death during surgery

[teedub]

alright, i figure somebody here among us posting losers (really, don't we have stuff to learn here??) can figure this out for me: if somebody dies during surgery, do they (or their insurance) still have to pay for the operation??

holla back

 

[duke05]

why would they not need to pay? if the patient dies, the hospital has still incurred costs in its attempt to keep him/her alive. imagine if some operation had a >50% mortality rate. Why would the hospital perform any risky procedure at all then, if they were to risk going under for it?

my 2 cents, i don't know the actual policy though

 

[Mutt]

Although Duke05's reasoning is sound, I doubt (unless insurance is involved) that a hospital would get a family to pay for a surgery that resulted in the loss of their loved one. Granted, paperwork that was signed may include a release of liability with regard to lawsuits for the resulting death, I doubt they also include a clause stating that payment is due in full whether or not the person survives. It should be that way, but I think somehow mercy might make it's way into the exchange.

 

[edfig99]

alright, i figure somebody here among us posting losers (really, don't we have stuff to learn here??) can figure this out for me: if somebody dies during surgery, do they (or their insurance) still have to pay for the operation??

holla back

if a patient is insured, than an effort will be made to bill the insurance, irrespective of outcome. when you "register" as a patient, one of the many forms signed (besides an attempted release of liability which is usually not binding) is an authorization to contact insurance companies for payment of services render, and further, that you will pay for services deemed by the insurance company to not be covered.

if a patient is uninsured, believe it or not the hospital will attempt to collect payment on the services rendered (my wife has dozens of bills from when her father died and was still getting them even 2 or 3 years after he died, the last one being $25 for the tv and phone in the room!) since no one else was named as "co-responsible" for payment, the letters were simply "returned to sender -- person deceased" 🙂 for a spouse, it may be different, i'd have to check with one of my billers to find out...

ed

edit: so when the hospital doesn't get paid, the estate of the deceased individual can be sued to recoup payment. whether or not they go through this everytime someone dies with a bill, i'm not sure...it may depend on the dollar amount, or they can write it off...sorta depends on how stable the hospital is financially, and whether or not they want to use up those resources pursuing payment.

 

[Psycho Doctor]

if a patient is insured, than an effort will be made to bill the insurance, irrespective of outcome. when you "register" as a patient, one of the many forms signed (besides an attempted release of liability which is usually not binding) is an authorization to contact insurance companies for payment of services render, and further, that you will pay for services deemed by the insurance company to not be covered.

if a patient is uninsured, believe it or not the hospital will attempt to collect payment on the services rendered (my wife has dozens of bills from when her father died and was still getting them even 2 or 3 years after he died, the last one being $25 for the tv and phone in the room!) since no one else was named as "co-responsible" for payment, the letters were simply "returned to sender -- person deceased" 🙂 for a spouse, it may be different, i'd have to check with one of my billers to find out...

ed

yup sadly, that is absolutely true. 🙁 money hungry institutions

 

[greendot]

If one is uninsured, wouldn't the hospital attempt to bill the patient prior to surgery, except for acute emergent situations?

 

[BaylorGuy]

I don't know if any of us have any idea about this...i'll ask some of my co-workers at work tomorrow (Anesthesiologists).

 

[ShyRem]

Yes, greendot, many hospitals require patients to pay "upfront" for all but emergency surgeries. Also true for many procedures and tests - if you are uninsured and need a non-emergent MRI or CT scan, you may be required to pay up front.

 

[edfig99]

If one is uninsured, wouldn't the hospital attempt to bill the patient prior to surgery, except for acute emergent situations?

well they can't bill until the services are actually rendered. so for something elective i've seen surgeons just push off patients to use city hospitals where the rates are much lower than at a big tertiary center. alternatively, the surgeon might waive his fee if the patient can produce the facility fee or some portion thereof. if the patient proceeds with surgery when they are uninsured, then they will have signed a form saying they agree to pay for all charges incurred during the procedure. they'll work out some payment plan or something.

where they get screwed is that insured patients get charged rates MUCH lower than what an uninsured patient gets charge because of the contract agreements they make with the plans. so for example, let's say the hospital normally charges $3000 for an appendectomy...Plan A may get charged $3000, but the hospital agreed to take payment of $1500. Plan B, same deal, but they may pay $1800. What's the uninsured patient getting charged? maybe 4 or even 5000. Why? Because they lost money for taking Plans A and B, so they try to recoup it from the uninsured. there have been dozens of articles written about this you can probably google.

 

[IgweEmeka]

yup sadly, that is absolutely true. 🙁 money hungry institutions

money hungry institutions feeding money hungry physicians. Bro, thats life. You pay for services rendered under a contract. Think of whether this said institution would still exist if all costs for surgeries resulting in death were overidden. I don't think SDN would exist. My $0.02.

 

[duke05]

Although Duke05's reasoning is sound, I doubt (unless insurance is involved) that a hospital would get a family to pay for a surgery that resulted in the loss of their loved one. Granted, paperwork that was signed may include a release of liability with regard to lawsuits for the resulting death, I doubt they also include a clause stating that payment is due in full whether or not the person survives. It should be that way, but I think somehow mercy might make it's way into the exchange.

You need to make the distinction between a surgery that resulted in the loss of a loved one and surgery where a loved one was lost. Of course if the surgeon/hospital was at fault, the hospital may offer some monetary compensation. But it is a common occurrence for patients to die at the fault of nobody, and there is no way any hospital would still be standing if they absolved all charges incurred..

 

[it.]

i've killed mice during surgeries...quite irrelevant to the topic at hand, but i'm important, so...

 

[Medinsane]

interesting topic!

 

[Law2Doc]

yup sadly, that is absolutely true. 🙁 money hungry institutions

Not sure how it is about being money hungry. Nearly all hospitals operate at a loss. The hospital and staff incurred costs in performing the surgury (the bed space isn't free, the doctors time isn't free, all equipment, chemicals, blood used needs to be cleaned or replaced). There was a ready supply of patients the hospital and staff could have treated in that time and space, which was contracted for by the surgury recipient. The health field doesn't work on a contingency fee basis -- i.e. they don't guarantee their results will be satisfactory or else your money back. No health facility runs under the only pay if you live policy (to do so would basically eliminate the ability to get surgury or significant healthcare for all elderly, infant, imuno-compromised, and other higher risk groups) -- mortality is the sad part of medicine. If the hospital didn't meet the reasonable standard of care, the patient's family will have other recourse (in a courtroom), but otherwise, the hospital provided the service for which it was engaged, and after an appropriate time, a bill will be sent.
And to the extent it is an insurance patient, why should the hospital and its subcontractors (doctors), which tried to extend the patient's life through surgury, get stiffed while the insurance company gets to sit on all those premiums they received from the patient over the years?

 

[lexrageorge]

There was an interesting article in the local newspaper (Boston Globe) regarding how hospitals are changing the way in which they handle "unexpected adverse outcomes". Hospitals used to universally claim that they did all they could, etc., even if the negligence was obvious.

Now, they are reviewing such cases to decide if the "standard of care" was met. If it was not, they will meet with the family, explain the situation, and offer a settlement. As to the OP's question, I guess if the death was determined to be a result of an "unmet standard of care", the charges would waived.

Supposedly, the hospitals that have adopted this policy have seen malpractice lawsuits drop dramatically. If the patient's family feels that the hospital was fair, they are a lot less likely to go to court. Even though hospitals do win most malpractice suits, they still incur significant costs (legal fees, dr's forced to take time to answer depositions, etc.). As expected, malpractice lawyers HATE this new practice, and are rumored to be considering legal action. 😡

 

[63768]

someone has to pay. if you want services and you agree to pay for them (via self-pay or insurance), whether or not you benefit from the services, you pay for them. it's not about being money-hungry. it's about what is right and what is just. if you use my instruments, you're going to pay for it.

there's no room for sympathy in the medical field. physicians are supposed to be empathetic, not sympathetic. there's a difference.

 

[pagemmapants]

money hungry institutions

Hm. It's interesting that most hospitals (ESPECIALLY ERs) operate in the red. I say that the doctor still spent time on the patient, the room was still being used, the equipment, monitors, and bed were all tied up for that time, and the meds (particularly anaesthetics) were still used. Thus, someone needs to pay the bills, regardless of how "heartless" it might seem. Medicine is still a business.

edit:: Sorry, I just realized this is almost exactly what someone else said prior. Still stands, though. . .

And as far as the uninsured, I would have to say that the reason they charge so much for uninsured patients compared to what they charge the insurance companies is that, in a way, the insurance companies are a) buying in bulk and b) almost guaranteed to get their money in. Most insurance companies have a huge number of patients, so chances are they're responsible for getting a huge number of bills paid, which means a larger chunk of cash for the hospital. When you buy t.p. in bulk it's cheaper per roll; why not the same with surgical procedures? In addition, insurance companies are reliable whereas the uninsured masses are pretty much guaranteed to NOT get their bills paid - that way if they're charged 5000 they might decide they can spare 1300 and in managing to pay THAT much of it they're really covering the majority of their procedure. Perhaps if they were charged 1300, they'd only come up with 400. The more you charge, the more likely it is that they'll come up with something resembling fair compensation.