridiculous.
Posted by Dragula
Laguna Seca
Member since Jun 2020
4844 posts
Posted on 2/19/24 at 10:48 am to
Congrats on now throwing 96mph.
Posted by Undertow
Member since Sep 2016
7282 posts
Posted on 2/19/24 at 10:48 am to
You think any of that had to do with going to the office of one of the top surgeons in the world for those types of procedures?
Posted by Trevaylin
south texas
Member since Feb 2019
5725 posts
Posted on 2/19/24 at 10:49 am to
let us know when your ultimate portion is 350 dollars or less
Posted by Tarps99
Lafourche Parish
Member since Apr 2017
7269 posts
Posted on 2/19/24 at 10:50 am to
quote:

So I had a labrum tear and bicep tenodesis (relocation of the bicep tendon) fixed last week at the Andrews Institute (Dr. James Andrews' facility) in Gulf Breeze Fl. Operation lasted 70 minutes. Guess how much the claim that went to my insurance company was.

If your guess was 12K for the use of the surgery center + 73K for the surgery you get a cookie. I have not seen the anesthesiologist cost yet but im sure that'll put me over 90K.

I mean what are we even doing here with health care costs...


Just wait until you find out how much the insurance actually paid.

Your insurance has a contract where that 90k in charges is more like 9k out of the insurance companies pocket. Sometimes they do this so your reach your out of pocket max sooner. While your bill will be what your out of pocket max deductible is.

At least this happened in February instead of December where you had one procedure in December and then another one again early in the year, you would have to pay the out of pocket max deductible twice.
Posted by Corinthians420
Iowa
Member since Jun 2022
6056 posts
Posted on 2/19/24 at 10:50 am to
quote:

Andrews Institute (Dr. James Andrews' facility)

so you went to the doctor that major league pitchers and NFL QBs use for their shoulder surgeries?

and you are shocked it cost a lot? do you realize how much money his normal clientele makes?
Posted by 9Fiddy
19th Hole
Member since Jan 2007
63980 posts
Posted on 2/19/24 at 10:51 am to
quote:

I mean what are we even doing here with health care costs...

And the kicker is that's not even close to what the doctors and surgery center will receive. When you get your EOB, it always shows the "contract rate," meaning the rate the insurance company agrees to pay based on the procedures. While still high, they won't be even close to $90K.

I'm 100% convinced the only reason those high prices are initially sent to the consumer is to make the consumer say, "oh thank God I have insurance." It's a scheme by the providers and the insurers to keep the insurers in business.
Posted by OvertheDwayneBowe
Member since Sep 2016
2868 posts
Posted on 2/19/24 at 10:52 am to
quote:

mean does any normal person? I get that will be negotiated down between the ins company and the Dr/surgery center but the fact it even starts that high is ridiculous


Well we have to pay for all those people working to negotiate.

Think of the hospital and insurance employees that wouldn't have jobs if we just had set rates for services. Stop being selfish.
Posted by LarryCLE
Member since Apr 2017
1543 posts
Posted on 2/19/24 at 10:52 am to
quote:

American the beautiful

Still preferable to waiting months for the surgery in Canada or just being crippled for life in some third world country.
Posted by KamaCausey_LSU
Member since Apr 2013
14431 posts
Posted on 2/19/24 at 10:52 am to
quote:

Another one who doesn’t understand how medical billing works.

I don't understand either. How exactly does it work. Physician/Surgery Center sends over a monopoly money quote, insurance company says we'll pay $X, surgery center says, "sounds good, thanks."?

What is the purpose of the insane bill sent to the insurance company? Just a game to see what they will/won't pay? Padding the bill to get more money out of insurance?
Posted by LSUnation78
Northshore
Member since Aug 2012
12033 posts
Posted on 2/19/24 at 10:52 am to
Yea, i know. Its not uncommon for it to shock people.

But its not really the cost of healthcare because the billed amount that goes to insurance is no where close to what the actual reimbursement will be.

There is also the no surprise act now so they cant unexpectedly drop a dode hammer on you because the random anesthesiologist they used was OON. Even when you do get oon services, you can usually get them to settle for like 50% of what the billed amount is with very little fuss. I’ve done it several times after each of the kids were born.
Posted by JasonDBlaha
Woodlands, Texas
Member since Apr 2023
2263 posts
Posted on 2/19/24 at 10:54 am to
The andrews institute in Pensacola is super expensive in general because so many pro athletes have paid ridiculous money to get surgery there. My arthroscopic shoulder procedure was no more than $15,000 without insurance. The idea of paying $50,000+ for shoulder surgery is absurd unless you’re a multi-millionaire who has hundreds of thousands of dollars worth of disposable income.
This post was edited on 2/19/24 at 11:06 am
Posted by poochie
Houma, la
Member since Apr 2007
6137 posts
Posted on 2/19/24 at 10:54 am to
Just cut my arm of instead of paying $100k.
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