Rant: Cancer Lesson #65 — No More Port in a Storm
A few weeks ago, I got an EOB (Explanation of Benefits) for a “medical procedure” (one of my favorite euphemisms of all time) from our insurance company. This form explained how much they would and would not pay, how much the hospital would write off, and how much we owed. Since I hadn’t had any appointments in November, I thought the hospital had mistakenly billed our insurance for someone else.
My daughter reminded me that I’d gone in for a port flush — a process so minor that I’d forgotten about it. A nurse stuck me in the arm — thereby accessing my port, ran saline through the device to keep it clean, and gave me a shot of Heparin to help prevent clots. Total time elapsed: About five minutes.
Seriously, it probably took to take off my jacket than it did for the “procedure.”
Imagine my shock when I read the following figures on the EOB.
Sterile Supply — $17.00
Procedure — $588.00
Insurance Company Payment — $309.76
Insurance Company Adjustment — $217.80
Amount You (I) May Be Billed — $77.44
I was sure it was a coding error.
When the actual invoice arrived, I immediately called the “Questions about your bill?” number. After three days of phone tag — don’t get me started on that topic! — I finally got to speak to a person, who told me the invoice appeared to be coded correctly.
How could this be? When I visit my doctor and have a port flush and have blood drawn, the bill is less than $600, more like $200.
She couldn’t answer that.
I understand medical treatment is expensive. No one survives any kind of major or chronic illness without learning that. But $600(!) for a five-minute treatment is beyond expensive.
It’s insane.
I asked if there was any way I could protest the exorbitant fee and learned I could dispute the bill.
I did.
Today I heard back. No surprise, they say the bill is correct. These costs, it seems, are set by Medicare and not the hospital.
Keeping my port means having it flushed every two months. How can I reconcile having our insurance waste $1,858.56 a year on this? And the $464.64 that I would be paying could be better spent (perhaps on my daughter’s college texts?).
I’m going to have to have the device taken out, which really ticks me off.
Explanation of how a port works can be found at: http://tinyurl.com/y8snrty Image above from same site.
If you haven’t read Cancer Lessons #6 and #20, you may be wondering, “Why does she want to keep the damn thing anyway?”
Here are the links to those lessons: https://kymlucas.me/2011/03/31/cancer-lesson-6/ https://kymlucas.me/2011/05/23/cancer-lesson-20-any-port-in-a-storm/
Read them now.
I’ll wait.
After my MRI, I was bruised from several inches above both elbows to several inches below. I wish I’d taken a picture.
I’m whining. For that I apologize. But I have blood drawn every time I see my doctor. This means I can look forward to a lot of poking and prodding around in my arms as the nurses try to find a vein.
Or, as they like to call it, I’ll experience a lot of “pinching.”
Still, chemo nurses are the best in the business when it comes to finding a vein. Maybe I’m making a tempest in a teapot.
I hope so.
Because there will be no more port in a storm.
Reading, Writing, Ranting and Raving 
Depending where you went to get your port flushed you might have been charged what is call a “facility fee”. Meaning they charge you extra. From looking at EOB they probably used hospital billing codes which they can and do charge more than what maybe charged in your doctor’s office. I work in a medical building and it’s crazy! I never understood why when people got sick they wouldn’t go to the doctor. I’m beginning to realize why. When your insurance company only allows you so much per year then the rest comes out of your pocket. Good luck.
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My doctor is based at the hospital, and unfortunately I learned through experience that for the most part, it’s only chemo nurses who know how to correctly use a port. But thanks for the insight. I’m not even sure my doc has an office since he’s an onc. When I get sick, I go to my GP — I know that much. 🙂
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The whole medical billing thing is nuts. Apparently, there are some concierge doctors cropping up who no longer take insurance at all. Instead, they charge a patient a flat monthly fee of, say, $50-$100 to cover any standard medical procedure. They recommend that their patients only get “major medical” coverage to cover big things like cancer and heart attacks. The doctor covers pretty much everything else such as immunizations and setting broken bones. Plus, the doctor is on call 24-7. The doctors have found that they save money this way because the no longer have to staff a billing office to deal with insurance companies and medical billing all day.
Amazing.
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It is amazing. I remember when the person who did the billing actually worked at the doctor’s office and knew about what the doc had and hadn’t done. It’s impossible for doctors to function that way now. Costs them too much.
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I read Dyanne’s comment and she is correct.
You need to file a complaint– in hard copy writing– with your insurance carrier about this overcharge–which it is and ridiculous to boot. Then TELL them you want to find a “clinic” where you can have your port flushed for less money than it cost this time. There have to be some clinic’s around that do this for pts with ports like yours
Ask for one located close to you.
I don’t understand WHY your oncologist’s office doesn’t do this.and my next phone call would be to his/her office asking WHY they don’t do this and offer to fax the statement/bill to them with your questions. Sometimes a doctor is NOT aware of what things cost and if he/she is $$$ conscious he’ll try to help you out. A single dose vial of heparin does not cost $600.
and the nurse’s ability doesn’t cost $500. If it did I’d be a millionaire!!!
marylou
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My doctor’s office is part of the hospital. I called him and spoke to his nurse when I got the final response from the hospital, but they’re all part and parcel of the same thing. I know I should fight it, but I’ve arranged to have it taken out.
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