Here are four takeaways from the report:
1. Richard Wyler required an emergency appendectomy in late June at an out-of-state, though in-network, hospital. Mr. Wyler underwent laparoscopic surgery and the hospital discharged him the next day.
2. The hospital billed $76,081 for the procedure. When including anesthesiologist and other provider expenses, the total grew to nearly $80,000, according to the report. Mr. Wyler’s insurance company has a contracted price for the surgery, and said the eligible amount was only $15,384 of the charge. Mr. Wyler is responsible for $3,076 of the bill.
3. Two companies specializing in medical billing advocacy reviewed Mr. Wyler’s bill. Victoria Caras, founder of Colorado-based Aspen Medical Billing Advocates, told KSL.com it “doesn’t really matter what [hospitals] charge” in response to the nearly $80,000 bill. “They’re only going to get the amount the insurance company agreed to.”
4. Ms. Caras and Whitney Duhaime, vice president of Denials Management in Salt Lake City, said had Mr. Wyler been uninsured, they would have fought a $13,849 charge for the patient’s abdominal and pelvis CT scan. Ms. Duhaime said the scan should only cost between $500 and $2,500. On Healthcare Bluebook, the price range for the procedure was about $300 to more than $6,000.
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