Kaiser Permanente - confused
Nov 27th 2012, 9:58 pm
#31
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Re: Kaiser Permanente - confused
Aye, fine in the end, able to see a doc a couple hours after I called as he had a cancellation, good job too as things were a spot bloody painful. Then a 6 hour wait at the hospital for a scan, so me and the kids buggered off to the mall for a few hours before heading back.
Then a handful of drugs, antibiotics and painkillers.
Yet to see a bill, so I might weep yet
Then a handful of drugs, antibiotics and painkillers.
Yet to see a bill, so I might weep yet
Hope the bill isn't too painful.
Nov 27th 2012, 10:09 pm
#32
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Posts: 14,049
Re: Kaiser Permanente - confused
I agree with Speedwell - of course you can choose. Go through the list of urologists that are available through your insurance plan and chose the one that suits you. If your plan required you to see your general practitioner prior to seeing the urologist, the GP may be able to give you a few recommendations. The urologist (the office staff, actually) should be dealing with the insurance company, not you, and the staff know perfectly well what the insurance will cover and what the remaining cost to you should be.
This is not a complex procedure, it's quick and simple. You should not be billed by a half-dozen different people. A single bill from the doctor's office.
Regards, JEff
This is not a complex procedure, it's quick and simple. You should not be billed by a half-dozen different people. A single bill from the doctor's office.
Regards, JEff
Well yes, I know what I would choose, what wasn't clear from the start was how I choose - or even if I could choose! The difference in the types of surgery (local vs general) wasn't even mentioned, just the setting.
If it's one thing I've learned, it's that you have to keep phoning until you get somebody that is (a) willing; and (b) able to explain.
If it's one thing I've learned, it's that you have to keep phoning until you get somebody that is (a) willing; and (b) able to explain.
Nov 27th 2012, 10:09 pm
#33
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Re: Kaiser Permanente - confused
I looked back at a previous email from Kaiser and noticed it had a different phone number. So I phoned it and this is what was said:
$1750 comes from $1500 deductible plus 10% copay of $2501 surgery cost. That's if you're put to sleep in an outpatient clinic.
$30 is the copay if done in a doctor's office.
The reason for the confusion is because Kaiser are in a transition stage where some plans cover the cost as a preventative measure and some don't, and some cover a general anaesthetic and some don't.
So - and she stressed this - as long as I find out in the initial doctor visit where the setting will be, I should know whether it's going to be the former or the latter. In other words, it's up to the doctor where it'll be - though I thought that the vast majority are done with local anaesthetic.
I hope.
$1750 comes from $1500 deductible plus 10% copay of $2501 surgery cost. That's if you're put to sleep in an outpatient clinic.
$30 is the copay if done in a doctor's office.
The reason for the confusion is because Kaiser are in a transition stage where some plans cover the cost as a preventative measure and some don't, and some cover a general anaesthetic and some don't.
So - and she stressed this - as long as I find out in the initial doctor visit where the setting will be, I should know whether it's going to be the former or the latter. In other words, it's up to the doctor where it'll be - though I thought that the vast majority are done with local anaesthetic.
I hope.
I used to work in a hospital in the UK where we had a surgeon who would 'snip' his private patients in a room just off ER every Wednesday afternoon.
They all were snipped under local anaesthetic. Talk about careful walking after the op
Only used to take about an hour overall.
Nov 28th 2012, 1:38 am
#35
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Re: Kaiser Permanente - confused
I already don't like the sound of Kaiser Permanente. They sound like the kind of people who would chop off your bollocks and charge you half the value of your house for doing so.
Nov 30th 2012, 12:36 am
#36
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Re: Kaiser Permanente - confused
A friend organised a visit for a group of NHS GPs to Kaiser this year so they could share best practices.
Nov 30th 2012, 1:40 am
#37
L2, GC, Surrey, OH, TX!
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Re: Kaiser Permanente - confused
whether its in office or hospital depends on what facility the chosen doc has at their disposal. if they are just in an office somewhere then they may need to send you to a 'facility which ups the cost.
my husband had it done recently at the same time he had hernia surgery so it was only around 2-300$ cost which the insurance covered.
my husband had it done recently at the same time he had hernia surgery so it was only around 2-300$ cost which the insurance covered.
Nov 30th 2012, 10:40 am
#38
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Location: West of philly - not quite Lancaster
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Re: Kaiser Permanente - confused
This whole thread throws up the stupidity of the whole health care system over here......and the fact that they throw these numbers at you - before deductable, co pay etc.......you're supposed to think that just because the Hospital charges $2000 for an op - but hey with insurance you only pay $200....you're getting a bargain....
Hubbys op - private clinic in Reading was 175 pounds......in out......snippity snip snip and a drive home.....simples......
A
Hubbys op - private clinic in Reading was 175 pounds......in out......snippity snip snip and a drive home.....simples......
A
Nov 30th 2012, 1:08 pm
#39
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Re: Kaiser Permanente - confused
I've been on the other side of this area, in as much as, since I've been in the US I've had a circumcision, and we've both gone through some other testing prior to actually getting pregnant - for me, sperm viability test and some post-op testing for a couple of issues..
My brain still explodes when the statements come through from Select Health and then from the various medical providers. To be hones, I'd rather not see the statements from the insurance company as I just want to know how much to pay!
For the circumcision, I paid my deductible up-front to the hospital and then, a number of weeks after the op, and once all the bills had been settled, I got a check back from the hospital for over-payment.
It'd be nice if they could work out exactly what I had to pay, rather than use some of my money for their own purposes while they decide.
My brain still explodes when the statements come through from Select Health and then from the various medical providers. To be hones, I'd rather not see the statements from the insurance company as I just want to know how much to pay!
For the circumcision, I paid my deductible up-front to the hospital and then, a number of weeks after the op, and once all the bills had been settled, I got a check back from the hospital for over-payment.
It'd be nice if they could work out exactly what I had to pay, rather than use some of my money for their own purposes while they decide.
Nov 30th 2012, 1:44 pm
#40
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Posts: 14,049
Re: Kaiser Permanente - confused
Note that the "they" who charged you upfront and then refunded the overpayment is not the same "they" that decided what your share of the cost would be. The former was the hospital, the latter was the insurance company.
Regards, JEff
Regards, JEff
Nov 30th 2012, 1:56 pm
#41
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Re: Kaiser Permanente - confused
The morning of major surgery to remove my massively infected, life-threatening time bomb of a useless, dead kidney, a Catholic hospital told me I suddenly owed 800 dollars. I had to call eight friends and borrow various amounts from each one. The surgery was late while I begged them to wait for me to come up with the money, and almost had to be rescheduled for three weeks later. The doctor said it was a good thing I was able to come up with the money because he thought three more weeks would have done irreparable damage to my body. When I asked him what I should have done if I couldn't raise the money, he just shrugged. "These things happen, it's just bad luck," he said.
I'm utterly disgusted.
As if you didn't have enough on your plate!!
Glad it worked out...
Dec 1st 2012, 1:27 pm
#42
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Location: Purgatory (PU, USA)
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Re: Kaiser Permanente - confused
Frightening. Reading some of the stories on here makes me believe that I simply have to go back home. I have no health insurance at all and it's only a matter of time before I get sick. Haven't even been for a checkup in 5 years.
Dec 1st 2012, 2:48 pm
#43
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Re: Kaiser Permanente - confused
It's almost impossible to find out how much treatment will cost you because it depends of how much you've already spent that year, your deductible and out-of-pocket costs, where you have the procedure (in network or out) etc etc.
Dentistry is a lot better at costing as the dental office seems to be better connected to the insurer (if you have one). I just had a root canal and at my initial consultation I asked the receptionist what it would cost and how much my insurance covered. She came back immediately with $1400 and looked up my plan and told me 100%. She confirmed the numbers on my next visit and I just got a simple bill the other day showing the cost ($1400), the amount paid by insurance ($1400) and the amount I owed ($0).
So this was as good an experience as it could have been for me, but such as system can easily lead to cost inflation.
Dentistry is a lot better at costing as the dental office seems to be better connected to the insurer (if you have one). I just had a root canal and at my initial consultation I asked the receptionist what it would cost and how much my insurance covered. She came back immediately with $1400 and looked up my plan and told me 100%. She confirmed the numbers on my next visit and I just got a simple bill the other day showing the cost ($1400), the amount paid by insurance ($1400) and the amount I owed ($0).
So this was as good an experience as it could have been for me, but such as system can easily lead to cost inflation.
Dec 1st 2012, 8:38 pm
#44
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Re: Kaiser Permanente - confused
Dentistry is a lot better at costing as the dental office seems to be better connected to the insurer (if you have one). I just had a root canal and at my initial consultation I asked the receptionist what it would cost and how much my insurance covered. She came back immediately with $1400 and looked up my plan and told me 100%. She confirmed the numbers on my next visit and I just got a simple bill the other day showing the cost ($1400), the amount paid by insurance ($1400) and the amount I owed ($0).
Dec 2nd 2012, 1:33 am
#45
You aint seen me, right?
Joined: Oct 2005
Location: US of A, TN
Posts: 3,573
Re: Kaiser Permanente - confused
Sounds like a lot of work for everyone involved, I think it's time Geoff has the "Let's try anal" discussion with the wife.