Question:
How do I effectively challenge my hospital billing?

During my Open long-limb retrocolic Roux-en-Y bypass surgery there was a complication. I am not in the medical field so I certainly am not a expert in any way. I will copy from my operative report. "The distal stomach was divided after two TA-90 staplers had been placed across the approximately 4 cm long stomach margin. These were tightened into position and fired. The stomach was divided between staple lines. Immediately, the proximal pouch spacer was removed. The staple line bled quite significantly and required an oversew to complete the line. This was done with running 3-0 PDS. The stapler was then released from the lower pouch. Immediately, bleeding began along the greater curvature portion of the staple line, and gastric spillage was evident. The stapler had misfired. The entire staple line was grasped with Babcock clamps and oversewn with 3-0 and then oversewn again with 2-0 PDS suture." I was not aware of any of this until today, over 2 months after my surgery when I obtained a copy of my operative report. I then looked over my bill statement from the hospital and saw that the TA-90 Staplers and cartridges were bill to me and they were very expensive. Should have to pay for something that apparently did not work properly "misfired"? Additionally should I have to pay for other costs associated with the correction of the TA-90 staple misfire, ie. additional OR time? I am not sure this is the correct forum for this question but I would appreciate any comments or input. Thanks in advance.    — Michael T. (posted on July 23, 2003)

July 23, 2003
Michale - email me offline @ [email protected] I worked in medical billing for 14+ years and can probably help you. Barb Open RNY 4/07/03 235/175/126-130
   — Barbara C.

July 23, 2003
Did you have to pay out-of-pocket for the stapler and the cartridges or was your insurance billed and your insurance company paid? If you had to foot the bill then you should find out what company makes the stapler that misfired and have your lawyer contact that company. The company should reimburse you for any out-of-pocket expense you had due to the stapler being defective or compensate you IF you suffered problems due to the misfire (i.e. extended hospital stay, increased pain, loss of blood needing iron or blood tranfusion, etc.). The hospital should have filled out a form regarding the defective equipment and then the hospital would have been reimbursed for the cost of the extra stapler and cartridges and then should not have charged you.
   — Kristen S.