After my bunion surgery, I needed to wear one of these walking boots in order to protect the bones from trauma and to prevent flexion of the foot. I've had lots of experience with the old plaster casts from polio-related surgery decades ago, and I have to say these modern boots are much lighter and more comfortable, and more easily removable for bathing than even the split walking casts of previous eras.When they gave the boot to me at my pre-op visit, I asked (naively) whether I would return it to the clinic or to the hospital. The nurse said that it was mine to keep, and that the cost was part of the "package deal" for the surgery. Realizing that I only needed it for a couple weeks, I asked what to do with it afterwards. Could I sell it on eBay? Her reply was that everyone gets new boots, noone wants an old dirty one, and besides I might be sued if someone wore my boot and fell down.
When the bill came for my pre-op visit, I noticed that the boot was invoiced for $300. Curious, I searched it on eBay - where I did find one offered (inset photo) by an orthotic shop. This one is described as "Condition: New: A brand-new, unused, unopened, undamaged item." The cost? $43 as a Buy-It-Now. And with free shipping.
I'm still waiting for the hospital bill to see what they charged me for the crutches they gave me ("part of the deal" again). I've already spotted the same ones on eBay for $8 + $9 shipping. I'll bet the hospital didn't bill me $17.
Think about this if/when you have elective surgery scheduled and can plan ahead.
I've just paid £25 for a pair of crutches in a private hospital in Britain. (I'd have got a free loan pair from a state hospital.) That's about $40. I'll be interested to compare that to what you paid. Incidentally the whole package (MRI, bone scan, hip surgery, two days in the hospital, several visits to the surgeon before and after the surgery and a physio course afterwards) cost the equivalent of about five thousand dollars. I'm not sure how that compares with the US. My employer pays for the insurance and does shop around for the best value, so I assume that competition keeps prices reasonable.
ReplyDeleteAbsolutely, if you have an adequate boot, crutch, post-op shoe, bring it with you and see if your surgeon thinks it will work for you. The companies who make these things have such a corner on the market it's shameful. Huge mark-ups. On the other hand, when they've been well used, they really do get trashed, at least the soft bits and velcro fastenings. Still, always worth a try to bring your own if possible.
ReplyDeleteA long time ago, when I worked at a car dealer, if a repair job needed a couple of dabs of grease, we charged the customer for entire can. All told we probably made thousands of dollars from each can.
ReplyDeleteLater, when I was in the hospital after an accident, I noticed the same thing. If I was given two aspirin, I (or more accurately my HMO) was charged for an entire bottle.
When I had knee surgery a few years ago I went to a second-hand store and bought a crutch for $4. I wrote my name on it, and gave it to the nurse before the operation to put in my room. They still tried to bill me for one of theirs when I left.
I'm not getting any younger, and I ride a motorcycle, so I still have the crutch. And next time, I'm bringing my own aspirin, too.
Good luck with that. (Bringing your own aspirin.)
DeleteUnfortunately my wife and I have had several occasions where we had to be hospitalized for procedures or medical emergencies. Both of us are on medications for chronic disorders.
When we have arrived with our properly prescribed and properly dispensed prescription medications, the hospitals have insisted that only medications dispensed by the hospital pharmacy be administered and "charted" while we were in the hospital.
In one case, this also applied to the nicotine patches my wife was using when quitting smoking. The hospital insisted on supplying ones from its pharmacy and charging us 5-7 times what we'd paid for the exact same patches.
This happened in different hospitals in different states.
I think you mis-describe your bill, Stan. You paid $50 for the boot, and $250 for the professional advice and the fact that the clinic is taking responsibility for giving it to you.
ReplyDeleteThe other item on the bill for the same day was "physician visit" $75 for about 15 minutes + 20 minutes nurse time.
DeleteThe $300 is for item "Pneumatic Walking Cast" (Dx:729.5)
Actually, anonymous, I'm guessing that's incorrect about the professional advice being a part of the price. When I had surgery, doctor's fees etc. were all broken out separately.
ReplyDeleteThank you for your timely information. I am looking into this as I am getting my cast off (from a broken ankle) on May 15th and I am not sure if my insurance will be covering my boot! I'd much rather pay $50. than $300!
ReplyDeleteI had the same experience; I was charged $300 for the boot and later found it on-line for $50, but I wouldn't have been able to wait to have it delivered, I needed it immediately! (I had just fallen off some stairs and was correct that I had broken my ankle. At least it was a clean break and didn't need a cast.)
ReplyDeleteOn the other hand, before I went to the hospital I sent my husband to the thrift store around the corner because I remembered they had a few pairs of crutches for $4 a pair, so I snagged a pair of those.
I would suggest tagging this post under "ethics." Surely the "do no harm" of the Hippocratic Oath, includes to the patient's finances.
ReplyDeleteInvoicing is only half the story. Check your insurance EOB and the final statement to see how much of this charge was actually collected and how much was contractually a write-off (aka: adjustment).
ReplyDeleteI thought I would offer my 2cents. I work at a major family practice clinic in the NW and we have just created a new policy for orthotic equipment and other supplies that are given to a patient at the visit. This new policy gives the patient a heads up that they "could" get this item OTC (over the counter) and quite possibly cheaper. What they wont get is the personal fitting that we can provide. Also there is a pretty good chance we stock the item we are recommending and it is available right then&there. Otherwise the patient would need to shop around and do a price comparison and potentially waiting on the delivery which might make it cheaper overall but its a buyer be ware sort of thing. You could injure yourself further with improperly sized or fitted equipment. I think its pretty cool that the patient is now being made aware that they do not have to take what is offered if they want. In Stan's case why bother shopping around if its included in the surgery package, but if you are paying out of pocket then certainly shop around.
ReplyDelete"In Stan's case why bother shopping around if its included in the surgery package..."
DeleteBut of course it makes the surgery package more expensive.
I am sooo glad you posted this and I saw it in time!! I found out my insurance would only cover 50% of my tall CAM walking boot and the Reconstructive Orthopedic's office could charge up to $900. for a boot! I went online and researched the type of boot I will need, emailed my Dr's. office with a link and asked which one my doc recommended. They got right back to me and my boot is now on order and will be here in plenty of time for my uncasting next Tuesday! I just ordered it here: http://orthotape.com/ - Total w/ 3 day shipping - $91.00. Thanks again Minnesotastan!!
ReplyDeleteThat makes my day (and re antoine0387's comments above, I'm glad you made the purchase using advice from your doctor's office re the details).
DeleteAfter I got out of my cast for a broken ankle, I paid $150 for a similar boot. I used it for a month and it now sits in a corner of my room. It made my life so much easier by giving me back my mobility. I asked my orthopedist if low-income patients get the boot for free, and he said no - they stay in the cast longer, then graduate (quickly and painfully) to a normal shoe. I'm now looking into donating my boot to a medical supply charity, if there is one.
ReplyDelete