In my previous post about the cost of delivering a baby, I noted that the hospital and doctors had charged a total of $24,520 “gross” before the insurance company discounted for reasonable and customary charges. We continue to receive various notices from the insurance company for additional fees.

Just a couple of days ago, another insurance notice came in for a total of $5,213 for line items like “nursery”, “drugs”, 3 “laboratories”, and “auditory exams” that were submitted to them by the hospital. Actually, our baby never spent time in the nursery (he bunked in the same room with us per hospital policy, but maybe that counts as the same thing). Running total in charges so far: $29,733.

The interesting thing about this bill is that the insurance company won’t be paying for the $5K in charges, and neither will we. Apparently these charges are covered in some sort of global or all-inclusive or “case rate” reimbursement.

Like in my other post, I still can’t figure this out. Either the hospital/doctors are charging actual costs, and the insurance companies are paying “less” than they should, or the hospital/doctors are charging extra amounts above reasonable costs, and the only people paying them are those who are uninsured. Or maybe I’m still misunderstanding how this whole system works.

Regardless, I’m definitely starting to see why it is so many people end up in bankruptcy due to medical costs.

It’s been about a month since our baby boy was born, and the bills and insurance statements from our delivery have started to roll in. We’re currently on a Cigna PPO plan, so we (thank goodness) only pay a small fraction of the costs below, but it’s been eye-opening to see how much the hospital and doctors charged for our 60-hour (2 1/2 day) stay.

What I’ve always wondered is, are people who don’t have insurance charged the full amounts below since they aren’t eligible for the “reasonable and customary charges” discount? If so, that seems scandalous. Just look at how much the hospital stay cost. I still can’t imagine how that charge is even justifiable.

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