My doctor is out of network on my insurance plan and I would like to know how much doctors are being paid for this surgery from insurance companies.
Stay with in network. If not you are looking at around 100k plus
Wow ! Is that how much your insurance company paid your doctor for your TKR? Where did you come up with this amount if it is not what your insurance company paid?
I am on Ohio and had a right knee replacement and all together with hospital stay, pt, meds anesthesia, the actual implant and Surgeon fees and miscellaneous about 50K.
Deb from Ohio and that was in network...I had a great Surgeon and entire experience. 8 weeks out now!
I am on Ohio and had a right knee replacement and all together with hospital stay, pt, meds anesthesia, the actual implant and Surgeon fees and miscellaneous about 50K.
That is a rough estimate. It all depends on where you have it done. I had my done in pa. Bills totaled around 100k. Now we all know what is billed versus what is paid.
Is that what you paid or insurance paid
Again that is what the bills were, not what I paid. But with,out of network you will pay a pretty pennie. Go on line and look at your insurance info it will tell you what you need to pay out of network. My guess will be if you use an out of network doctor you will need to pay because it was not an emergency.
Reimbursements run differently depending on how the practice is set up. Some are owned by hospitals, some privately. You have to take so many things into consideration......the paid reimubursement in my area where I go is around $12000. However, the Dr gets nowhere near that in his pocket. He is paid a salary and some form of profit split. These things are so structured and planned you see a really good surgeon with tenure will make more than a guy with just a few years in practice. Unless you actually saw a Dr's contract you haven't an idea what he's actually making. Before people become obsessed with Dr's salaries, many of these people come out with school loans of over $100000.
I paid about 6K Tom....
I often wondered how much my bilateral TKR and 6 day hospital stay would cost if I had to pay. Based on these numbers - OUCH!!! As a Canadian it cost me nothing.
I heard $1400.
In New Jersey non medical people get more than that for busting them up......right Chico?
Sorry, my bill was for $46,000. Medicare according to my doctor said he only gets $1400. And he was bitching because he said Medicare cut it down to that. I m in fla.
This is just a comment for any UK people looking in - if you are horrified at these figures being quoted, you are right to be!
In mainland Europe the charges are IRO 11,000 euros - that is the entire charge inlcuding hospital room charges, surgery, rehab and medication.
In the UK? NHS, no charges at point of delivery. If the NHS is privatised? Anyone's guess.
I believe your doctor is correct, I have also been told that is all a Doc gets paid through Medicare. Docs in network do not get a whole lot more from what I have heard. I was hoping that someone would have an EOB where it shows exactly the amount that was paid to the Doc for the surgery in New Jersey. Thanks for the responce.
As far as I know all Insurance Compaines have to send out an EOB (explination of benifits) which shows the exact amount paid to the doctor. I am not debating or obsessed with how much anyone makes all I was asking was if anyone knows for a fact what their Isurance paid the Doctor for a TKR in New Jersey. Thanks anyway.
EOB shows what its paid to the practice, in essence. For example, my wife recently fell and broke a hip. The PHR was done by a Dr in a practice that is owned by a hospital. The billing and payment shows the payment going to the dr when it actually funnels into the hospital and the Dr is paid a base salary. Again, really hard to tell how you could divide everything up to know what the Dr is being paid on an individual basis. About the only way you would ever really know is off The Dr was a lone wolf in a private practice. Not may if any of those left.