bills for bags

LAURIE · 02-07-2007, 04:02 PM

Now that I am receiving chemo weekly(taxol and heceptin), I have started to really feel the cost of chemo bags and syringes not being covered by insurance. Each week I am now paying $140.00 (this includes $25 co-pay). Are most insurance companies like this? I can't wait to be limited to only 1 bag of herceptin each week. I really have not been worrying about the cost of things until now, I still figure they will get paid eventually. I really wish they could reuse the bags. I now wonder how much we are being charged for the 2 tylenol each week? Has anyone used a supplemental insurance to defray the cost your primary insurance does not cover? I guess it would be hard to get now?

janet/FL · 02-07-2007, 05:51 PM

Hi Laurie
I was being billed 60 dollars a shot for Heprin for my port. This is a very inexpensive drug. Finally, I think the hospital decided not to even bother billing me or the insurance company for it!
Also, when you are through with the Taxol, you might consider every three week Herceptin. It will be easier on your pocket book, or nerves waiting to see who pays what, and is supposedly the same effectiveness as the every week infusion, though some people and bodies perfer one over the other.
Most likely your insurance company will come through. Sometime it takes a long time. You can call your insurance company and tell them your problem, that you have breast cancer and need help with figuring out the bills. Most are supposedly very helpful. Mine was. Good luck.

juanita · 02-07-2007, 06:55 PM

I was charged for more little items at the first onc I went to than I was at the second one. And the rates for just being there were lower too. Which i thought is funny because the onc now has a more established practice, but the other is part of a network.

tousled1 · 02-07-2007, 07:03 PM

Laurie,

Why would you be getting two bags of Herceptin every week? Are you sure that one of the bags is not just fluid to keep the port going while you're getting the Herceptin? As for the tylenol, you can take 2 tylenol yourself right before your treatment. Just make sure you tell the nurse that you have already taken the tylenol. I don't get any premeds not even tylenol with my Herceptin. As for cost, you may want to check with your state agencies to see if they can offer you any assistance with the medical costs.

SusieQ · 02-07-2007, 09:17 PM

Here is how I am managing the billing challenges: Ask your medical provider and insurance company for statements that includes the timeframe of your entire treatment.

I first look at the insurance companies statement and highlight only the "patient responsibility" charges and match up the date of service with the medical providers statement.

Call the insurance company and let them know what your medical diagnosis is and how you need their help to keep the out of pocket costs down. Ask them to help you figure out if the medical provider is using the correct billing codes. Sometimes, the insurance company does not question the billing codes -- they just data enter the information and the outcome is the outcome.

Our insurance company is suppose to pay 100% on anything related to the labs, scans and treatment of my breast cancer -- less a nominal copay for the Doctor's Visit and Surgical Center Visit. I enlisted the help of my husband, it could be a friend, or relative, as a second pair of eyes to review the statements monthly.

We have found incorrect billing code charges for premeds and hydration infusions. We have also found billing code errors with nurse practitioner "OV" office visits. I was getting billed a "OV" for the 30 second "hello, how are you doing" visits and billed a $30.00 copay. Needless to say, my Onc Billing department took the OV charges off. Sometimes, the medical provider inadvertently inserted an OV code meant for medicine on the insurance billing form and I was billed $30.00. I also found extra copays when I had my first surgery. The insurance company deducted a $100 dollar copay from my Surgeon's bill, the Anesthesiologist's bill and the Surgi Center's Bill. I was only suppose to pay one $100 copay to the Surgi Center. Once I pointed this out, the insurance company sent out checks to my Surgeon and Anesthesiologists.

By the way, I have Aetna NAP - Open Choice plan -- expensive but I am so grateful for it!!! They have been great about paying for some very expensive diagnostic tests including my genetic test and the very inexpensive infusions. This is a lot of data -- I hope it helps!

rinaina · 02-07-2007, 09:37 PM

if you are insured, why are you being held responsible for any of the cost? i have not had to pay anything yet for chemo or herceptin with my coverage so i am confused.

SusieQ · 02-07-2007, 11:12 PM

Rinaina, I am sorry for the confusion. I have a plan (not an HMO) that requires me to pay a $30 copay for a visit (face to face with a Doctor/Specialist) and a $100 copay if I have surgery in a Surgi-Center. I like this plan because I can go to any provider, specialists, dx tests, and labs without pre-approval for any medical condition.

I just wanted to convey the billing issues I have had, between my Medical Provider and Insurance Company, and was able to fix by analyzing the statements. Maybe it might help someone else in the same boat.