Sometimes it hurts to question bills

[boondocks777]

I’m a first time mom and gave birth in December of 2021. When we finally got the bills I noticed that on my daughters bill it had nursery charges (level 1) on it. In my mind since she was in our room the whole time and never went to the nursery we shouldn’t have those charges. So I called up the hospital and asked about the charges but instead of just explaining that these are just basic room charges for the baby they sent it to the nurse auditor to get re-examined and they “fixed” my nursery charge from a level 1 to a level 2, which changed the nursery charges from $1.3k to $9.4k.

I have been back and forth with multiple people from the billing and patient advocate groups but they’re refusing the reverse the changes.

So moral of the story…you can question your medical bills but it might not work in your favor.

EDIT: In the sense of billing transparency I figured I would add in the EOB for my daughter's hospital bill. In total her bill is now $14,070.40 my insurance covered $12.827.60 and I owe $1,242.80. I think I had only owed about $500 before but I don't have a record of my after insurance before they changed the bill. Keep in mind this is just her bill so I still have to pay on my bill which was like $33k before insurance.

Laboratory - $1,755.00

Hc Bilirubin Total - 82247 (CPT®)

$121.00

Hc Cbc With Differential - 85025 (CPT®)

$194.00

Hc Antihuman Globulin Direct Each Antiserum - 86880 (CPT®)

$262.00

Hc Cbc W/o Differential - 85027 (CPT®)

$154.00

Hc Bl Smear W/diff Wbc Count - 85007 (CPT®)

$71.00

Hc Culture Bacterial Blood Aerobic W/id Isolates - 87040 (CPT®)

$420.00

Hc Newborn Metabolic Screen - S3620 (HCPCS)

$156.00

Hc Bilirubin Total - 82247 (CPT®)

$121.00

Hc Collect Capillary Finger/heel/ear Stick - 36416 (CPT®)

$40.00

Hc Bilirubin Total - 82247 (CPT®)

$121.00

Hc Bilirubin Direct - 82248 (CPT®)

$95.00

Medical/Surgical Supplies and Devices - $44.80

Hc Sensor Neonat Lncs 36in Finger Oxm Adh Low

$44.80

Nursery - $9,308.00

Hc Newborn Care Level Ii

$4,654.00

Hc Newborn Care Level Ii

$4,654.00

Before I called attention to this line item this category was:

Nursery - $2,086.00

Hc Newborn Care Level I

$1,043.00

Hc Newborn Care Level I

$1,043.00

Pharmacy - $516.60

PHYTONADIONE PER 1 MG (76329-1240-1) - J3430 (HCPCS)

$211.20

ERYTHROMYCIN 5 MG/GRAM (0.5 %) OINT 1 G TUBE (24208-910-19)

$95.30

HEPATITIS B VIRUS VACCINE (PF) 10 MCG/0.5 ML SUSP (58160-820-52) - 90744 (HCPCS)

$210.10

Preventive Care Services - $153.00

HC ADMIN VACC INJECT SGL OR COMBO VACC 1ST - 90471 (CPT®)

$153.00

Pulmonary Function - $144.00

Hc Zz Pulse Ox Single - No Replacement - 94760 (CPT®)

$144.00

Respiratory Services - $2,149.00

Hc Attn At Delivery 1st Stabilization Of Newborn - 99464 (CPT®)

$1,362.00

Hc Chest Percussion/vibration, Initial - 94667 (CPT®)

$787.00

 

[lllgt]

@boondocks777 I’m confused if she never left your room how did it go from level 1 to level 2?

 

[marlee12345678]

@lllgt NICU levels are partially determined by the amount of nursing care the baby requires. If baby is generally healthy, but for some reason requires more attention from the nurses or doctors, then a level 2 might be appropriate.

 

[boondocks777]

@lllgt They’re reasoning for the increase is due to needing additional oxygen and blood sugar monitoring, but outside of a handful of blood samples pricks after delivery I don’t remember a ton of additional things. She did have mecomium aspiration and had to spend and hour in the NICU for observation which I’m assuming is where this is coming from. I just don’t understand what it was originally billed at a level 1 if they’re claiming my it should really be a level 2.

They’ve also been super confusing about the explanations. The first response I got from them when I realized they increase the charge was that it was based on the care needed for the mom (they claimed I had hypertension, which I only had like 2 high bp readings the whole time).

 

[lllgt]

@boondocks777 Ohhh ok that does make more sense if she went to the nicu, even though it was a short stay. Sorry!! I would still see what you can do to get that lowered.

 

[katrina2017]

@lllgt They billed my grandpa $11k for an overnight stay in the hospital because he mildly bumped his head. At the time my dad was ok with it because he didnt want to risk my grandpa having a brain hemorrage and dying, but months later we realized it was all probably bs…also the dr didnt wanna release my grandpa because he had a BAC of .39…we had a hell of a night

 

[fez]

@boondocks777 Share it with NPR; they may investigate on your behalf and turn it into their series on medical billing craziness. Bad press coverage usually gets the attention of hospitals!

 

[boondocks777]

@fez I think I will! Thanks for the suggestion!

 

[dolomite1]

@fez Wait, did you read her follow-up? Her baby had mec aspiration, needed respiratory intervention, and had to be stabilized in the NICU. These are all interventions beyond standard newborn care. I’m all for calling attention to legitimate issues and 100% endorse that healthcare costs in the US are out of control, but I don’t get recommending call the media when the hospital appears to absolutely legitimately adjusted the bill.

 

[risensoul]

@boondocks777 It was explained to me that the nursery charges are for the monitoring by staff and supplies even though baby stays in room. The care for baby and necessary supplies hasn’t changed since getting rid of the nursery they go to. Then to be honest I did send my guy there the first night as I needed sleep and they just brought him to me to eat.

 

[doctored]

@risensoul You don't have to defend yourself for sending your baby to the nursery. We would have sent him every night if we had known about it. A nurse took it upon herself to not tell us about it because she doesn't believe it's the best thing for nursing babies. That bitch. I went through 40+ hours of labor and an unplanned c section for this lady to decide I'd be a bad mom if I needed to sleep a few hours uninterrupted.

 

[risensoul]

@doctored Oh no! That’s awful. Moms recovery is most important for baby and successful breastfeeding. I was blessed with my nursing staff and overall experience. They thankfully offered when they saw how exhausted I was. I remember sitting there wondering how on earth I would survive the first night

 

[churchreallyismylastname]

@doctored Mine didn’t even HAVE a nursery. Still pissed.

 

[marciemay]

@doctored It happened to me too. The nurse went one step further and told me I have to start taking care of her now as I will be alone at home from the next day. All this after 3 days of labor and unable to even sit without a donut pillow!

I still resent her so much!

 

[doctored]

@marciemay Agreed! My lactation consultant told me that I shouldn't use the nursery because I need to make sure we develop a good patch like right now. And that sending him there would pretty much make me a selfish mother

 

[marciemay]

@doctored I hate how they make it so difficult for new moms..

 

[wordnord]

@risensoul I wish I could have!!! They took away the nursery option at my hospital. I think it’s super important for the mom to rest up as well!

 

[oldhermit]

@boondocks777 It’s more expensive to keep the baby in the same room? I’m so sick of being screwed by healthcare expenses.

 

[katrina2017]

@boondocks777 Can you try talking to your insurance? They may not appreciate being wrongly charged either- worth a shot!

 

[yahsrule]

@katrina2017 Second this. If your insurance is paying part of the new higher bill, they might become surprisingly helpful on figuring out if the charge is valid (coded appropriately.) Worth a shot.