A Hospital Bill, Annotated

Two_nurses_with_baby_in_nursery_at_Toronto_East_General_and_Orthopaedic_Hospital,_Toronto,_ON

I still have not gotten my hospital bill for giving birth, and I will be a little bit anxious about it until I do. What I have gotten, though, is the bill from the hospital’s pediatrician for a one Mr. O’CONNELL,BABYBOY, as he was known for the four days he spent without a name. Our pediatrician did not have ‘privileges’ in the hospital where I gave birth (or, as I think of it, birth was done to me) so, as my OB informed me, quickly, and during my very last appointment, that the practice next to them that always has a pediatrician around Labor & Delivery would come by and check out our person, and we’d bring him to our pediatrician a few days later. I just said “Cool,” and didn’t ask any questions, because I am breezy and an easy, cooperative patient!

Looking at this bill, though, I guess my first and only question, repeated again and again throughout my hospital stay, should have been “OKAY BUT DO YOU TAKE MY INSURANCE?” It wasn’t, as I am a damned fool, and now I am in the fear. The bill doesn’t say “we don’t take your insurance” per se, it just pretends insurance is not a thing that exists, like maybe they’re hoping I will forget and just cut them a check for the full amount.

Anyway:

INITIAL HOSPITAL OR BIRTHING: $257.00

This is not what they charged my existence for him to be born, just his. His “birthing” ended up being via c-section so maybe $257.00 is the cost of my five-foot-tall obstetrician climbing up onto the operating table (for real, she had a knee up there) and pushing down my abdomen and yanking him out of a tiny hole she cut into my now ironically-named “bikini line”?

But no, this is only the pediatrician. I don’t remember one being there for the birth but then again I was on another planet. Presumably one was in the nursery where they took him to do all the things that were not in our “birth plan” which quickly went out the window. Anyway, $257 kind of seems like a bargain for having the medical establishment look over his new-to-this-earth body and pronounce it one of us.

I’ll take it.

COUNSEL RISK FACTOR 15MIN: $76.00

I wish I knew what this was about. Since this is the baby’s bill and not mine, I assume the counseling was for him. “I know you are new here but life is, well, it’s pretty complicated.” Just 15 minutes of explaining to him that human beings are the only species that are aware they are going to die.

No, it is probably when a woman came into my hospital room and explained to me all the ways I could die by getting a c-section, and had me sign something say I won’t be mad if I do. That was fun. It wasn’t 15 minutes, either! It was three minutes, tops. This bill should be $15.20.

SUBSEQUENT HOSP CARE, PER DAY: $121.00

I love the $1. $120 was not enough! Also note that $121/day for 24 hours of care costs less than the cheapest babysitter. Granted I was taking care of him most of the time — and by “taking care” I mean crying quietly to myself in a hospital bed while he screamed/ate/screamed/ate/slept.

But again, this is from the pediatrician’s practice, not the nursing staff. So what they mean is the two minute visit a baby doctor did to check on him. Does he have balls? Check. Do his hips work? Yes. Spine straight? Yes. “He’s boring!” one of the doctors said to me.

“Thank you, sir, here is $121.00.”

[It's fine! That seems like a fair price! What is fair anyway?]

HOSPITAL DISCHARGE DAY: $173.00

I’m guessing they checked him out super-hard this time, so it was an extra $52? They probably ran some tests. Did some screenings. Counted some baby balls. Which can we talk about this? One pediatrician said, “And the jewels are there, which must make Dad happy.” Dad? Are you happy your sons balls exist? “As a man with balls, I am very happy my son has them, too.” The last pediatrician we saw opened his diaper and was like “One, two, and three,” and I looked where she was tapping really quickly to make sure she wasn’t saying he had three balls but no, his penis was #3. Or #1. Let’s say it was #1.


TOTAL COST OF BEING BORN: $627.00

AND BY THAT I MEAN TOTAL COST OF BEING CHECKED OUT BY A PEDIATRICIAN ~3X: $627.00

I would call this pediatrician’s office but I have a fair amount of dread over this and very limited time for making important phone calls. Plus it is not 1 Thing Thursday so what do you want from me, world?

 

Photo via Wikimedia Commons

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37 Comments / Post A Comment

HelloTheFuture (#5,275)

I am very interested to hear more about the costs of having birth done to you. A friend of mine is sharing similar costs on Facebook and they have already reached the “thousands of dollars” level.

HelloTheFuture (#5,275)

(also LOL I am picturing a future where women don’t share horror stories about birthing pains, instead they share horror stories about the bills they got afterwards)

andnowlights (#2,902)

@HelloTheFuture Both are excellent birth control, though!

Congratulations on your new human being!

So far as the bill goes, you could try doing what I do, also known as “letting the professionals argue it out.”

Just call your insurance company first. “Hey, I got this bill from the office of Dr. (Pediatrician) and it has number (invoice number) for procedures carried out on (day 1, other day, and other other day of hospital stay). Have they submitted this to you?”

It takes like 30 seconds for them to check and the vast majority of the time, I get the answer I want to hear (“Yes, we have a copy of this; just keep yours for your records and once we’ve gone through the charges, the doctor’s office will send you a revised bill minus our portion”). If the doctor’s office hasn’t submitted it to my insurance (rarely), then I’ll call the office and ask them if they did, and if they haven’t (even more rarely) I give them my insurance info again and they send it right off.

I feel like this method strikes a nice balance between being lazy and avoiding dread, and besides, that’s why we pay for insurance, right?

tl; dr : Until I see the “insurance pays XXX amount” line on the bill (even if it’s a big zero, which I don’t think has ever happened), it’s not a real bill and it’s up to my insurance to take a whack at it.

@Gef the Talking Mongoose yes one of the best pieces of DAD ADVICE I ever got was to never bother with or assume you have to pay the first medical bill you receive.

crenb (#6,486)

@Gef the Talking Mongoose This is great advice! As someone that suffers from migraines and a slew of back problems, I will definitely have to employ this strategy next time a medical bill shows up.

BornSecular (#2,245)

Congratulations on the new Mr. Babyboy! This is also terrifying in more ways than one.

bgprincipessa (#699)

“And the jewels are there, which must make Dad happy.”
Does being a doctor give you free license to be creepy and sexist

LookUponMyWorks (#2,616)

@bgprincipessa It also always freaks me out how they refer to patients as “Mom” or “Mommy” or “Daddy” etc. Like, there is a chart in their hands with the patient’s name on it, damnit.

LookUponMyWorks (#2,616)

“I know you are knew here but life is, well, it’s pretty complicated.”

But really, isn’t this the best advice?

Also, I was ugh-ing so hard throughout this. That comment about babyboy’s “jewels”! The extra $52! Whhhyyyyy.

shannowhamo (#845)

@LookUponMyWorks the 1,2,3 counting also cracked me up! It’d be like counting 1,2,3 but meaning two labia lips and a clitoris! Or like 1,2,3 meaning 2 ears and a nose, it makes no sense! I know doctors need to get paid but it seems like it’s billed so weirdly (and I can only imagine what the actual hospital bill will be like.) My SIL had a baby in France and it’s like, no bills! (But they do pay for a private insurance above and beyond the regular state insurance, which I thought was interesting.)

readyornot (#816)

Ohmygod, just what you need, right, a bill with mysterious amounts for services you don’t remember in the midst of caring for a newborn.

My own experience with paying for medical care in pregnancy/labor is unexpectedly good, no thanks to my own diligence. Totally planned to get pregnant, totally never checked the costs. I’m a grad student, my school pays for Kaiser HMO coverage, I pay a small monthly premium to add my husband. (I think it’s $70/month.)

One of my male classmates asked what it would cost, and I didn’t know so I looked it up. Totally covered! All prenatal visits, all lab work, all ultrasounds, complete labor and delivery, all postnatal visits and even lactation consulting. Not even a copay. I feel so fortunate and like I did not do one thing to deserve to have such an easy time when others do not.

eatmoredumplings (#3,808)

@readyornot That is lucky! I’m also a grad student with health insurance that supposedly covers all prenatal and birth care, but I’ve already been getting bills. For example, I asked my ob/gyn’s practice whether they take my insurance, and they said “yes!”, but I failed to call my insurance company and ask whether she was “in network” AT THAT SPECIFIC ADDRESS, so we have to pay copays + 30%. Also, whenever a blood tests gets sent by a doctor’s office to an “out of network” lab, we get billed for that too (and that’s one of those “behind the scenes” things you don’t get to say yes or no to). So far, nothing in my pregnancy has been covered, and we haven’t even received all the bills yet.

readyornot (#816)

@eatmoredumplings I am sorry! I wouldn’t want to go through that while also dealing with pregnancy. Health care really is crazy complicated, and insurance companies definitely seem in the business of skirting their responsibilities wherever possible. I feel like there was a WWYD about an out-of-network lab, though?

I think in my case my good fortune results from a combination of grad school paying my premia and the fact that it’s an HMO. So I have to use the Kaiser primary care, OB/GYN, lab, and hospital, but then I never even see the bill. HMOs – truly the disengaged person’s budget-conscious choice. Luckily, I really like my OB and midwife and the hospital is about a mile from where I live. Minimal complaints!

honey cowl (#1,510)

Does he have your last name? RAD. Pls tell my bf that our future children will have my last name because I did (/will do) the goddamn hard part. Welcome to the world, O’Connell Babyboy.

Health care billing stuff around pregnancy is just bizarre. When my wife was pregnant with our first (note to fellow men – “we’re” never pregnant), I got a letter from the insurance company about two months before her due date. Our records indicate, the letter informed me, that a dependent of yours is pregnant. You must call us within 48 hours of the birth or we will cover nothing. Have a great day.

I called that day and asked if I misunderstood the letter. Nope, I was informed. It’s all in the plan details that my employer should have provided me with. “Put us on speed dial”, the woman on the other end of the line recommended. I did. Upon child’s birth, the phone tree went grandparents, siblings, insurance company, friends.

Allison (#4,509)

@Dana Cruikshank@facebook now this is making me wonder how it works with adoptions! My cousins adopted one of their kids a few days after he was born – or they took him home and the adoption was finalized what seemed like a year later. I wonder what the process is for adding to insurance in those cases.

beastlyburden (#6,122)

Congratulations!!

Pro-tip for when the hospital bill comes: even if you have insurance and even if you think you have too much money, APPLY FOR FINANCIAL ASSISTANCE. My friend–who, again, has decent insurance and makes decent money–got his insurance bill knocked down from $2,000 to, I dunno, $300 something, all for the price of a stamp to mail the form in? This is in Brooklyn, so seriously, why the hell not try.

bridgett (#1,989)

@beastlyburden Thank you for mentioning this! I had my first baby at the same time Meaghan did and the bills are starting to roll in. I just called the hospital and asked if they offer discounts. Because we’re paying in full within 30 days they’re giving us a 30% discount. The billing lady said we can do this for every bill we receive. Amazing! You never know unless you ask.

Damn this hits home. Due in three months with a kiddo who will have to go straight into the NICU due to a heart defect. Estimates I’ve read are around $95,000 before insurance HAHAHA LOL BYE SAVINGS.

I hadn’t even processed yet that he and I will get different bills. He’ll be a person! Crazy!

that one girl (#4,630)

@JNC Musings Factory Totally tangential, but I’m a pediatric cardiac ICU nurse and I hope that everything goes smoothly with your and your baby’s experience in the heart world. Cardiac babies are mighty mighty fighters and I am constantly awed by them and their families as they navigate the world. Good luck!

readyornot (#816)

@JNC Musings Factory best of luck to you and your baby.

@JNC Musings Factory Best of luck. I will be praying for you and your family.

Stina (#686)

@JNC Musings Factory Oh Hon. Apply for that financial assistance. Also there are people that can help negotiate that down for you. And check for double billing!

Best wishes to you, Mr. Factory and le petite Factory.

Allison (#4,509)

@JNC Musings Factory that bill won’t be fun (hopefully mostly for the insurance company!) but hopefully all that money will buy the best modern medicine has for the little dude!

crenb (#6,486)

@JNC Musings Factory Best of luck to you and your new baby. I hope everything goes smoothly and NICU is as painless as it can be. You and your little dude are going to be great! :)

Meaghano (#529)

@JNC Musings Factory Oh mannnn. Well I’m glad you guys have a plan in place for your little guy, and I’m excited for you to meet him! And yes, just wait til you open your mailbox and the Social Security Administration SENDS HIM MAIL. It’s crazy.

samburger (#5,489)

Oh my god I had no idea baby has his own bill at birth

CAPITALISM DECLARES HIM REAL

nature is amazing

Meaghano (#529)

@samburger lol yes and he has a SS# and everything. Sorry dude you are now in the System

halloliebchen (#5,373)

This is just another reminder that if I ever decide to have a baby (which seems likely), I will be having it in Germany with my German healthcare and my year of paid maternity leave THANKYOUVERYMUCH.

Congratulations again and Oh man, I am sorry your birth plan got tossed! But so glad to hear your baby is “boring.”

I had a c-section with my first child, and the only bill that really pissed me off was the “$148 per night for room and board” for the BABY. He slept in a plastic box in my room and I fed him! So SO mad.

My second baby was a vaginal birth, but somehow the hospital did not manage to ingest my insurance information when I handed it to them while having contractions one after the other. Every time someone came in my room, they would say “But you don’t have insurance, so . . . ” and I would say YES I DO, TAKE MY CARD RIGHT NOW. I totally lost my temper when the medicaid advisor called me because of my lack of insurance and made her take down all of my information again. I had to call three different “clinics” who took care of us in the hospital and give each of them my insurance information once we got home from the hospital. AGAIN.

Don’t even get me started on what happens if something is actually amiss with your baby. The amount of money charged for USELESS visits to a seemingly endless number of specialists when you are days past giving birth and too sleep-deprived to argue is just bananas. That, my friend, will put hair on your chest.

Lily Rowan (#70)

Aw, Meaghan. I hope you are doing better. (And definitely call the insurance company.)

baf (#5,342)

Ah, so glad I live in Canada. It’s all free, and my benefits through work cover a private room (a whopping $75 per night in Alberta) as well. The last thing I would want to worry about after having just given birth, by C-section no less, is to then worry about how you’re going to pay for it!

crenb (#6,486)

Yet another reason why if I ever have kids (which seems unwise considering I don’t even want to take care of myself most days)I’m doing so in not America.

Congrats on your new fiscal burden! (No really, congrats, hope you and the new one and all are doing well.)

eatmoredumplings (#3,808)

@readyornot That is lucky! I’m also a grad student with health insurance that supposedly covers all prenatal and birth care, but I’ve already been getting bills. For example, I asked my ob/gyn’s practice whether they take my insurance, and they said “yes!”, but I failed to call my insurance company and ask whether she was “in network” AT THAT SPECIFIC ADDRESS, so we have to pay copays + 30%. Also, whenever a blood tests gets sent by a doctor’s office to an “out of network” lab, we get billed for that too (and that’s one of those “behind the scenes” things you don’t get to say yes or no to). So far, nothing in my pregnancy has been covered, and we haven’t even received all the bills yet.

eatmoredumplings (#3,808)

You sound pretty chill about this! I hope that means that bills pale in comparison to…all of the other stuff involved in having a baby, because it’s a relief to imagine that there’s only room for so much anxiety.

If the bill doesn’t show any indication of the existence of insurance, definitely check on how long the baby can be on your insurance after birth (some companies it’s a few days), and call the hospital to give them that information. I just received a huge bill for a blood test from a lab at a hospital I’d never visited (the blood sample got sent there), with no indication of insurance existing, and I called the hospital and said “do you have my insurance information?” They didn’t, they took it down, and I’m waiting and hoping for a reduced bill. Shouldn’t hope too hard, but it seemed like a simple way to at least bring it down. Presumably you can do this too, if and when you have time and energy!

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