A friend writes:
Re shopping for procedure costs, I have learned that one the hard way.
I have a torn rotator cuff, which I went to Hospital for Special Surgery to have repaired. The surgeon insisted that, prior to surgery, he required that I get an “experimental” shot into my shoulder. He explained they take my blood, pull the white blood cells and plasma, and inject that back into the injury to encourage healing. (Apparently, if you are a professional athlete, this counts as doping…)
Needless to say, insurance didn’t cover the procedure and I paid $5k out of pocket for a very painful and completely useless experiment. I followed up with 6 months of PT and then the Dr. said he would operate. By that time, I was pregnant. So, I walked away from this guy and wrote him a letter saying that this had clearly been a medical shakedown and he should be ashamed.
I tell you all this because 4 weeks after I had this procedure, my brother-in-law had the exact same procedure on his hip. Performed at Duke and it cost him $400… That was the entire cost.
If I had known in advance, I would have flown to NC, gotten the nicest room at the nearby hotel, and still saved some money!
The shot is a PRP Injection (Platelet Rich Plasma) and beyond painful. If a doctor recommends this, I suggest finding a new doctor.
I used this hard-won knowledge to negotiate a rate with my OB for my twin pregnancy. I paid a flat fee, no matter what happened, and I wasn’t on the hook for anything insurance wouldn’t cover for her or the hospital.
(Editor’s note: We post such “A friend writes” episodes frequently. Here are some more. Also, here are our “10 questions to ask” to find out what stuff costs in health care, and “How to argue a bill.” Also: “How to appeal a denial.” To search and share prices, go here.)