Re: What do doctors charge

[Guest guest]

I haven't started my shots yet, but it is going cost me 250/month for the

medicine alone. Plus I pay 360/month for my other meds. The office won't do the

injections there, so I'm going have to have to go to the infusion center at the

hospital. Where they with charge as an outpatient administration! I'm curious

what everyone else pays now!

Tricia

Sent via BlackBerry from T-Mobile

-----Original Message-----

From: " Carol " <floridabouvs@...>

Date: Sat, 20 Mar 2010 19:28:26

< >

Subject: [ ] What do doctors charge

Can some of you let me know how your doctors charge for administering Xolair?

I just got a bill from the clinic: $76 for the doctor even though he isn't even

in the building at the time I get my shots, and $48 x2 for injection therapy,

total $172. A month! My insurance company pays $15.70, and the write-off is

$74.72. For some reason, the clinic calculated my patient balance as $81.58.

Is that a racket, or what???

Of course, I pay $200 every 3 months for my own medication.

Is everyone else equally abused by the medical community's way of charging for

these shots? Or is there a better way that I could suggest to my insurance

company?

They don't charge that much for allergy shots. How is this that much different?

Do I need to be looking for a new doctor?

BTW, I've been on Xolair for about 3 yrs, and it's doing well for me. I just

don't know if I can continue to afford it once I retire and end up in the donut

hole in the first month : -(

Thanks lots,

Carol

[Guest guest]

I know all about the doughnut hole by the end of January.

Actually, most doctors do not make much at all on Xolair even if they provide it

and it takes a lot of time for the nurse to prepare xolair and then you have to

sit there in their office for awhile, etc.  My original pulmonologist dumped

all of his xolair patients after the FDA mandate which eliminated

self-injection...and my ID doctor no longer provides Xolair because he did not

make anything on it...

So I am grateful to find a Dr. who has an infusion center which does the

injections.

Ashleigh

________________________________

From: Carol <floridabouvs@...>

Sent: Sat, March 20, 2010 2:28:26 PM

Subject: [ ] What do doctors charge

 

Can some of you let me know how your doctors charge for administering Xolair?

I just got a bill from the clinic: $76 for the doctor even though he isn't even

in the building at the time I get my shots, and $48 x2 for injection therapy,

total $172. A month! My insurance company pays $15.70, and the write-off is

$74.72. For some reason, the clinic calculated my patient balance as $81.58.

Is that a racket, or what???

Of course, I pay $200 every 3 months for my own medication.

Is everyone else equally abused by the medical community's way of charging for

these shots? Or is there a better way that I could suggest to my insurance

company?

They don't charge that much for allergy shots. How is this that much different?

Do I need to be looking for a new doctor?

BTW, I've been on Xolair for about 3 yrs, and it's doing well for me. I just

don't know if I can continue to afford it once I retire and end up in the donut

hole in the first month : -(

Thanks lots,

Carol

[Guest guest]

BTW my dose is 2 shots every 2 weeks.

Tricia

Sent via BlackBerry from T-Mobile

-----Original Message-----

From: mom2alexnabbie@...

Date: Sat, 20 Mar 2010 19:56:31

< >

Subject: Re: [ ] What do doctors charge

I haven't started my shots yet, but it is going cost me 250/month for the

medicine alone. Plus I pay 360/month for my other meds. The office won't do the

injections there, so I'm going have to have to go to the infusion center at the

hospital. Where they with charge as an outpatient administration! I'm curious

what everyone else pays now!

Tricia

Sent via BlackBerry from T-Mobile

-----Original Message-----

From: " Carol " <floridabouvs@...>

Date: Sat, 20 Mar 2010 19:28:26

< >

Subject: [ ] What do doctors charge

Can some of you let me know how your doctors charge for administering Xolair?

I just got a bill from the clinic: $76 for the doctor even though he isn't even

in the building at the time I get my shots, and $48 x2 for injection therapy,

total $172. A month! My insurance company pays $15.70, and the write-off is

$74.72. For some reason, the clinic calculated my patient balance as $81.58.

Is that a racket, or what???

Of course, I pay $200 every 3 months for my own medication.

Is everyone else equally abused by the medical community's way of charging for

these shots? Or is there a better way that I could suggest to my insurance

company?

They don't charge that much for allergy shots. How is this that much different?

Do I need to be looking for a new doctor?

BTW, I've been on Xolair for about 3 yrs, and it's doing well for me. I just

don't know if I can continue to afford it once I retire and end up in the donut

hole in the first month : -(

Thanks lots,

Carol

[Guest guest]

every insurance company is different, and copays are set up differently. it

probably also differs state to state. for me, my dr's office bills my shots as

" chemotherapy " (i'm told they can bill it as such b/c its a biologic

injectable), which has a zero dollar copay, according to my insurance. i get

charged $50 (my standard copay for a specialist) for a follow-up appt once a

month (i get 3 shots every 2 weeks).

hope that helps!!

>

> Can some of you let me know how your doctors charge for administering Xolair?

> I just got a bill from the clinic: $76 for the doctor even though he isn't

even in the building at the time I get my shots, and $48 x2 for injection

therapy, total $172. A month! My insurance company pays $15.70, and the

write-off is $74.72. For some reason, the clinic calculated my patient balance

as $81.58.

> Is that a racket, or what???

> Of course, I pay $200 every 3 months for my own medication.

> Is everyone else equally abused by the medical community's way of charging for

these shots? Or is there a better way that I could suggest to my insurance

company?

> They don't charge that much for allergy shots. How is this that much

different?

> Do I need to be looking for a new doctor?

> BTW, I've been on Xolair for about 3 yrs, and it's doing well for me. I just

don't know if I can continue to afford it once I retire and end up in the donut

hole in the first month : -(

> Thanks lots,

> Carol

>

[Guest guest]

Hi,

I know I'm VERY lucky, this is not the 'norm' but I pay $0 for the actual

Xolair and supplies. Since my pulmo/allergist is 1.5 hrs away from my house, I

mix the Xolair and bring it to my primary MD to inject. So my standard co-pay

for the primary is $15 and I just pay that every 2 weeks! I have it very good.

Meagan

>

> Can some of you let me know how your doctors charge for administering Xolair?

> I just got a bill from the clinic: $76 for the doctor even though he isn't

even in the building at the time I get my shots, and $48 x2 for injection

therapy, total $172. A month! My insurance company pays $15.70, and the

write-off is $74.72. For some reason, the clinic calculated my patient balance

as $81.58.

> Is that a racket, or what???

> Of course, I pay $200 every 3 months for my own medication.

> Is everyone else equally abused by the medical community's way of charging for

these shots? Or is there a better way that I could suggest to my insurance

company?

> They don't charge that much for allergy shots. How is this that much

different?

> Do I need to be looking for a new doctor?

> BTW, I've been on Xolair for about 3 yrs, and it's doing well for me. I just

don't know if I can continue to afford it once I retire and end up in the donut

hole in the first month : -(

> Thanks lots,

> Carol

>

[Guest guest]

The doctor's office part does sound a little bit " rackety " although I believe

it's all determined by insurance assuming you have [mis]managed health care of

some type.

When I was injecting at home it was $45.00 a month co-pay for the drug itself.

There were no other costs or fees since everything I needed came together in a

cooler. That was for 2 series of injections - 3 shots every 2 weeks.

When I was forced to go to an infusion center it was $45.00 for the shot

including the nurse and facility and drug but I had to go TWICE a month (every 2

weeks) making it double to $90.00 a month. There were no other fees such as

doctor or clinic or user or anything else. However, the cost of parking was

$10.00 and the cost of gas was about $12.00 and the cost of lunch about $12.00

and the toll road about $4.00. Then there were the 6 hours out of my day which,

depending on where I was working could run into a large amount of money when I

was pd. by the hour.

Does your ins company know how you're being billed? You might check with them.

It might be a good idea to discreetly check to see what it would cost elsewhere

too. My PCP told me a different story ... he said there was a lot of money in

it - the infusion center was billing $5,000.00 a pop although I think the ins

was only really paying $2,000. Not bad for almost no work for the infusion

center.

>

> Can some of you let me know how your doctors charge for administering Xolair?

> I just got a bill from the clinic: $76 for the doctor even though he isn't

even in the building at the time I get my shots, and $48 x2 for injection

therapy, total $172. A month! My insurance company pays $15.70, and the

write-off is $74.72. For some reason, the clinic calculated my patient balance

as $81.58.

> Is that a racket, or what???

> Of course, I pay $200 every 3 months for my own medication.

> Is everyone else equally abused by the medical community's way of charging for

these shots? Or is there a better way that I could suggest to my insurance

company?

> They don't charge that much for allergy shots. How is this that much

different?

> Do I need to be looking for a new doctor?

> BTW, I've been on Xolair for about 3 yrs, and it's doing well for me. I just

don't know if I can continue to afford it once I retire and end up in the donut

hole in the first month : -(

> Thanks lots,

> Carol

>

[Guest guest]

Mine is a part of a medical group and they set the prices.

It is called a " chemotherapy " injection and they charge 119.00 per shot.

I get two every two weeks so that makes it 238.00 a twice a month. Highway

robbery if you ask me.

BCBS writes it down to 98.00 a shot because they are in network with the medical

group. My insurance pays 80% and my secondary pays the other 20.

Doug

Group founder

[Guest guest]

Thanks to you all for replying.

I think the doctors get big bucks for treating patients with Xolair -- as in

my doctor earning about $100 for a wonderful MA using a machine to mix my

Xolair, take vitals, give 2 shots, then let me go on my way. I'm there for

all of 20 minutes from start to finish, and the only person I see is a MA.

I do plan to discuss with my insurance company how they have agreed to pay

for Xolair. My husband's company just changed to United from Blue Cross, and

BC had agreed to the " chemotherapy " designation, which I think is a crock.

Just because this is a relatively new and very promising treatment for a

chronic condition.

Sorry, but sometimes I feel that patients are taken advantage of.

And I work in health care.

Thanks for letting me vent.

Carol

'

[Guest guest]

On the other hand, Carol, I have to go to the local hospital outpatient services

department for my shots every two weeks. The hospital bills Medicare something

over $5,000 for these shots each time. Medicare pays a few hundred dollars and

so does BCBS as my supplementary insurance carrier. The total paid by both is

about $1,000 two weeks. As one who has quite a few medical proablems, I'm

always amazed at the raping of the Medicare system by unscrupulous, greedy

providers.

Ohldepharte

----- Original Message ----- by

From: Carol Corley

Sent: Sunday, March 21, 2010 8:32 PM

Subject: [ ] Re: What do doctors charge

Thanks to you all for replying.

I think the doctors get big bucks for treating patients with Xolair -- as in

my doctor earning about $100 for a wonderful MA using a machine to mix my

Xolair, take vitals, give 2 shots, then let me go on my way. I'm there for

all of 20 minutes from start to finish, and the only person I see is a MA.

I do plan to discuss with my insurance company how they have agreed to pay

for Xolair. My husband's company just changed to United from Blue Cross, and

BC had agreed to the " chemotherapy " designation, which I think is a crock.

Just because this is a relatively new and very promising treatment for a

chronic condition.

Sorry, but sometimes I feel that patients are taken advantage of.

And I work in health care.

Thanks for letting me vent.

Carol

'

[Guest guest]

Well guess I will put my 2 cents in too. Actually my bill is $2,371.86 for 4

shots a month........I have a co pay of only $3.10 and get extra help of only

$44. Guess the ins. co. picks up the rest.........thank God.

May today be twice as good as yesterday and half as good as tomorrow. Jan

From: onabeach@...

Date: Mon, 22 Mar 2010 22:47:40 -0400

Subject: Re: [ ] Re: What do doctors charge

On the other hand, Carol, I have to go to the local hospital outpatient services

department for my shots every two weeks. The hospital bills Medicare something

over $5,000 for these shots each time. Medicare pays a few hundred dollars and

so does BCBS as my supplementary insurance carrier. The total paid by both is

about $1,000 two weeks. As one who has quite a few medical proablems, I'm always

amazed at the raping of the Medicare system by unscrupulous, greedy providers.

Ohldepharte

----- Original Message ----- by

From: Carol Corley

Sent: Sunday, March 21, 2010 8:32 PM

Subject: [ ] Re: What do doctors charge

Thanks to you all for replying.

I think the doctors get big bucks for treating patients with Xolair -- as in

my doctor earning about $100 for a wonderful MA using a machine to mix my

Xolair, take vitals, give 2 shots, then let me go on my way. I'm there for

all of 20 minutes from start to finish, and the only person I see is a MA.

I do plan to discuss with my insurance company how they have agreed to pay

for Xolair. My husband's company just changed to United from Blue Cross, and

BC had agreed to the " chemotherapy " designation, which I think is a crock.

Just because this is a relatively new and very promising treatment for a

chronic condition.

Sorry, but sometimes I feel that patients are taken advantage of.

And I work in health care.

Thanks for letting me vent.

Carol

'

[Guest guest]

The Xolair charges I see are somewhat of a mystery to me. $76 is around what I

normally see on my charges to the ins co for the shots. They're usually listed

as " chemotherapy " but sometimes I've seen " immunotherapy " which is less.

The best I could tell was that " immunotherapy " applied to whenever the doctor

wasn't in the office when the shots were administered but I could never get it

straight and the ins co was no help in clarifying this.

I often see charges for the peak flow checks that are made each time I go in for

the shots.

In the end, I get hit around $30/mo for administration of the shots (that's

nothing to do with my co-pays for the medicine) and insurance pays the rest.

I don't have any complaint about the doctor making some money on administration

of my medicine. When I look at the whole picture, my doctor is helping to keep

me healthy and saving me money at the same time.

My doctor often gives me free samples of other asthma medicines I take which

saves me a lot on co-pays. Also, my doctor personally takes phone calls from

me 24/7 without charging me a penny and that has saved me expensive trips to the

the ER.

Thankfully, I have good insurance now and can afford my charges but soon I go on

Medicare and that will be a whole different story. I will not be able to afford

the donut hole so will have to do without many of the medicines I currently

take. Xolair will probably have to go and I'll have to ration the others. I'll

probably get to know the folks at the ER real well then.

>

> Can some of you let me know how your doctors charge for administering Xolair?

> I just got a bill from the clinic: $76 for the doctor even though he isn't

even in the building at the time I get my shots, and $48 x2 for injection

therapy, total $172. A month! My insurance company pays $15.70, and the

write-off is $74.72. For some reason, the clinic calculated my patient balance

as $81.58.

> Is that a racket, or what???

> Of course, I pay $200 every 3 months for my own medication.

> Is everyone else equally abused by the medical community's way of charging for

these shots? Or is there a better way that I could suggest to my insurance

company?

> They don't charge that much for allergy shots. How is this that much

different?

> Do I need to be looking for a new doctor?

> BTW, I've been on Xolair for about 3 yrs, and it's doing well for me. I just

don't know if I can continue to afford it once I retire and end up in the donut

hole in the first month : -(

> Thanks lots,

> Carol

>

[Guest guest]

Ohldepharte, since I'll be going on Medicare in about a year I'm very interested

in how you're being treated with Xolair.

Are you being treated with Xolair as a drug (subject to the doughnut hole under

Medicare part D) or as a medical treatment for an illness (subject to the rules

of Medicare parts A or B and your medigap insurance)?

And I agree with you on the raping of the Medicare system which I have seen as

caretaker for my 93 year old mother.

My take on this is that Medicare indirectly helps bear the brunt of health care

for people that have no insurance, and employer-fed insurance companies that

short change the hospitals and doctors.

And yes, there's always the greed factor at work. It's not just in medical

care.

I think Medicare has been one of the most inefficient socialized medical care

programs in the world because it has indirectly morphed into the default

back-door source of government health-care funding for US residents from all

walks of life. And since that was not it's original design, it's done a poor

job of it.

>

> On the other hand, Carol, I have to go to the local hospital outpatient

services department for my shots every two weeks. The hospital bills Medicare

something over $5,000 for these shots each time. Medicare pays a few hundred

dollars and so does BCBS as my supplementary insurance carrier. The total paid

by both is about $1,000 two weeks. As one who has quite a few medical

proablems, I'm always amazed at the raping of the Medicare system by

unscrupulous, greedy providers.

>

> Ohldepharte

>

> ----- Original Message ----- by

> From: Carol Corley

>

> Sent: Sunday, March 21, 2010 8:32 PM

> Subject: [ ] Re: What do doctors charge

>

>

>

> Thanks to you all for replying.

> I think the doctors get big bucks for treating patients with Xolair -- as in

> my doctor earning about $100 for a wonderful MA using a machine to mix my

> Xolair, take vitals, give 2 shots, then let me go on my way. I'm there for

> all of 20 minutes from start to finish, and the only person I see is a MA.

> I do plan to discuss with my insurance company how they have agreed to pay

> for Xolair. My husband's company just changed to United from Blue Cross, and

> BC had agreed to the " chemotherapy " designation, which I think is a crock.

> Just because this is a relatively new and very promising treatment for a

> chronic condition.

> Sorry, but sometimes I feel that patients are taken advantage of.

> And I work in health care.

> Thanks for letting me vent.

> Carol

> '

>

>

[Guest guest]

Barry - (have I got that right?) I can't say I have much in the way of details

on medicare and xolair. My pulmo dude set it all up about three years ago. All

I know is that I have to go to the hospital OPSU (outpatient services unit) for

my shots every two weeks. I have to register each month for some reason, a

minor inconvenience. I call ahead to let them know I'm on the way, and they

order the stuff from the pharmacy so I won't have to wait so long. All told,

I'm usually in and out in about an hour. The hospital bills medicare about

$6,000 for the shots every two weeks - I think medicare and BCBS pay a total of

about $1,000, and I don't have to pay anything, except when the coding weinies

at the hospital screw up and I get a bill for something like $50, which is less

painful to pay than fighting with the hospital coders and the insurance

wingnuts. At any rate, medicare EOBs refer only to omal... injections. Wish I

could be of more help.

OP

----- Original Message -----

From: mister_manganese

Sent: Wednesday, March 31, 2010 2:03 AM

Subject: [ ] Re: What do doctors charge

Ohldepharte, since I'll be going on Medicare in about a year I'm very

interested in how you're being treated with Xolair.

Are you being treated with Xolair as a drug (subject to the doughnut hole

under Medicare part D) or as a medical treatment for an illness (subject to the

rules of Medicare parts A or B and your medigap insurance)?

And I agree with you on the raping of the Medicare system which I have seen as

caretaker for my 93 year old mother.

My take on this is that Medicare indirectly helps bear the brunt of health

care for people that have no insurance, and employer-fed insurance companies

that short change the hospitals and doctors.

And yes, there's always the greed factor at work. It's not just in medical

care.

I think Medicare has been one of the most inefficient socialized medical care

programs in the world because it has indirectly morphed into the default

back-door source of government health-care funding for US residents from all

walks of life. And since that was not it's original design, it's done a poor job

of it.

>

> On the other hand, Carol, I have to go to the local hospital outpatient

services department for my shots every two weeks. The hospital bills Medicare

something over $5,000 for these shots each time. Medicare pays a few hundred

dollars and so does BCBS as my supplementary insurance carrier. The total paid

by both is about $1,000 two weeks. As one who has quite a few medical proablems,

I'm always amazed at the raping of the Medicare system by unscrupulous, greedy

providers.

>

> Ohldepharte

>

> ----- Original Message ----- by

> From: Carol Corley

>

> Sent: Sunday, March 21, 2010 8:32 PM

> Subject: [ ] Re: What do doctors charge

>

>

>

> Thanks to you all for replying.

> I think the doctors get big bucks for treating patients with Xolair -- as in

> my doctor earning about $100 for a wonderful MA using a machine to mix my

> Xolair, take vitals, give 2 shots, then let me go on my way. I'm there for

> all of 20 minutes from start to finish, and the only person I see is a MA.

> I do plan to discuss with my insurance company how they have agreed to pay

> for Xolair. My husband's company just changed to United from Blue Cross, and

> BC had agreed to the " chemotherapy " designation, which I think is a crock.

> Just because this is a relatively new and very promising treatment for a

> chronic condition.

> Sorry, but sometimes I feel that patients are taken advantage of.

> And I work in health care.

> Thanks for letting me vent.

> Carol

> '

>

>

[Guest guest]

Thanks for the reply, OP. (yes, Barry is fine ...I go by a lot of names).

It's encouraging to hear that, as a Medicare recipient, you normally don't pay

anything. That suggests to me that Medicare is willing to recognize Xolair as a

medical treatment, not a drug, at least in some scenarios.

Right now my Xolair is being covered under an employer-sponsored prescription

drug plan and I've been concerned that when I go on medicare, Xolair would

continue to be handled as a drug, subject to the disembowelment of the doughnut

hole.

So I'll be talking to my doctor about switching my Xolair shots from a

prescription drug to a medical treatment as I approach Medicare soon.

> >

> > On the other hand, Carol, I have to go to the local hospital outpatient

services department for my shots every two weeks. The hospital bills Medicare

something over $5,000 for these shots each time. Medicare pays a few hundred

dollars and so does BCBS as my supplementary insurance carrier. The total paid

by both is about $1,000 two weeks. As one who has quite a few medical proablems,

I'm always amazed at the raping of the Medicare system by unscrupulous, greedy

providers.

> >

> > Ohldepharte

> >

> > ----- Original Message ----- by

> > From: Carol Corley

> >

> > Sent: Sunday, March 21, 2010 8:32 PM

> > Subject: [ ] Re: What do doctors charge

> >

> >

> >

> > Thanks to you all for replying.

> > I think the doctors get big bucks for treating patients with Xolair -- as

in

> > my doctor earning about $100 for a wonderful MA using a machine to mix my

> > Xolair, take vitals, give 2 shots, then let me go on my way. I'm there for

> > all of 20 minutes from start to finish, and the only person I see is a MA.

> > I do plan to discuss with my insurance company how they have agreed to pay

> > for Xolair. My husband's company just changed to United from Blue Cross,

and

> > BC had agreed to the " chemotherapy " designation, which I think is a crock.

> > Just because this is a relatively new and very promising treatment for a

> > chronic condition.

> > Sorry, but sometimes I feel that patients are taken advantage of.

> > And I work in health care.

> > Thanks for letting me vent.

> > Carol

> > '

> >

> >

[Guest guest]

What is the difference between a drug and a treatment?

> > >

> > > On the other hand, Carol, I have to go to the local hospital outpatient

services department for my shots every two weeks. The hospital bills Medicare

something over $5,000 for these shots each time. Medicare pays a few hundred

dollars and so does BCBS as my supplementary insurance carrier. The total paid

by both is about $1,000 two weeks. As one who has quite a few medical proablems,

I'm always amazed at the raping of the Medicare system by unscrupulous, greedy

providers.

> > >

> > > Ohldepharte

> > >

> > > ----- Original Message ----- by

> > > From: Carol Corley

> > >

> > > Sent: Sunday, March 21, 2010 8:32 PM

> > > Subject: [ ] Re: What do doctors charge

> > >

> > >

> > >

> > > Thanks to you all for replying.

> > > I think the doctors get big bucks for treating patients with Xolair --

as in

> > > my doctor earning about $100 for a wonderful MA using a machine to mix

my

> > > Xolair, take vitals, give 2 shots, then let me go on my way. I'm there

for

> > > all of 20 minutes from start to finish, and the only person I see is a

MA.

> > > I do plan to discuss with my insurance company how they have agreed to

pay

> > > for Xolair. My husband's company just changed to United from Blue Cross,

and

> > > BC had agreed to the " chemotherapy " designation, which I think is a

crock.

> > > Just because this is a relatively new and very promising treatment for a

> > > chronic condition.

> > > Sorry, but sometimes I feel that patients are taken advantage of.

> > > And I work in health care.

> > > Thanks for letting me vent.

> > > Carol

> > > '

> > >

> > >