Medical billing still broken

Back in June I was doing a major project in the yard and rolled up half the professionally laid astroturf. It’s a major job and weighs a ton… A couple of days later I stepped on the rolled astroturf and an 8-inch turf nail went through my shoe and into my right foot. It went in pretty deep, not just a surface cut.

After cleaning up, covering the hole I realized I needed a tetanus shot. It was already 6:30pm, I called a couple of local urgent care offices and checked their prices. Both said the shot cost $40. I decided to head to the Boulder Community Urgent Care in Superior.

Having filled in my details on a tablet, I was called in and shown to a cubicle. A few minutes later a nurse/doctor practitioner came in, asked a few questions, cleaned the wound and agreed to the shot, having also explained I’d need to take a specific antibiotic that they’d supply the first dose of as my pharmacy would be closed at 7pm. We also agreed that as I was paying cash, an X-Ray wouldn’t be done, but if I had pain in a few days to comeback.

A few minutes later, I was done. I had to checkout and the front desk said that the bill was $192.40 – I was speechless. I asked for a line item/detailed statement and was told they couldn’t provide one then, but I could call the billing dept. later and get one. I paid by credit card and left with a credit card receipt.

BCH Bill for the actual tetanus shotImagine my surprise when a few weeks later when I got the bill from BCH. Yes, that’s right, the bill was for the administration of the tetanus shot. You have to be kidding?

I’d paid $192.40 and that didn’t even include the tetanus shot for $40, discounted by $6 for “cash”. I waited a couple of days and called the BCH Billing dept. I had a productive “how can this be accurate calls” and the woman I spoke with, after a few minutes, agreed to waive the $34 fee.

This though embodies everything that is wrong with the American healthcare business. You can’t get an accurate price up front; they then nickle and dime you for every small part of the process; when you checkout you get a final amount, but you can’t see how that is made up; you pay by credit card and leave, and then weeks later you receive an additional, unexpected bill. That’s if you are lucky.

Author: Mark Cathcart

Formerly an Executive Director of Systems Engineering and a Senior Distinguished Engineer at Dell. Prior to that, an IBM Distinguished Engineer working for the Systems Group in NY and Austin. I'm currently "retired until further notice".

2 thoughts on “Medical billing still broken”

  1. Ouch. In more ways than one.

    FWIW — and I recognize this is hardly universal, or even necessarily common: the combination of Medicare and Federal retiree (my wife’s) BC/BS is seamless and Just Works. No paperwork, no co-pays, no deductibles. It’s not inexpensive — requires paying both premiums — but it shows how insurance CAN work.

    1. Oh yes it can definately work, mine did in the UK using my company provided top up insurance I scheduled surgery, went into a private hospital and post surgery write an ibm redbook while never seeing a bill.

      The only reason it seems so broken to me is I’m paying cash and I can’t understand why they don’t have an itemized bill. I get that the medical staff maybe busy doing actual medicalthings, and so I’m fine if they are for a deposit upfront, and then settlement within 30 days or receipt of an intemised bill.

      Who would by a car this way…

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