Hospital Charges Plan G

[vic120]

I have Husb Wife clients on Plan G, The Husb passed in hospital, And wife gets a bill for $1,450 When I called the hospital they said it is probably self-administered drugs Does that sound right?

The other part I don't like is they can't tell me for sure what it is only that they are 80 % sure that it is for self-administered drugs but not 100% sure that is what it is, But they will send a new itemized bill to the client,

Still, $1,450 for self-administered drugs seems like a lot, And if it is true does Part D cover at all or is it all on the client?

 

[somarco]

Haven't found it yet, but I believe the hospital is allow to (over)charge for self admin drugs while a hospital inpatient. Staff is required to note drugs in medical records taken as inpatient even if staff does not administer the drugs.

https://www.cms.gov/outreach-and-education/outreach/partnerships/downloads/11315-p.pdf

This from UHC although it applies to THEIR MA plans might offer some insight
https://www.uhcprovider.com/content...-guidelines/s/self-administered-drugs-sad.pdf

http://www.hcpro.com/HIM-44956-859/Selfadministered-drugs-excluded-from-Medicare-coverage.html


Self admin drugs in hospital outpt setting
https://www.medicare.gov/pubs/pdf/1...Administered-Drugs-in-Hospital-Outpatient.pdf

Office of Inspector General Authorizes Hospitals to Discount or Waive Certain Drug Charges for Patients Classified as “Outpatients”  || Center for Medicare Advocacy

 

[LostDollar]

I was charged $26.50 by the hospital for a single pain pill as an outpatient. I wondered at the time why the nurse was so careful to see I handled the pill and the water glass myself. I found out when I got the bill.

I don't remember what those cost when I filled the prescription later, but it wasn't very much, so yes I could believe $1,500 for self administered drugs in a medical situation resulting in a patient's death.

(kgmom said I could turn the bill in to my part D plan and get reimbursed 6 cents for the pill. I didn't bother.)

 

[LostDollar]

On mine, I could see billing detail on the medicare EOB and the Med supp EOB too (I forget technical names for those).

 

[vic120]

On mine, I could see billing detail on the medicare EOB and the Med supp EOB too (I forget technical names for those).

I only just seen the medical bill, My wife usually handles this stuff she called the hospital, Looking at it there is a charge for like $585 under self-administered dugs and there are like 5 other drug charges that amount to like $3000, I can't figure any combo to equal $1,450

This was full bill includes the other hospital charges all totals and Medicare and med supp pays and shows leftover of $1450

But they won't tell me more only that they will send a specific itemized bill to the client

Have to wait and see on snail mail

 

[somarco]

Check the Medigap EOB as well. Between Medicare Summary Notice and EOB you MAY be able to get closer to the truth.

FWIW my wife was recently in the hospital. Three or four Rx charges. Other than via IV neither of us recall her getting/taking medication.

Sometimes the doc will order med's which are administered PRN. Odd how those that are never given to the pt stick to the charges and are never reversed.

It may take some detective work on your part and theirs to get to the truth.