Anesthesia Fee's

[DaFreak71]

Late last year I had an EGD done, and since I didn't have health insurance, I was a self pay patient. I paid up front and was told to expect a bill from an outside anesthesia provider for a few hundred dollars. A few months later I got the bill for about $400, which I paid. In the past month I have gotten another bill for anesthesia from the surgery center where I had the Endoscopy done. They want $650.00 for their CRNA. If this were a legitamate bill, I don't know why they wouldn't have charged me up front along with everything else I paid, or why it took five months to bill me.

My question is this: With a routine EGD, what is a reasonable fee for anesthesia? The cost of my procedure was $1200.00, so paying $1000.00 for such a routine procedure with no complications seems a bit high to me. I am especially suspicous of this place because they tried to bill me $1900.00 for a biopsy that I had already paid $150.00 for. So far, if I had paid them everything they asked for I would have spent $4,600.00 (including doctor fee) for a routine EGD that took about 20 minutes to do. Sounds a bit fishy to me.

Any thoughts on what a typical fee would be for this procedure? Thanks in advance for any information!

Love this board!

Chris Carlson

(current ADN nursing student..about to graduate!)

[talaxandra]

I have no idea what US fees and charges would be, but when I had elective surgery in 2003 the bill fromt he anaesthetist also arrived several months after the bills from the hospital (who charged me a night's bed stay when I left from recovery! I rang the billing department, who told me that recovery room is not included in the cost of surgery )

[apaisRN, RN, CRNA]

No idea about costs, but definitely challenge the bill. I get more bills that are wrong than are right from the local hospital/health care network. I get billed for copays I paid at time of service, billed for labwork associated with a study I was in (I do not need pregnancy tests every month as the study required and I am certainly not going to pay for them!). My husband's PCP billed our insurance for office supplies when they should have billed for wrist braces out of the stockroom, and man did the insurance lady chew me out when I called to question why it was denied. I don't understand why it's all so screwed up. If my credit card company made errors so often, they'd be out of business because no one would want their card! So how come health care gets away with it?

[yoga crna]

There are usually two components of the total procedure bill for anesthesia.

One is for the professional anesthesia provider for administration of the anesthetic. This amount is calculated on a simple formula of base units and time units. In other words, the longer the case takes, the more the anesthesia bill. I think an EGD is 5 base units and probaly 2-4 time units (it is acceptable to add pre and post-op care in time units. The total units are multiplied by a conversion factor ($ amount established by the practitioner). For example a 30 minute EGD would be 5 base units x 3 time units = 8 units x $50 (conversion factor in some parts of the country) for a total of $400. By the way Medicare determines the conversion factor, which is around $17-$19.

The second component is charged by the hospital or ASC for the anesthesia component of supplies and medications. I don't know how this is calculated, but rest assured the prices are inflated over actual costs.

You should not have been charged for two professional fees (assuming this is not Medicare) and should question both and ask for an itemized statement.

This is information all of you should know. Those of us in private practice live it every day, but is is useful information to know for everyone who is in a position to negotiate a compensation package.

Yoga CRNA