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The cost of getting minor outpatient surgery at Sacred Heart Hospital (the hospital which a report Mr. Ichi cited yesterday is one of the "most affordable" hospitals in the state)

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2seaoat
boards of FL
TEOTWAWKI
Joanimaroni
Hospital Bob
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Hospital Bob

Hospital Bob

I just read Studer's bio. He's a former President of Baptist Hospital.

Guest


Guest

Bob wrote:I just read Studer's bio.  He's a former President of Baptist Hospital.  
Yep Remember when it was going to be shut down and sold to West Florida but the deal fell though?
I think he has many more that 28 clients(?), those 28 made the top 100
.

Guest


Guest

Baptist Health Care expansion
Current event marker.png This article documents a current event.
Information may change rapidly as the event progresses.
The expansion of Baptist Health Care away from its main Baptist Hospital campus has been attempted on several occasions, most recently in 2008, when the organization announced plans to buy West Florida Hospital. However, after a major credit crisis affected Baptist's ability to obtain the necessary financing, the deal was called off at the beginning of 2009.

[edit]Background

For years, Baptist Health Care has sought to expand its service away from its main Baptist Hospital campus, which is located near Pensacola's urban core and provides indigent care for a large number of low-income patients. The hospital averages about 50 percent occupancy at any given time,[1] and Baptist has sought to transfer some of its allowed acute medical care beds from Baptist Hospital to other branches in more affluent neighborhoods. However, such a transfer is only allowed after following the state's Certificate of Need process, overseen by the Agency for Health Care Administration, which has repeatedly denied requests by Baptist Health Care. Baptist officials have argued that the process is anticompetitive and overly regulatory, and that the ability to serve more "paying customers" would offset losses and increase their financial capacity to provide charity care.

In 2000, a state legislative amendment that would have benefitted Baptist Health Care with a specific Certificate of Need exemption was submitted (and quickly withdrawn) under State Representative Durell Peaden's name, though he denied any knowledge of it and claimed "[a] lot of amendments get filed with my name on them … people think if they put my name on them, they'll pass."[2] Baptist admitted that their lobbyist authored the amendment, but would not identify the sponsor. State Representative Jerry Maygarden was suspected of submitting it, as he was a senior Baptist executive and an outspoken critic of the Certificate of Need process; he insisted, however, "that was not my amendment and that was not my language."[2]

On May 2, 2001, in the final days of the state legislative session, Maygarden quietly arranged an amendment to a massive Medicaid bill with a provision that would allow Escambia and Santa Rosa hospitals to transfer beds to satellite facilities as needed. Officials at other major health care providers came out in opposition to the measure, saying it would benefit only Baptist, Maygarden's employer, as no other organization wanted to transfer beds. "I gave the same authority to Sacred Heart that I gave to West Florida that I gave to Baptist," Maygarden said. "They all have satellite facilities without beds. … I have steadily told them that what they are doing is protecting market share, and I think that's wrong. I've given them all the same options. If they don't want it, that is their choice."[3]

The bill passed quickly, and Maygarden's amendment survived Governor Jeb Bush's line-item vetoes. After a coalition of Baptist's competitors filed suit, the law was declared unconstitutional by Leon County Circuit Judge Kevin Davey, who wrote in his ruling, "[t]he statute does not pertain to a matter of statewide importance, nor can the statute reasonably be construed to be a demonstration project."[4]

In 2004, Baptist announced plans to build a $60 million hospital adjacent to its Baptist Medical Park - Nine Mile facility, which would house 96 beds transferred from the main Baptist Hospital campus. The transfer would have been the result of a coalition with about a dozen other Florida hospitals who wanted legislative exemption from the requisite Certificate of Need process.[1] The plans were again opposed by the other area health care providers — especially West Florida Healthcare, whose West Florida Hospital averaged only 33 percent occupancy and would have been less than a mile from the new hospital.[5] The Santa Rosa County Commission considered opposing the legislation on behalf of Santa Rosa Medical Center, which would have been impacted by a new hospital nearby, but ultimately did not take action.

The legislation was withdrawn. However, in the same year, Baptist successfully lobbied to exempt Escambia County (among five others) from a "grow in place" bill that would have benefitted competitors like Sacred Heart by allowing them to expand at existing facilities without state permission.[6]

In 2006, Baptist Health Care was said to be in talks with West Florida Healthcare about collaborating to improve their services and reduce costs. According to West Florida president and CEO Dennis Taylor, "We're trying to find ways to work together. If we can find ways to work together, it saves the community a tremendous amount of resources."[7] These discussions were never formalized and were called off weeks later, as West Florida's parent company HCA was in the midst of a pending $33 billion buyout by a group of private investors.[8]

[edit]2008 plans

On June 26, 2008, Baptist Health Care officials announced a major expansion project that included the purchase of West Florida Hospital for $245 million and approximately $85 million in new construction. The expansion was intended to be completed within a few months, with an agreed upon deadline of December 31.

  Baptist Health Care expansion
This acquisition will enhance the best of both organizations and provides for expansion of our services to meet the needs of our patients and the community. … We know the acquisition of West Florida Hospital will allow us to continue our high standard of personal care while expanding services to serve the entire Northwest Florida region.
  Baptist Health Care expansion
—Al Stubblefield, President/CEO of Baptist Health Care
The organization signed an asset purchase agreement with West Florida's parent company, Hospital Corporation of America (HCA), after which the necessary regulatory approval was obtained. However, the frozen credit markets related to the subprime mortgage crisis and recession prevented Baptist from obtaining the financing necessary to close the deal. According to a financial expert quoted by the Pensacola News Journal, "Baptist is pretty well leveraged. They have a substantial debt load, a lot of which comes from their financing the Andrews Institute."[9]

As late as October 2008, Baptist CEO Al Stubblefield remained confident that the expansion would move forward and that Baptist was "well positioned to go to the bond markets by the end of this calendar year."[9] However, as the deadline passed with no bonds issued, the expansion will likely not take place.

Had the purchase been completed, the current West Florida Hospital on Davis Highway would have become the new Baptist Hospital, supplementing the presence of Baptist Medical Park - Nine Mile in north Pensacola. The campus would have featured an expanded Baptist Cancer Center in affiliation with the Moffitt Cancer Institute; Baptist Neurosciences Center complemented by a rehab hospital for neurologic and orthopaedic conditions; Baptist Heart & Vascular Center of Excellence; and an expanded Emergency Department. The new Baptist Hospital would have also offered a new parking garage and new physician office buildings. Additionally, Baptist Health Care would have assumed the current West Florida Hospital Primary Care Practices (nine neighborhood medical centers), creating the largest primary care network in the region.

Because of the merger collapse, Baptist lost an estimated $8 million in forfeited earnest money.
[10]

Yella

Yella

Bob wrote:
Joanimaroni wrote:It's unbelievable.
To really appreciate how unbelievable it is,  let's put it in perspective.

I own two vehicles.  I paid 10 grand for a Toyota Prius and 4 grand for a Toyota Tundra.

Two very nice good running vehicles,  a car and a truck,  cost me $14,000.

This goddamn motherfucking cocksucking cunt licking little biopsy costs me over $20,000.

At a so-called "non-profit" hospital run by a fucking church that don't pay no goddamn taxes!
And let's not forget the CEO is paid 950,000$ a year to run the hospital. Folks, that's 18,000$ a WEEK! And she has a whole bevy of Department Directors who aren't being paid peanuts.

http://warpedinblue,blogspot.com/

Hospital Bob

Hospital Bob

A Bedside Chat with Susan Davis,  President and CEO of Sacred Heart.

Lady, I sure hope you can find my $20,000 in the laundry too. lol

Guest


Guest

Bob wrote:Chrissy,

If you really are going to examine all the statements,  I accidentally left one out.
I included the first bill you see here for "anasthesia".  But I failed to include the second "anasthesia" bill you see here.
So that means the anasthesia didn't cost $4350.  The cost for anasthesia is actually $4350 plus $2100 equals  $6450.  

$6450 for anasthesia alone!!!!!  You just can't make this shit up.  

The cost of getting minor outpatient surgery at Sacred Heart Hospital  (the hospital which a report Mr. Ichi cited yesterday is one of the "most affordable" hospitals in the state) - Page 3 Bills511

BUT,  I failed to include this other one which is also for "anasthesia"...
The cost of getting minor outpatient surgery at Sacred Heart Hospital  (the hospital which a report Mr. Ichi cited yesterday is one of the "most affordable" hospitals in the state) - Page 3 Bills119

Oh but it gets even worse.  As you can see,  the insurance company is only contributing $375 to that $4350 bill and goddamn nothing to the $2100 bill.

Here is the list of coverage my insurance policy provides me.  Take note of the entry I've circled labeled "anasthesia".

What this obviously means is,  even though this hospital and this surgeon knew I was using my Mega insurance because they were in my PPO network,  THEY WENT OUTSIDE OF THE NETWORK FOR ANASTHESIA WHERE I HAD NO GODDAMN COVERAGE!!!

The cost of getting minor outpatient surgery at Sacred Heart Hospital  (the hospital which a report Mr. Ichi cited yesterday is one of the "most affordable" hospitals in the state) - Page 3 Insura10


I have examined them at great lenght. I even went to billing. No where in the CPT manual is a code that begins with "E".

All the other codes are standardized CPT codes, easily I can tell you what those are. The path ones I can tell you off the top of my head. But those "
E0360" etc codes. Nothing.

I'm not sure if that is some sort of code the ins is using or if its a CDM code made up by the hospital. But they are not standardized CPT codes.

I just wasted my lunch on this so if it is a bunch of shit your trying to pull off on someone may you rot in hell. If not, I suggest you call the hospital and find out what those codes are. Because like I said, they are not standard CPT codes.

If you want, I may and I say maybe because I'm a little untrusting at the moment because of this. I may still tell you what all the other codes are. The CPT codes are numbers not with letters FYI.... The only time a letter is involved and its not the prefix to it is when there is a modifier. so again. Your on your own with the "E" codes. sorry.

Hospital Bob

Hospital Bob

Chrissy wrote:

I just wasted my lunch on this so if it is a bunch of shit your trying to pull off on someone may you rot in hell.
I swear on my mother's and father's graves that I am not pulling anything and that those are actual statements I received in the mail.

Hospital Bob

Hospital Bob

p.s. somebody is coming to get me out of the house in a few minutes (if I don't get out of this house I'll go crazy cause I haven't been out since sunday morning) so I won't be able to reply to anything else until later.
talk to you later.

Guest


Guest

Bob wrote:
Chrissy wrote:

I just wasted my lunch on this so if it is a bunch of shit your trying to pull off on someone may you rot in hell.  
I swear on my mother's and father's graves that I am not pulling anything and that those are actual statements I received in the mail.
OK, here's what I will do. I will take the CPT book home tonight and give you the procedures for each code. Except the "E" codes. If you havnt called to Sacred yet I will call them and find out wtf those are.

Im so busy here I just cant take that much time to do it at work.

Thats the best I can offer you. Go enjoy the day. I wont be home for a couple of hours which is early for me.

Guest


Guest

88189 Flow cytometry, interpretation; 16 or more markers

88307, biopsy, the larger one I can assure you

88305 biopsy, regular small biopsy\

88360 Imunohistochemistry(IHC) with qualitative cell count

88342, IHC, regular diagnostic

88332, additional frozen section

88331, initial frozen section

99214, office visit, evaluation

01610QK, Anesthesia

83615, with a modifier of 26… they checked your LDH, LD

99213, another out pt doctor consultation

E0300, the OP radio/lab. These are not in book. Speculate their CDM. Possible to get wrote off. Because most ins will not pay miscellaneous codes like this. FYI

99205, another office visit, consult, new patient

85730, has a modifier of 26 = means path read it. PTT time. To see if your blood clots, must have before surgery.

83615, another LDH. Not sure why you have two. This is the second ive seen on different bills.

78195, with modifier of 26, Lymph node image

99202, I cant find this one. Question it

38740, axillary lymphadenectomy, the surgery part

78195, modifier 26, lymphatics and lymph node imagining << I see this again on a separate bill by itself.

01610QX, this is anesthesia again. I see two separate bills for this

All those “E” codes. I am thinking that is some sort of CDM of the total procedure. Are you sure you are supposed to add these two together? If not your bill is half of what your thinking. You need to call. They are not going to give me any info because HIPAA just got very tuff even moreso on Sept 23 ,13.

knothead

knothead

Good job Chrissy, you put in the effort to help a forum friend so good for you!Very Happy 

Joanimaroni

Joanimaroni

Good job Chrissy.....

Here is a list of new patient codes...including the one you were looking for




CPT/HCPCS CODE CPT/HCPCS CODE DESCRIPTION
99201 OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A PROBLEM FOCUSED HISTORY; A PROBLEM FOCUSED EXAMINATION; STRAIGHTFORWARD MEDICAL DECISION MAKING.
99202 OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: AN EXPANDED PROBLEM FOCUSED HISTORY; AN EXPANDED PROBLEM FOCUSED EXAMINATION; STRAIGHTFORWARD MEDICAL DECISION MAKING.
99203 OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A DETAILED HISTORY; A DETAILED EXAMINATION; MEDICAL DECISION MAKING OF LOW COMPLEXITY.
99204 OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A COMPREHENSIVE HISTORY; A COMPREHENSIVE EXAMINATION; MEDICAL DECISION MAKING OF MODERATE COMPLEXITY.
99205 OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A COMPREHENSIVE HISTORY; A COMPREHENSIVE EXAMINATION; MEDICAL DECISION MAKING OF HIGH COMPLEXITY.


dumpcare



Nekochan wrote:LOL, Bob.   

About the problems...my son was over here the other day and he said that the government should have hired someone who knows how to handle lots of traffic--like Google--to set up the system.  Of course, that job probably went to the lowest bidder...so it ends up costing taxpayers more than it would have it they had just hired someone who could get the job done right in the first place.
From what I can see after researching this there was no bidding, it was a non bid contracted awarded.

dumpcare



I talked with guy the other day who owed around $20,000 to SH and went in a made a deal for $5000 and they accepted.

Guest


Guest

ppaca wrote:I talked with guy the other day who owed around $20,000 to SH and went in a made a deal for $5000 and they accepted.

A fellow that was hard of hearing went into a store and picked up a item.  He went to pay for it and the cashier told him "that will be 10 dollars and 10 cents, Please"  The guy put down a dime and started to walk out. The cashier yelled  I said 10 dollars and 10 cents!!!!"  The old guy just kept walking, She was about to yell again when her boss said "Let him go.  We made a nickle on him"  Kinda like the Medical system

Joanimaroni

Joanimaroni

ppaca wrote:I talked with guy the other day who owed around $20,000 to SH and went in a made a deal for $5000 and they accepted.
With Bob's luck they would probably add $5,000 to his bill.

Guest


Guest

You guys are awesome. sometimes yall just make my heart swell, guess that's why I keep coming back.

Joanie, what do you think those E codes are?

Anyway, I would go to battle with sacred for bobs benefit, although im not there and he aggravates me sometimes, but he amuses me more than aggravates.

And yes, I have known of people negotiating cash pay out prices such as ppaca mentions. we all agree. bob go get em.

I do have a few other questions for bob though.

Bob, did they see reed Sternberg cells in your lymph node? and did the flow come back T or B cell.

I wish you well. I really do

Joanimaroni

Joanimaroni

Chrissy wrote:You guys are awesome. sometimes yall just make my heart swell, guess that's why I keep coming back.

Joanie, what do you think those E codes are?

Anyway, I would go to battle with sacred for bobs benefit, although im not there and he aggravates me sometimes, but he amuses me more than aggravates.

And yes, I have known of people negotiating cash pay out prices such as ppaca mentions. we all agree. bob go get em.

I do have a few other questions for bob though.

Bob, did they see reed Sternberg cells in your lymph node? and did the flow come back T or B cell.

I wish you well. I really do


I gave the definition of the corresponding code for 99202

E code may refer to EM codes......Evaluation and Management of hospital patients.

dumpcare



Gee, no telling about many more bills might come in if they "Evaluated" you Bob.

Hospital Bob

Hospital Bob

Chrissy wrote:

Bob, did they see reed Sternberg cells in your lymph node? and did the flow come back T or B cell.

First of all, thanks gals (I mean that word in the best way) for breaking the codes and all the other help you're giving me. I think as a team we can beat this shit and when we do the trophy is yours (I'll settle for hanging onto at least enough to eat on).

But to answer your specific question, Chrissy, those bastiches never gave me any pathology reports and I was too stupid to ask for them. So I have no clue and not only that, I realize what a layman I am because those terms are like greek to me.

Guest


Guest

Bob wrote:
Chrissy wrote:

Bob, did they see reed Sternberg cells in your lymph node? and did the flow come back T or B cell.

First of all,  thanks gals (I mean that word in the best way) for breaking the codes and all the other help you're giving me.  I think as a team we can beat this shit and when we do the trophy is yours (I'll settle for hanging onto at least enough to eat on).  

But to answer your specific question,  Chrissy,  those bastiches never gave me any pathology reports and I was too stupid to ask for them.  So I have no clue and not only that,  I realize what a layman I am because those terms are like greek to me.
Go get your pathology reports and your flow report please.

The important thing here with the lymphoma is if its T or B cell originated. If it was reed Sternberg cells then I feel pretty good about it because hodgkin's lymphoma is pretty harmless compared to other lymphomas. lymphomas can be very hard to determine cell linage.

you need to find out, I am more concerned about this than what you said about your melanoma.

Can you go and get those tomorrow please?

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