Hospice Charges to Medicare

16 years ago

My MIL with end stage colon cancer signed on with hospice in mid June. She had a nurse and a social worker that visited her once a week.

They took her BP and temp and just visited with her for about 10 minutes, if that.

In the beginning of August she got worse fast and hospice then came twice a week.

Four days before she died on August 16 they sent over a hospital bed and a different nurse came with the heavy duty drugs for pain.

We hired our own 24 hour care for her.

All of her meds and supplies were paid 100% by her insurance.

Hospice made a total of 13 visits with her from mid June till she died on August.

We just received a copy of the statement where hospice billed medicare......just under $13,000.00.

Granted hospice provides wonderful service and support, but I am inclined to think that $13,000 is alot.

It's not like they were caring for her, or were ever there for more than 10 minutes.

For anyone that has dealt with hospice, does this sound like normal charges?

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Comments (16)

monica_pa Grieves
16 years ago
I can't remember what hospice charged for Frank, and my mother was only 4 days with hospice care.
But, I think they probably charge a flat fee, regardless of the number of visits, or length of visits.
What you pay for with hospice is also the 24 hour on-call availability of medical help, the administrative work for reporting to doctors, ordering medications, etc. and you also have to count in travel costs for the visiting professionals.
donna_oh
16 years ago
Jenni, My DH had hospice for 2 days & I really can't remember what the bill was. I do know that Hospice helped him more then any doctor!

Why not call Hospice & ask them, then you can let us know! The charges really do sound rather high!

Donna (^_^)
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nodakgal
16 years ago
DD said those charges wouldn't surprise her. They had hospice for Steve for a couple months before he died. In the begining not as often as toward the end,they were there almost every day and DD did alot herself. They were a huge help with the lift, hospital bed, IV pumps and lots of things. I shudder to think of what his bill was. I don't know if insurance paid or helps pay any of it. The aids and nurses were great to both Steve and Jasmine and after his death too. Kind and caring but wow I had no clue on this!
gadgets
16 years ago
I'll have to ck with my sister to see if she remembers charges for her husband. It's been almost 3 yrs since his death so she might not remember. They were absolutely wonderful with her. And just a couple of wks ago one of the hospice gals took her to lunch....after all that time.

Shirley
gillian_41
16 years ago
I had Hospice for 5 months for my husband the charge to Medicare was $3,000.00 a month, they took care of all meds and supplies needed, as he was up and around until 2 days before he died did not need beds, walkers ect. They were wonderful people to deal with had all kinds of different services to offer, and our favourite nurse still calls and stops by to visit me if she is in the area.
Gillian.
yborgal
16 years ago
Just because Hopspice billed Medicare for that amount doesn't mean Medicare paid that much. Generally, Medicare has a set fee schedule for services and that's what they pay. Anything over and above that is written off.

This applies to doctors as well. A doctor can bill your insurance company, say $350.00, for a check-up but if the insurance company only allows $35.00 for the visit, the doctor writes the balance off.
kacram
16 years ago
Hospice was worthless in my mom's instance. Don't even know why they bothered the few trips.
Terri_PacNW
16 years ago
Monablair..or charges you if it's allowed by your insurance..
Lindsey_CA
16 years ago
Jenni, does the $13,000 represent a total of all charges? That is, does it include the medications, durable medical equipment, etc.? If so, the $13,000 doesn't seem too horrible. If it's just for the person's visits, but not anything else, then it's outrageous.

I know you said that her meds were covered by her insurance, but that wouldn't necessarily prevent the hospice service from billing again for the meds. Medicare would disallow those charges as a duplicate billing.
yborgal
16 years ago
terri, that's true but more so in the past than now.

Most doctors nowadays are contracted with insurance companies to be willing to accept payment in the allowable amount stipulated by the insurance company.

I honestly can't think of a current insurance company that is the old-fashioned traditional type, but maybe there still are some out there.
jenni_ca
Original Author
16 years ago
Lindsey it does not include any meds and the only equiptment was a hospital bed for 4 days. She had Kaiser and they paid 100% of everything. She had no co-pay and she didn't pay a cent for any tests, treatments or medications.
What hospice billed for was stricly their time.
Lindsey_CA
16 years ago
Goodness, they ARE being greedy, aren't they?! You said there had been a total of 13 visits and you mentioned a social worker and a nurse. So, if it had been 13 visits by each, that would be 26 visits, into $13,000, for a charge of $500 per visit!

Did you just see a "lump sum" bill, or is there an itemization? If just a lump sum, I'd firmly request that they provide an itemized billing, to see exactly what they feel adds up to that amount of money. They very well could have errors on the bill, and you are totally within your rights to dispute any item. Too often people get outraged at the amount, but then figure, "oh, well, the insurance will pay for it" which is part of the reason why insurance costs have skyrocketed. Kudos to you for questioning the amount.
jenni_ca
Original Author
16 years ago
All we recieved was a statement of the charges for 6/19-7/19 and one for 7/19-8/16.
There were no itemizations at all for anything.
The social worker did not come as often as the nurse. She came a total of 8 times.
I just think it's alot of money for what they did.
Up until about 5 days before she died she did not require any care at all. She was completely mobile and totally taking care of herself.
Even the last few days the caregivers we had there were doing everything she needed.
To be quite honest, everytime hospice came it was more like a social call...someone visiting her and taking her vitals and chatting.
We are going to request an itemized statement.
monica_pa Grieves
16 years ago
To be quite honest, everytime hospice came it was more like a social call...someone visiting her and taking her vitals and chatting.

That's a normal hospice visit. one of the objectives of hospice to stay away from a cold, clinical approach to a "patient", and instead get the information they need via conversation with a "person". During those chats, they were observing her physical movements, color, and looking for any subtle signs of pain that the person is not complaining about.

Pain management is their forte.
Lindsey_CA
16 years ago
"Pain management is their forte."

Yes, the purpose of hospice is to keep the patients comfortable until their death. Generally speaking, once a patient is put into hospice care, nothing more is done to extend their life - only to make their remaining time as pain free and comfortable as possible.

Hospice care also provides a respite for the caregiver(s).
monica_pa Grieves
16 years ago
About a month before his death, Frank wanted to go to our favorite restaurant at the mall, for a steak dinner. He had lost the use of his legs, and needed to be lifted into and out of a wheelchair and the car for any transport.
Hospice provided a volunteer who did all the heavy work for us, and Frank got his dinner, and a spin around the mall for what he knew was the last time.

Although the man was a voluteer, it takes time and effort to coordinate little "extras" like this.

PS - We insisted our helper join us for dinner, and the three of us had a great time.

Hospice Charges to Medicare

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