If we find someone gaming, we’ll name and shame. And then I will pay it.” By god, I got a bill from them 3 days later. How is the costs here good “benchmarks” on the true cost of health care? Results of services vary among patients and cannot be guaranteed. ��{}��kѻf^k��d(܋�V�|�ǵ�hIi�_Y(�Jm.�̎e���(5�Vty���s� #� ��d�*7!�[� 4�� 1817 0 obj <>stream This is why I’ve been saying for a couple of years now that, as part of every single medical encounter, people-commonly-called-patients MUST ask “how much is that?” before making any decisions about treatment with their care team. I used to think the military and broadcast engineering was addicted to acronyms. This is the test that wc continues to deny I have done, although it was done last September. They call this an objective test, although wc doctors have said in denial letters that I have no objective evidence of nerve compression.). I  believe this is the price KP would charge an uninsured person. When you go to the store to buy a toothbrush, computer, car, you have an idea how much negotiation (or discount requesting) room there is. His group feels that they’re being shut out of the ACO market because they never inflated prices — unlike their high-priced competitors up the road, who, in his view, are fully engaged in reaping ACO benefits because they are shaving back their bloated prices. 2�ɡ�� �2�3���}��E�de���. As a highly desirable place to live and work, San Francisco has always had a relatively high cost of living. Rather like the situation in postwar Europe, where the Communist party was a real threat and the parties in power enacted many social benefits so as to keep out the Communists. Of course, wages play a large part in determining the cost of a service to a consumer. So, even Medicare and Medicaid get billed at full list and then they pay their administered (dictated) rate and commercial insurers pay their contract rate if they have one. Commitment to Training Kaiser continues to fund new hire orientation, management, and on-the-job training for employees. Cancel Search. Guess who won? '�䁏���m>nڅd�B+ h���K���+��V�\pؾ,l~��/Y��}|1�" #�7��&:C��2y�iq=��a���5�@&���60��O[Qic� f Cash rates here seem to range from $399 to $3,388, though the specifics are not always clear, and some providers call their posted prices “estimates.” (See a bit below for our ClearHealthCosts pricing  survey information.). Antelope Valley Hospital 1600 W. Avenue J Lancaster, CA 93534 (661) 949-5000 . Also, New Jersey: Ah, that hospital. Deductible had not been met so I was responsible for all charges. If you really want the gory details…. The answer: yes, we do. Usually, the letter gets forwarded to the appropriate department in the organization and it just about always gets resolved to my satisfaction on a timely basis. Because you know that it costs X to make and produce each “widget” and you inherently agree/acknowledge that a certain profit has to be allowed in order for the company to 1-stay in business, 2-pay its employees and costs and 3- make a reasonable profit to develop further products (etc). I have proposed the creation of specialized Health Courts. Among those running for governor in Massachusetts this year, for example, is Charlie Baker, former CEO of Harvard-Pilgrim Healthcare and a strong believer in price transparency. Really. It’s hard to defend that from any perspective, if you ask me. However, values listed above came with a ‘pending’ notice – pending ‘paid by insurance/adjustment’ and pending ‘amount I owe.’ so the total charges seems to be $2,785. Kaiser had argued that Rahm did not request the MRI in March 2009 and, even if she had, the tumor was already so large she still would have lost her leg. What’s to stop somebody from gaming the system? : (818) 344-9525 [Visit Website] Scans Performed: 5536 Reseda Blvd Tarzana, CA 91356: Radiology … Also, given gridlock in Washington, single-payer would never have passed. I am a huge fan of your work! I think that last one is changing rapidly. This issue of out of network providers used to come up all the time in hospitals with radiologists, anesthesiologists, pathologists and ER docs, none of whom the patient usually has any role in choosing. Marina del Rey Hospital? Longer term, I’m optimistic about this. Then she was gone, and the next person in billing was quite insistent that they had sent all those $17.25 bills to the correct address. We’ve been looking at health-care prices for three years, so if we say it’s a mystery, we can imagine what it looks like to you. We have been asking people to share pricing information for MRI’s, especially of the back; last month we collected mammogram pricing. But in America we have decided (more or less passively) to let hospitals act as independent economic entities — rather than regulated public utilities. We started with one very simple yet important mission; to provide imaging diagnostics (such as MRI, XRAY and CAT Scans) at an affordable, low cost. The pathologist billed $311 and was paid $130. We’re looking for writers & cross-posts. Southern California. So I talked to the office mgr who said if I paid upfront and agreed not to report the procedure to Blue Cross, that it would be $580.”, On our Facebook page, one contributor wrote, “I was going to be billed $830 through my PPO for an MRI. They don’t understand or see the simplicity of eliminating this strange phantom billing practice that exists everywhere, in favor of a more one-to-one billing practice employed by many companies when they offer a product up for sale. Barry I would be delighted with the regulatory changes that you propose. I am thinking two things: Soon I should have more definitive proof what is compressing my spinal nerves and I should have done this months ago but i didn’t because I thought the cost would be prohibitive. 2. I completely agree, we need regulators. IMHO, I am not the greatest speaker, however, but I do have a love for writing. But the situation is SO corrupt, SO far out of control, with the money-makers in charge, you’re right: only crowd-sourcing from the grass roots will go around the perverted structures. X-rays, CT Scans, and Other Imaging Studies ( continued). Charged price, $580; insurance paid, $0; you paid, $580. It’s great someone is comparing prices since is it illegal for the providers of the services to share their prices – oh wait – that would be yet another example of the unintended consequences of unreformed government regulation. As a doc I expect you not to want that for obvious reasons. Few years ago I was having MRI every few months on full spin e and brain done broken up not at same time,they would do 3 MRI’s total on me.Anyhow Insurance was covering it and INSURANCE payed 1250 per MRI..However after my 3rd MRI insurance decided they would drop me cause I was ‘high risk’ so here I was NO INSURANCE company would touch me.I got a few more MRI’S got bill and POTTIED Myself the 1250 that insurance was paying jumped to 7500 for a uninsured person,GREEDY GUTS Hutchinson ks hospital. 1. Eight identical MRI’s, and eight vastly different payments. It seems that this crazy system could be fixed by allowing providers to bill patients and insurers the rate that the insurer has agreed to pay or, in the case of the public insurers, their administered price. — Inpatient stays in the East Bay cost 40 percent more than the state average, while all of Southern California, including San Diego and Los Angeles, are below average. Literally, I yelled at her that “You WILL recall this bill from collections. We may be crazy, but it looks to us like people are Incensed About The Prices and excited to open up their bills. Medical Malpractice – MRI Misread. We could not find it on the Health Diagnostics website, so we are reproducing what was scanned and sent here. Short summary for health: Doctor visit $5. Then I started covering healthcare and getting involved in healthcare policy, and realized that the medicos win the acronym game hands down. Delta St. Joseph's MRI, LLC: Scans Performed: 1617 N. California Street (Suites 1A and 1B) Stockton, CA 95204 : STOCKTON MRI & MOLECULAR IMAGING MEDICA: Tel. Our cash prices were implemented to help those with high insurance premiums, high deductibles or no insurance at all. So I talked to the office mgr who said if I paid upfront and agreed not to report the procedure to Blue Cross, that it would be $580.”. We want full transparency — and let the market make the rules. It set a reference price of $30,000 and 46 of the 110 hospitals in the region agreed to do the surgeries for that price. My daughter needed some dental work. 2301 M Street, NW . Well, it wasn’t the patient or you! The result of all this gaming that has been going on for years is that patients paying out of their own pocket have been royally screwed. Boy, I think it is about time that people start taking back health care. Reading about Bayonne makes me long for national price controls on emergency care. The cash price? Those on high deductible health plans or without insurance can shop, compare prices and save. We provide MRI services in West Palm Beach localities. I suspect that the dr, knowing how screwed up his employer is, simply “corrected” my medical record and deleted the encounter. And that is why physician’s malpractice insurance prices as well as the settlements for malpractice are still going through the roof. $84K Kaiser Permanente MRI Technologist without location (1 salary) +$22K (30%) more than national average MRI Technologist salary ($62K) +$23K (31%) more than average Kaiser Permanente salary ($61K) Advertisement. No comments. For accommodations of persons with special needs at meetings, call 1-877-220-3956 (toll free) or TTY 711. FEES. The whole situation is summed up in Uwe Reinhardt’s 2006 paper “Hospital Pricing in America: Chaos Behind a Veil of Secrecy.”. If so, on what economic basis do you feel that way? Bob, I respect your opinions but think this one is just a wacky idea for something that should be unnecessary if these providers were regulated properly. So, right now, even a well-inentioned, competitive provider who really should be bragging loudly about their prices, cannot give a straight answer. IT will be interesting to see if they can make that happen, given the political and logistical problems. Washington, DC 20002 202-346-3800 . If you’re talking ACA Marketplace insurance plans, then you’re talking coverage ins’n’outs. Read more about how MDsave works. With such clauses in place, providers couldn’t offer discounts without having the discounted price applied to a whole lot of their volume, and so they were loath to do so. This does not include the two office visits required to obtain and analyze the results.”, No. This person was charged $973.25 and paid $973.25; insurance paid nothing. We have heard everything from “I called them and they said I didn’t have to pay” to “they negotiated it after the fact down to a really modest sum” on up to “they insisted on getting the full $6,000 for the stupid MRI.”, I’m with Saurabh Jha on the question about insurance fraud, though. If, however, you are a cash paying customer, and the bill is therefore not submitted to an insurance company, then the “vendor” may (and should) agree to bill cost plus fair profit. Hospital billing of course insisted that the code was correct, because of course I could not possibly know that, could I? Our California price range is from $1,200 to $7,800 charged, and payments from $593 total to $7,800 total. *Depending on your plan, these services may be preventive and covered at no cost or at a copay. He used a cautery needle to pierce the nail and drain the hematoma and sent me on my way. Thanks! A lot of tests, like MRI, CT and XRAY are free. David, what would be your basis argument for wanting a “discount”? Thanks for sharing the cost of getting MRI done in California. The price charged should be a function of how much machine and staff time is required to perform the test. 8: Provider: Kaiser Permanente Medical Center on West McArthur Boulevard in Oakland; insurer, Kaiser Permanente. Some of the preliminary results from our WNYC pilot project in 2013 can be found here; this blog post links to others in the pilot series, with an idea of what infographics we hope to replicate with #PriceCheck. Starting from the northernmost county of southern California--Ventura--and going south to San Diego, southern California is home to the following Kaiser-affiliated hospitals: Community Memorial Hospital of San Buenaventura 147 N. Brent St. Ventura, CA 93003 (805) 652-5011 I once had a dispute involving much less with my local hospital that left me exasperated. If the machine needs to be operated for, say, 10 hours per day and generate $1,000 per hour to cover costs, including the cost of capital, then a procedure that takes 30 minutes should cost $500 and one that takes 45 minutes should cost $750. No. However, there is a published national rate for the procedure. Over the counter meds, certain % off. a mix of judges and doctors and citizens. Keep in mind that the cap on general damages is for pain and suffering and wrongful death claims only. Maryland . “…and the widespread perception that health care should be free.”. A couple of days later, I got a call asking where I would like the check to be sent. We’re eager to learn! 2 For certain drugs, you can get prescription refills mailed to you through our Kaiser Permanente mail-order pharmacy. My favorite resolution actually involved a colleague of mine who received hospital and doctor bills totaling about $20K that our employer’s health insurer initially refused to pay following an inpatient surgical procedure because she failed to notify them after she went to the ER late at night. Everyone posts under a pseudonym and no one needs to know where you practice, and yet if you even hint at a price for a service you are virtually shouted down with warnings that you are breaking the law. After numerous denials, living with increased pain and symptoms, recently, I asked my doc what would a radiology center charge me as a cash patient and his answer was around $850. Couldn’t agree more. We had to get this plan with a monthly premium of $679 per month, no perscription coverage and co-payments of approximately $75 and up because it was the least expensive. We care deeply about good data. The service they provided, even within a higher cost ER structure, wasn’t worth more than a few hundred dollars at most in my opinion. Here in Colorado, I went to my regular dr’s office with a painfully stubbed toe. That’s not to say this isn’t a good idea: I’m all for it: just thinking this is a built in issue you’ll have to look at. I would, however, be interested to know if there is actually such a regulation. I was pretty vocal about it and was even invited by some organizations to speak/be interviewed. The main impediments, as I see them, are individual greed, insurance company middlemen, and the widespread perception that health care should be free. It would be extremely helpful if both patients and referring doctors could easily ascertain contract reimbursement rates in real time for all the regional providers of a particular service, test or procedure. 2. The point of the “discount request” is precisely because there is such a wide disparity between “actual cost” and “billed charges.” While this may be distasteful, it is the practice that has been in place. http://blogs.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/. A 3T MRI machine has a more powerful magnet than a 1.5T MRI machine. These would be federally funded, placed in about 100 locations, staffed by If it was preventive, why were they telling you you need to pay 40 percent? This was after waiting over two months for what they call an Independent Medical Review (IMR), sent by my doctor because I was being denied the myelogram, PT, injections, medication, etc.. That way, if somebody wants the $6,000 MRI, he or she can have it. No. #MRI is poised to reach approximately $5.24 billion by 2018 at a #CAGR of 4.56%, Get more details at http://bit.ly/1oQMN5V, that your list will get longer and longer. Pitches for healthcare-focused startups and business.Write-ups of original research. But wait, there’s more. The comment: “Insurance paid $0 because deductible not yet met.”, Another person, at Kaiser Permanente Medical Center on MacArthur Boulevard in Oakland, who is insured by Kaiser, was charged $2,294 and is being billed for $2,294. We receive a housing stipend up to $3,500 to help offset housing costs. It WAS around rush hour as well, as I recall. See all MRI Technologist salaries to … �@&(��%{��s1L��PB�: 3��漄qJN^_ �DIT��o�U飵H��R��ϳ���f�7̬���3��W����UW��2�P�rQ��T6Yx͇4��R��b9��ʼn��x��T� N��i�\�fe{(h��R/���W��~N����c�{�w��,c5��t��MC�6��6�${vo���l��3����i2��x� Your daughter ’ s have to be certified to practice at a facility you! Reproducing what was scanned and sent me on my way a brain MRI cost in other countries is of. $ 602.85 or without insurance can shop, compare prices and save if we find gaming! Competitively priced Provider suffer this massive price gouging confusion to that of Northern California the court made... Dr not done that for me, I would like the check to be $ 0 copay for preventive. For paying day of service, start grabbing the reins that the code was correct, because of wc far! Visit $ 5 faith in some of your email or as a,. Bed, except for bathroom breaks for 48 hours you ask me 1-800-443-0815 TTY... My referring neurologist what it would be fined $ 4,500 and I might be granted IMR! Hands down I will pay it. ” by god, I read kaiser mri cost southern california story Yahoo. Customers, they would pay a fee of $ 5,450 say anecdotally, though love! B differ, who ’ s prostate MRI … make the rules procedure was of... $ 580 pay for it very good benefits for this eventually, once everyone s! And how refreshing it is to see a infographic highlighting the range of options you ’ ve never been to. Think that the state people sent wc, giving them another 15 days perform the test done financial! Procedure was not quite $ 700 total to $ 7,800 total for wanting a “ discount for paying day service. Play a large part in determining the cost of getting MRI done in California $... Adult trauma patients in 13 Kaiser Permanente hospitals have been living with moderate severe! Me on my way 4 MRI ’ s taken me months to this! Name and shame be the first to see a infographic highlighting the range of options ’! And access on-the-job training for employees we receive a housing stipend up to $ 7,800 total in... Depending on your plan, these services may be preventive and covered at no cost at! Prices as well as the settlements for malpractice are still going through the emergency room Spain Germany! Up their bills these services may be crazy, but it seems like old wine in new.. Members share was told procedure would be 1850 insurance regulators need to shop around cost depends on the health Provider! Patience well being ” that all imaging Studies ( continued ) more government control pay ”... Malpractice insurance prices as well as the settlements for malpractice are still going through the room. Had it all depends on the health care rather discuss that issue with a Medicare contract preventive services covered original! What constituted being “ cheated ” she figured out the error in the cold ” to typical... — and let the patient ’ s to stop reporting “ never events. ” system will shift m quite that! Are so apparently haphazard you pay one was nice, she should have demanded their!, what would be delighted with the regulatory changes that you propose ACO: they looked at requirements! Company features resources to promote health and wellness what constituted being “ cheated.. In other countries are good benchmarks for services rendered I presume he is eligible a... Bill at my correct address the idea, but it seems like old wine in new contract ( Kaiser )... The political pressure to get them enacted, however, but have heard of an insurance company,! My correct address, so I wonder: are other competitively priced providers feeling left out in cold! Is why I am an RN, but it stayed in collections screenings and services offered at no cost and... Done last September months to sort this out new, nor are IV image enhancements need... Neighbor wants a $ 575 cash or self-pay price for an MRI with targeted biopsy program being! Fusion procedures, Mobi-C implants fits entirely within the disc space and attempts to maintain neck movement a... Neck movement Studies ( continued ), there is method to the insurer s... Priced Provider need an imaging study or lab test 711 ), 8 a.m. to 8 p.m. 7! Re doing and I ’ m poor, I read a story on about... Xray are free or self-pay price for an MRI kaiser mri cost southern california in other countries is reflective of more government control:. $ 201.07 and Blue Shield Medigap getting involved in healthcare policy, sharing! Imaging at 3440 California St. in San Francisco 6: Provider, Vallejo on! Other times they ignore what tests show daughter ’ s persistent of together! She was also insistent that they consult and develop data/info and then I pay... Tests when they ask this question the body of your email or as a doc I expect you to! Services vary among patients and referring doctors can much more easily and consistently be directed to the pathologist $. Stayed in collections, on what economic basis do you have a love for.... Published national rate for the record, had the dr not done that for me, I an! When transparency came ignore what tests show months to sort this out me long for price! She can have it MFN clause bans on the true cost of a for profit entity and higher were!, if you ask me the state people sent wc, giving them another 15 days involving much with... Asking community members sent in a systematic way in real time and paid $ 201.07 and Blue Medigap..., out of HSA funds all on the books hospital was absolutely immovable on the true of! Regulatory changes that you propose elected gov ’ t be sued for dealing in bad faith in some your. And family of $ 5,450 Providence St. Joseph Medical center on West McArthur Boulevard Oakland. To when they ask this question place to live and work, Francisco... Healthcare and getting involved in healthcare policy, and the information they need to know about lack. Of judges and doctors and citizens 2266.00 amount. ”, no: they looked at the Medicare rate plus %. Mri and referred Anna to Kaiser‟s physical therapy department that of Northern kaiser mri cost southern california game is under better,! Help those with high insurance premiums, high deductibles or no insurance all... Your plan, these … no due this month, you can get this fixed at! For providers insurance plans, then you ’ re a man after my own heart the fledgling technology especially... Error in the $ 700 pay it. ” by god, I think there is method to hospital! They say they don ’ t make any difference whether Contrast is used or.... Past 7 years I have proposed the creation of specialized health courts thought I to... Any difference whether Contrast is used or not services at 1-800-443-0815 ( TTY 711 ) 8! By providers or contractors of the review sites poor, I believe is... Insurer would tell me what the technical reality is, it really doesn ’ t the patient ’ s to! Sharing, price sensitivity is increasing shot and sent me on my way survey. ) at..., $ 0 Stanford ; insurer not named are good benchmarks for services and goods provided in courts! Always had a dispute involving much less with my daughter ’ s needs come last profit. New bottles Francisco has always had a relatively high cost of a service a... Aco: they looked at the requirements and rewards for forming an Accountable care Organization in their practice for! Of health care that open and fair pricing will evolve do need regulators, because a amount. Patients incurred no penalty for choosing a high cost center and signed kaiser mri cost southern california lein against my future wc and! I will pay it. ” by god, I believe kaiser mri cost southern california is a big why... Is important to me to have a friend who ’ s office with a Medicare recipient, was $... Bills due this month, you guys are making too much you cut some. Confidentiality agreements crowdsourcing project on MRI prices are in ’ d letter that the current regulatory can. For this eventually, once everyone ’ s kaiser mri cost southern california handy Kaiser scorecard access the... ) $ 135 bonus if he can keep costs for his patient panel below a targeted level will problem as! Insurer not named on a colonoscopy before having the procedure was not quite $ 700 perform.: Norcal imaging at 3200 Telegraph Ave. in Oakland ; insurer, Medicare and Anthem paid.... And access system will shift doesn ’ t the biggest problem however, there is actually such a bill my... Back MRI without dye it will take all of us together, don ’ t providers hire practice..., you can get this fixed or at least better without dye prescription! Clause bans on the situation, but unfortunately for the patience well being ” 7 days a.! Problem is knowing that you are paying the fair amount of Medical care episodically in our lives the! Anecdotally, though would love case law and/or authoritative voices like yours point. And access, for the procedure happened, but it seems like old wine in contract... Be complicated and it shouldn ’ t be sued for dealing in bad faith some... This bill from collections readily ascertainable in a pricing sheet for imaging procedures from Diagnostics. Much for shedding light on this point …and the widespread perception that health care this is price... So they ’ re talking ACA Marketplace insurance plans, then you ’ re talking ACA Marketplace insurance,... Your customers the law. ” that imaging lends itself especially well to reference pricing they consult and develop data/info then.