SI Joint Fusion :: My Surgery Costs

There’s a part of me that feels a little weird putting my medical bills out there for all to see. But I decided to do it because I know it may help some people who are desperately trying to piece together information. I think I blocked all my personal info and just left the charges in plain view. So without further adieu, here are a few things to keep in mind:

 

  • MOST IMPORTANT:  Charges will vary from facility to facility, region to region, and doctor to doctor. These are not standardized charges. IN ADDITION, doctors, hospitals and other medical service providers are constantly evaluating and reevaluating their prices structures, and insurance companies are constantly negotiating and renegotiating their contracts with various providers. Even if you get the very same surgery with the very same doctor at the very same facility, your numbers may be different than mine. Doctors and hospitals often have to increase their fees, due to circumstances that are not readily visibleI would appreciate it if you wouldn’t assume the worst if your charges are different than mine. Please be kind in your inquiries and try to give folks the benefit of the doubt. Not everyone is trying to screw us (and I understand the knee-jerk reflex to jump to that conclusion!) The medical system is a very imperfect system and most people are doing the best they can to navigate it.
  • I had a unilateral (one side) minimally invasive SI joint fusion with Dr. Carter Beck in Missoula, Montana.
  • I have Blue Cross Blue Shield of Texas. Both Dr. Beck and St. Patrick Hospital were in-network for me.

After I decided to have the surgery, Beck’s office staff submitted the evidence for pre approval, and I eventually got this letter:

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I was ecstatic. I scheduled the surgery and had the procedure done on January 28. In mid-February I got this letter:

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I freaked out. They couldn’t change their minds after the fact, could they? It took several weeks and many phone calls to work it out. After being put on hold several times, my CSR came back and said, “This surgery never should’ve been approved. I have no idea how you got that first letter. We are going to cover it since we committed to do so.” Phew!

 

An aside, one of my trusted Facebook friends who also had insurance woes after-the-fact recommended that I be super sweet and kind, that that would get me further than being angry and demanding. She was right… be nice!!!

 

Alright. So here are the bills. I decided not to try and go through them line by line. I’m not really qualified to do that and am content to let you look up procedure codes and draw your own conclusions. However, I’ll make a couple of observations on each one.

 

Here’s the hospital bill. I did not spend the night; I was an outpatient. Notice that the implants were billed by the hospital rather than the doctor. Looks like each implant was around $3700. I can’t substantiate this, but I’ve heard that iFuse implants are $9k apiece (3 x 9k = 27k.) Can anyone confirm or dispute this? Also, I paid the anesthesiologist separately, but I think the anesthesiology charge on this bill was either for equipment or medication, NOT for the doctor’s fee.

 

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When I met with the hospital rep and got the above print out, she told me that if you pay the balance within 60 days of the first invoice, you can get a 5-10% discount! Ten percent of my bill would’ve been over $2k, if I’d had to pay it out of pocket!

Here is the nerve monitoring bill. Comments are on the bill itself.

 

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After I paid the anesthesiology bill, I must’ve shredded the invoice. But here’s my insurance company’s explanation of benefit.

 

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Missoula anesthesiology was WONDERFUL. The last time I had surgery I woke up with a very sore throat and a rattle in my lungs. After my SI Fusion surgery, the anesthesiologist came and told me that I am one of the rare people who are difficult to intubate. Apparently because of my esophageal anatomy the regular tube they insert during surgery didn’t work well. He gave me a letter to give to any subsequent anesthesiologist so they’ll know in advance to get different equipment for me. I am now assuming that my previous anesthesiologist didn’t know this and somehow forced the tube down my throat in a way that left me injured after my last surgery. Sad.

 

Finally, here is my bill from Dr. Beck.

 

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Please keep in mind that I am not an insurance expert, so you’re on your own in terms of deciphering all of this. I’m just making it available for you in the hope that it’ll give you some info that’ll be helpful to you in the long run.