The bills are starting to trickle in. I am amazed by the cost of surgery and all of the procedures associated with it. To summarize for those just joining the discussion, I had a routine doctor visit last month and part of the visit was a routine ECG. The ECG showed classic atrial flutter and was confirmed with an ultrasound. When doing a stress ECG I actually went into Ventricle Tacacardyia for a few heart beats as my heart raced to 300 beats per minute.
The initial doctor visit - $190 + $40 for ECG.
Secondary doctor visit - $190 + $400 for Echo and $400 for stress ECG
week 1 total - $1220.00
Visit with Electrophysiologist - $190 + $40 for ECG
Transesophageal echocardiogram (TEE) - $8000
week 2 total - $8320
Cardiac Ablation - $101,000
week 3 total - $101,000
month total - $110,540
Of this, the insurance company agreed to pay the hospital a pre-negotiated amount near $67,000 and asked me to pay about $4,000.
Let's put this in perspective. If I were part of a pre-participation screening program I would have gone to my school and had an ECG done for $15. If nothing were found, I would be done until four years later given that you only need to screen middle school and high school students once every four years. The alternative was to go to a doctor and get a routine physical which probably would not include and ECG. The doctor would have missed the atrial flutter because it sounds like a regular fast heart beat to someone not trained to listen for atrial flutter. The cost of the doctor visit would have been $75-$100 with a $25 copay. My out of pocket expense would have been $25 and I would continue participating and in all likelihood have collapsed on the field from dizziness or heart failure.
If something were found on the ECG, as it was in my case, I would have been labeled as follow up or high risk. In my case I would have been labeled as high risk. I would have gone to the Cardiologist and paid the $190 + $400 for the Echo and $400 for the stress ECG. This would have cost $15 for the screening ECG and $990 for the follow up exam. With the follow up exam, I would have paid my $25 co-pay and insurance would have picked up the rest. My out of pocket would be $40 to get screened in as a heart risk or screened out as clear to participate. Given that there was something there, I would have had the TEE performed as well as the Ablation at the same cost. As an aside, the TEE is a fascinating process. The doctor slips a small ultrasound machine down your throat and images your heart from inside your ribs. The pictures are much more accurate and can pick up blood clots and potential issues that could effect an ablation. I understand why this is not done as a screening protocol and requires a Cardiologist but the fact that they can slip an ultrasound machine inside the body and image the heart is interesting.
The alternative to screening was an ambulance/life flight ride, an emergency room visit, and emergency surgery. I don't know the cost of this option but my gut tells me that it is more expensive than just outpatient surgery that we scheduled ahead of time.
Given that we are three weeks after the surgery and I have started a routine of working out and loosing weight, I am glad that we performed the initial screening. I doubt that I would have been able to get back to bike riding, woodworking, and racket ball post emergency room visit as soon as I did with outpatient surgery.
Yes it was scary for my whole family that I had something wrong with my heart. Yes we started looking at things differently. Yes I am glad that I not only had the screening done but that we are providing it as a service for other people around the state.
pat
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