Monday, December 4, 2017

An Interesting Case of Wasted Healthcare Dollars

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Recently I was reading an article on  The article stated a mother was offered the chance to have her 5 year old daughter’s ears pierced while she was under general anesthesia for another procedure.  The mom thought that was a nice offer by the surgeon and agreed, only to receive a bill for $1877 from the hospital for the procedure which was not covered by insurance.
From the article:

Only months later did O’Neill discover her cost for this extracurricular work: $1,877.86 for “operating room services” related to the ear piercing — a fee her insurer was unwilling to pay.

At first, O’Neill assumed the bill was a mistake. Her daughter hadn’t needed her ears pierced, and O’Neill would never have agreed to it if she’d known the cost. She complained in phone calls and in writing.

The hospital wouldn’t budge. In fact, O’Neill said it dug in, telling her to pay up or it would send the bill to collections. The situation was “absurd,” she said.

“There are a lot of things we’d pay extra for a doctor to do,” she said. “This is not one of them.”

Kelley and the hospital declined to comment to ProPublica about the ear piercing.

Surgical ear piercings are rare, according to the Health Care Cost Institute, a nonprofit that maintains a database of commercial health insurance claims. The institute could only find a few dozen possible cases a year in its vast cache of billing data. But O’Neill’s case is a vivid example of health care waste known as overuse.

Now I will be the first to admit that overcharges occur in hospitals routinely.  The part of the whole article that I found mildly amusing is… the procedure the 5 year old was in for?  A simple lingual frenectomy.  Now perhaps there is more to the story as far as management goes.  Perhaps the child is very frightened & difficult to control without general.  Perhaps there is more to this than meets the eye.  However, if this was a routine lingual frenectomy, that could have been done in my office with a few drops of local, no bleeding, no scalpel, no sutures, no post-op pain.  I would have done this with a laser.  I do it all the time.  So, in my opinion, the entire reason the child was in the hospital could have potentially been not necessary… potentially.  I don’t know all the facts.

However, if you are considering a similar procedure for your child, consult a dentist before going to a hospital.

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