Sam Bauman: Examining a hospital bill

A few weeks ago I got a call from a reader about a hospital bill his wife received after a four-day stay at the Carson Tahoe Health. I decided to look into it to see what’s in a hospital bill. The hospital was quite cooperative but couldn’t delve into the details because of patient privacy laws. The couple had discarded the bill.

After a couple of weeks they got a duplicate bill, which they shared with me. The wife is a user of Medicare, the husband uses the Veterans’ Administration. As it turned out, Medicare paid for almost the entire bill.

Her bill showed a total of $25,278.70 but the wife was responsible for just $1,219.50. I went over the bill as an educational experience.

The wife suffers from Chronic Obsessive Pulmonary Disorder, and had gone to the ER when breathing became difficult at home even with oxygen.

So looking at the bill the first item was $2,497 a day for the room at the hospital, $9,988 for the four days. Expensive yes, but a hospital room comes with many medical devices, meals and 24/7 patient care — not your usual highway motel.

Then lots of fees for medication. Highest was $571.50 for insulin lispro.

Then four injections of sodium chloride daily at $42.30 each.

It might be well at this point to mention that hospitals have a menu of fees for each service, procedure or for supplies such as aspirin. For the wife the $3.80 fee for each Ipratropium bromide represents one inhaler device. She was given these often.

Next on the bill was oxygen daily at $502 a day for each of the four days she was in the hospital.

Then a biggie — B-Type Natriuretic Peptide, $529. This is a drug for blood pressure. Next came a CK-MB, which is to measure myocardial infarction and costs $180. Then Comp Metabolic PNL at $165, for 14 blood tests. Next is CPK total, an enzyme $93. Followed by Metabolic PNL again, $165.

And another CPK for $165.

Now something new, Troponin I, a cardiac relaxer, $153. And glucose by Glucometer, no charge for several applications. Then a Renal Panel for kidney assay, $135.

These total $1,585 for “total chemistry.”

Finishing off page two of the bill CDC+Diff at $121 each, a blood count. And that is the end of page two. Five more to come!

Page 3 starts with $363 total hematology. Next $134 for culture/sputum bacteriology and microbiological. Followed by two X-rays of chest, $359 each. Also a bronchodilator, $248. Followed by a chest wall manipulation $160. Then a small volume nebulizer four times, $106 each time.

The small volume nebulizer is repeated several times, $106 each time, along with chest wall manipulation $160 several times. Last item on page is RSMC PT Evaluation, $461. This is an exam of the physical condition of the patient.

End of page 3.

First two items on page 4, Physical therapy evaluation, $461 (again) and RMC Swallowing Assess, twice, $504 each time.

Now a total of emergency room costs, $2,070. (The bill isn’t written in chronological order.) Following with various medications under $100 each, and Enoxaparin sodium twice at $286 each for a total of $2,061 for drugs. Then other small fees until at the bottom of page 6, $263 each for EKGs.

Total bill, $25,278.70 to Medicare, with the wife owing $1,219.

That’s a portrait of a well-documented hospital stay of four days.

The wife is back at home, using oxygen 24 hours a day.

This was an education and wearying experience. If you have a hospital bill you may want to go over it line by line, using a computer to explain the medical terms. After several hours on this bill, my back hurts and I want to sit back. Good luck if you examine you hospital bill. I hope that you find a hospital as helpful as Carson Tahoe Health.

Sam Bauman writes about senior issues for the Nevada Appeal.