Appendix Surgery Leads To Surprising Bill For Uninsured Veteran : Shots – Health News – NPR

“Prior to the appendectomy, I was trying to find property and homes to acquire, and that is pretty much completely off the table today,” states Shannon Harness, a veteran who was uninsured when he had two appendicitis-related surgeries in 2019. The bills totaled up to $80,232.

Rachel Woolf/Rachel Woolf for KHN

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Rachel Woolf/Rachel Woolf for KHN

” Before the appendectomy, I was searching for property and houses to buy, which is practically completely off the table today,” states Shannon Harness, a veteran who was uninsured when he had two appendicitis-related surgeries in 2019. The bills totaled up to $80,232.

Rachel Woolf/Rachel Woolf for KHN

In late August 2019, Shannon Harness awoke to major pain in the lower ideal side of his abdomen– an indicator of appendicitis. Harness scheduled it to the emergency clinic of the only healthcare facility in the county: Heart of the Rockies Regional Medical Center in Salida, Colo. After a CT scan, medical professionals informed Harness he had severe appendicitis and needed instant surgical treatment. A surgeon carried out an appendectomy that night and released Harness the next day. But a number of days later, Harness felt sharp discomforts where his appendix had been. The pain grew until he was on the floor yelling. “It was disturbing,” states his partner Eliza Novick-Smith. “He has a quite high pain tolerance,” offered previous injuries from military service and mountain cycling. Harness returned to the hospital, where another CT scan exposed a blood clot the size of a brick floating in his pelvic location, an unusual complication that probably originated from clipping and stapling the appendix tissue in the very first surgical treatment, his cosmetic surgeon says. Harness would need another operation to look for the source of bleeding and to get rid of the clot.

Total owed: The initial hospital costs was $80,232 for both surgical treatments: The first surgery cost $35,906 and the clot surgery cost $44,326. What provides: Uninsured patients are incredibly vulnerable to exorbitant health center expenses. “As somebody whos uninsured, you are getting an unnegotiated rate,” Wright says– a rate obtained from the hospitals master cost list.

When Shannon Harness woke up to symptoms of appendicitis in August 2019, he went to the emergency room of the only medical facility in his county: Heart of the Rockies Regional Medical Center in Salida, Colo. He was uninsured at the time.

In Colorado, every health center is supposed to have an extensive charity care program for uninsured patients that make less than 250% of the federal hardship level. Harness said the medical facilitys financial services workplace at first informed him he was disqualified for their assistance program as well as the Colorado Indigent Care Program. The medical facility would use just his previous 2 pay stubs to validate his earnings, he states.

Rachel Woolf for KHN

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Rachel Woolf for KHN

The healthcare facility wouldnt answer any questions about Harness care or costs, even though he gave it approval to do so. Resolution: Harness filed a grievance with the healthcare facility with the aid of Novick-Smith, who is a legal representative, to press back on the bills for the two surgical treatments– $35,906 for the very first and $44,326 more for the second– and reveal issues with the quality of care. In November, the health center decided to give Harness a 30% discount for both surgical treatments– leaving him with a still large bill of $56,162.40.

Harness and his partner Eliza Novick-Smith negotiated with Heart of the Rockies Regional Medical, using to pay the hospital $12,000 upfront. However the health center turned down that deal. Harness is now working out a payment strategy with the medical facility.

Rachel Woolf for KHN

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Rachel Woolf for KHN

More than 6 months later on, in March, the health center told Harness he would have to pay for the second surgical treatment due to the fact that it was a risk he accepted by concurring to the appendectomy. Harness final expense from the hospital, Fagerberg wrote, stands at $22,304.17 after modifications that consisted of a self-pay discount rate. Harness and Novick-Smith stated that still seemed too high to them, and after some research, used to pay the medical facility $12,000 upfront.

Harness went back to the medical facility, where another CT scan exposed a blood clot the size of a brick floating in his pelvic location, an uncommon problem that the majority of likely came from clipping and stapling the appendix tissue in the very first surgical treatment, his cosmetic surgeon says. The medical facility would not address any concerns about Harness care or bills, even though he offered it authorization to do so. Resolution: Harness filed a complaint with the healthcare facility with the assistance of Novick-Smith, who is a lawyer, to press back on the expenses for the two surgeries– $35,906 for the first and $44,326 more for the second– and reveal concerns with the quality of care. In November, the health center chose to provide Harness a 30% discount for both surgeries– leaving him with a still significant bill of $56,162.40.

Harness final costs from the healthcare facility, Fagerberg composed, stands at $22,304.17 after changes that included a self-pay discount rate.

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