An experiment... How much will my insurance cover...

[MichaelB]

So, the initial billied amounts are lower than the sky high rates we have seen referenced elsewhere, and even those rates appear to be discounted in your final bill. The beginning of a new trend, or just an indication that Kaiser is trying hard to keep a lid on hospital costs?

 

[ivinsfan]

so you are saying you will have to pay 5600 hundred dollars out of a gross bill of 11.508.

What part of this did your insurance actually pay? 80/20 after your deductible...? your final total seems high to me..compared to the original charge..it's routine here to see 40% or more knocked off the original billing costs. I'm curious how much of the 5907 was a knockdown by the insurance company.

 

[rodi]

so you are saying you will have to pay 5600 hundred dollars out of a gross bill of 11.508.

What part of this did your insurance actually pay? 80/20 after your deductible...? your final total seems high to me..compared to the original charge..it's routine here to see 40% or more knocked off the original billing costs. I'm curious how much of the 5907 was a knockdown by the insurance company.

I think the deductible (4500) was hit - and then we only owed 80% until the max OOP hit. There was another bill for $777 (mentioned elsewhere in this thread... So between both bills - we're close, but not quite at the max OOP for the year.

Yes - Kaiser is very good at managing costs. The doctors are employees paid a (nice) salary and benefits. Kaiser owns and operates their facilities. It is a completely closed network.

They entice good doctors with the promise of regular hours, less on call time, the opportunity to pursue practice in specific specialty areas for a percentage of their work time. For example our pediatrician loves doing NICU neonatal work... she does 10 hours a week on NICU cases and the balance is done doing standard clinical pediatric work. She loves it because she has other ped's to cover her when she goes on vacations and she still gets to work in an area of passion (NICU).

The surgery was done at an outpatient surgical center... so no overnight costs.

I knew the cost to me wouldn't exceed the max OOP - but it's nice to see that it came in even lower (pending any further bills.)

What really surprises me is the pre-adjustment costs on the panoramic xrays - only $48 and 53... And after adjustment only $30 total for both.