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Cost of having a baby at GBMC? IS this right?
So I just got a letter from Charles St OBGYN, which is where I have been going while pregnant... and they want an $840.00 deposit. They said this didn't even include any charges that may come from GBMC after having the baby. I have until the 7th month to pay, but is this really right? Do you pay this much on top of paying for hopsital costs? How much are the hospital costs going to be? I have BCBS insurance and I have never heard of this much money!!! AHHH, I'm thinking I'm going to pay $840.00 then pay a ton of copay's and then pay $1,000 or so dollars in hospital fees?
Any feedback?
Thanks 
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Re: Cost of having a baby at GBMC? IS this right?
I went to Charles Street OBGYN thru my pregnancy and loooved them....but that's another story. What you are experiencing is not the practice...that's your insurance. I have Cigna and I will tell you what I paid throughout the entire pregnancy.
Office fee for paperwork (one time only) $35 I think?
I never had any copays for any of the numerous visits, even for the dating u/s out of the office, NT scan at the hospital, or anatomy u/s at the hospital. The only copays I was billed for after my baby was born was $40 for each in-house sonographer visit at the end of my pregnancy. I was high risk and required two u/s a week during the last few weeks. It was considered a specialist visit, even though it was deemed medically necessasry. I did fight the office billing staff and my insurance company on it after DD was born, but it just wasn't part of the pregnancy package Cigna has.
For GBMC, I had a normal, vaginal delivery, with an epi, and was in and out in less than two full days. I got multiple bills/statements after DD was born with nursery costs, labor and delivery costs, post partum costs (I think the total was 8K maybe...again, with no complications), but I was only responsible for my deductible...$200/day, pay up to a max of three days. GBMC also hits you with a tv and phone charge...I think that totaled $50 that we also had to pay to the hospital after we got home.
I then had to pay a copay for the 6 week post partum office visit since I wasn't pregnant anymore and thus, not covered under Cigna's pregnancy package.
I have bcbs (is it carefirst?) and paid nothing for my first birth and have paid nothing so far with this birth. I never paid any hospital fees for my first birth. And no co-pays so far. I think maybe I had to pay $10 in lab fees for genetic testing for my age, but I think that is the normal co-pay
Is the practice considered "out of network" for bcbs ?
Call the insurance company FIRST. What happens is that medical offices send you the bill (sometimes it says late notice when you never get the first bill), you pay not wanting to be late and mess up your credit, and then insurance pays the doctors office later, so they get paid twice, once by you, once by the insurance company. And then the doctors office takes a looong time paying you back. It's happened many many times to me, and BCBS just said to me - don't pay the bill, call us first to make sure it's covered and in process of payment. My mom also worked in medical billing, it happens a lot that they send bills right away before insurance has a chance to send payment. They have your insurance information, but it doesn't mean they actually submitted it right away or got money from them right away.
You should talk to the Benefits Counselor at the company where you have your insurance. (If through your work contact HR and they will direct you to the right person.) Alternately, you could ask to speak to the office manager at your doctor's office. Either of these people should be able to sit down with you and explain what your portion of the dr and hospital bills will be.
Since your doctors office works with the insurance company a lot, they have a pretty good idea of what an uncomplicated vaginal delivery will cost and they have calculated that your likely patient responsibility will be $840.
From what you say above, I am going to take an educated guess. I believe that your insurance has a co-pay AND co-insurance. This is extremely common with PPOs and Fee-for-Service insurance plans. Co-insurance amounts are usually 80/20 or 90/10, meaning the insurance company pays 80 or 90% and the remaining 20 or 10% is called the patient responsibility.
Here is an example of how an insurance policy that includes co-insurance works:
Insurance company ABC's Maternity coverage plan:
$50 co-pay for specilist visits. However, Patient only pays a co-pay at the first OB appointment, there is no co-pay thereafter.
Sonography is paid for at the specialist rate, but only if done at a plan radiology clinic. (eg cannot have sonogrphy done at the dr office.)
Medically necessary lab work requires no-copay.
$100 co-pay for hospital in-patient admissions. There is a 5 day cap on co-pay's per admission. (eg if you are there 6+ days, you no longer owe a co-pay for each day after day 5)
Maternity coverage under the plan is covered 80% and patient co-insurance is 20%.
Delivery: The patient has an uncomplicated vaginal delivery at hospital XYZ . Patient is admitted and delivers on day 1, and is in post-partum for 2 days, for a total hospital admission of 3 days.
Billing: The hospital bill is $5,000 (totally made up!) and the doctor's fees are $1,000 (again made up.)
The patients portion of the bill is as follows:
CO-PAYS-
Co-pay for pre-natal visits $50 x 1 (only pay the first time, no co-pay thereafter)
Co-pay for sonography $50 x 2 (at radiology clinic)
Inpatient Hospital Co-pay = $100 x 3 day admission (day in labor, + 2 days post-partum)
Total co-pays = $450
CO-INSURANCE- (80/20)
Hospital bill- $5,000. Hospital deducts the 300 co-pay for a total balance of $4700. Insurance pays 80% or $3760, patient responsibility 20% or $940.
Doctor's Bill- $1000- Insurance pays 80% or $800 and patient pays 20% or $200
For this example:
Total co-pays paid by patient- $450
Total co-insurance paid by patient : $1140
TOTAL Patient costs = co-pay ($450) + co-insurance ($1140) = $1590
Total paid by Insurance: $4560
Again these numbers were TOTALLY made up so that the math would be easy...
(Assuming the $840 you were quoted represents a 20% co-insurance, that means the total doctor's bill for a vaginal delivery is $4200, and your insurance company will pay the other 80%, or $3360.)
Francesca Pearl is here! Josephine Hope is almost 3!
Agree with pp regarding it depending on your insurance. I worked in billing in an OB office and it was my job to figure out how much the patients would owe and set up a plan to pay it up front. Some patients have a copay for each visit, but with the amount you have to pay, my guess is you have a high deductible or coinsurance (where insurance cover part and you cover part, usually 90%/10% or 80%/20%).
Not sure if they explained, but pregnancies are billed "globally". This means that all visits (with the possible exception of the first) plus the dr's services at the delivery and PP visits are billed at one time after you deliver. They are estimating how much you will owe. Unfortunately, all too often the dr sees a patient 10- 12 times for prenatal visits, delivers the baby, then sees the patient at least once for post partum and when the bill goes out they never get paid. I am not suggesting you would do that, just explaining they have to protect themselves when they invest that much time. You would be shocked at the number of patients that just ignore the bills or flat out say they aren't going to pay.
Also, I think you said they mentioned it, but that amount is only for your OB's services. The hospital will bill you separately, as will the anesthesiologist, and any places where you have ultrasounds and tests done. If you have any questions, I'd be happy to try to help!
I'm with a different OB office but delivered at GBMC. I received a letter from GBMC saying they estimated the cost & that I could pay them at that time, put money down or just wait to receive the bill after he was born. I just waited. The only thing I paid upfront was the copay when we got to the hospital.
As for the bill after leaving the hospital, mine was $1183
Find out what your yearly out of pocket is for your insurance and then check your maternity coverage also.
With E, I paid $10 and that was it. Well, we have new insurance now and for any next baby our yearly oop is $3000, so that's what the next one will cost.
It sucks.
Thanks so much for the information.. that is so helpful!! You get pregnant and then all of this information is thrown at you at once.... makes me nervous.
P.s. I like your debt free ticker, we are trying so hard right now to have everything paid off before the baby gets here, but you know that is soooo hard to do!
Farintea, how far along are you? I am going to Charles St OBGYN as well. I got a bill from them today for a $50 administrative fee. I am now curious to know if more is coming our way!I will be calling my insurance to double check our coverage!
I have only been in once so far, to meet with the nurse practitioner, do you like the doctors? We really want to deliver at GBMC (its where I was born!) and needed a doctor with evening hours so I wouldn't have to use all the leave time I have saved up for baby!
Just wanted to chime in on Charles St OBGYN. I absolutly LOVE THEM! I've been going to them since I was 15 and through out my entire pregnancy but I didn't realize how special and amazing they were until the end of my pregnancy. I had a normal/simple pregnancy up until 36 weeks. At that point, everything started to fall apart and I have no idea what I would've done without all 3 doc's and Gloria leading me through everything. Each one of them had a key role in my delivery and recovery. I ended up (unfortunately) having a C/S w/ Dr. Erdman. She made a very scary and unplanned situation very calming. Every nurse that asked if Dr. E was my doc based on the quality and precision of my incision. Evidently she is well known around there for that. Dr. Ottenritter got to calm me down when I went through a brief period of PPD and guilt b/c DD was early. He spent about 20 minutes on a Saturday morning in my hospital room just talking to me and explaining it was not my fault. When it came time to go home and my nurse was acting like a fool, Dr. Singh was amazing and helped calm me down and get me home.
I would recommend this practice to anyone. Congrats on your pregnancy and good luck!
Little late but - I got a letter from my OB/GYN that they charge $3000 for L&D and I would be responsible for about $500k so they asked me to pay up front. I also got and admin fee of $15 for FMLA paperwork. They said this has nothing to do with the hospital I would be billed for that later.
I agree with the PPs about contacting your insurance or maybe referencing your insurance book to see how pregnancies are covered.
I just paid it, I figure I would have to contact the dr and find out what they charged for the visits as well as the hospital or L&D portion from the drs. I have a $1500 limit and I figure I will reach that with all the dr. bills.