The (High) Cost of Cancer Treatment: 2

Or, How Cancer Patients Spend (Waste) Their Time: 1

As I've mentioned elsewhere, I recently changed cancer centers. After eight years with the University of Washington Medical Center and the Seattle Cancer Care Alliance, I switched to the Swedish Cancer Institute.

When I wrote The (High) Cost of Cancer Treatment: 1, I reported that my bill from SCCA for September 1, 2006—for three drugs, Herceptin, Avastin, and Zometa—was for $20,052.19.

That made me wonder what my new cancer center was charging me for the same treatment.

So I pulled out an explanation of benefits from WSHIP, my health insurance plan, for December 21, 2006.

On that date, I received the same three drugs that I was getting at SCCA (Herceptin, Avastin, and Zometa) plus another drug Aranesp, that I believe was to boost my low red-cell count.

Swedish billed my insurance company $43,681.23 for that one afternoon's treatment, plus an additional $102 for my brief visit with my doctor on that day.

Well, this surprised me, since it was TWICE the amount that SCCA billed for the same treatment, except for the Aranesp, which I do not get routinely. But at first I couldn't figure out the bill because there were four line items for drugs and none of them was named.

Four items with "drugs required detailed coding": one for $22,739.31, one for $9,599.10, one for $5,253.00, and one for $3,151.52. I thought maybe there was an error in the bill, maybe I had been billed twice, or that the $22,000-and-change item was the total for the three drugs I usually get ... Who could tell?

So, to the phone. I called Swedish and asked for the billing department.

This is where the story gets funny, or pathetic, depending on your point of view.

It took me 15 phone calls--that's right, 15--to get an answer to my billing question: What drugs did I receive on December 21 and how much was I charged for each of them?

I took notes on the back of the bill.

By the time I was at Phone Call No. 5, I started telling each person I spoke to how many people I had already talked to.

Phone Call No. 5 was to Mary in "clinical relations." Mary couldn't help me, but she was very nice and gave me three names and numbers of people who she thought might be able to help.

And so it went, up to Call No. 14, when I spoke to Jackie in "pharmacy billing." At first, Jackie said she couldn't help me, that I should call the regional billing office. But when I explained that I had already talked to them (Call No. 4) and that they were unable to give me the information I was seeking, she took my number and said she would call me back.

Which, amazingly, she did within a few minutes (Call No. 15), and she was able to give me the names of the four drugs I had received on that date plus the prices of each.

So, having survived (barely) that ordeal, I was left to wonder why one cancer center charges $9,496.47 for one dose of Avastin and another cancer center in the same city charges $22,739.31.

The same thing for the Herceptin. SCCA charged me $6,254.95 for one dose of Herceptin, and Swedish charged me $9,599.10.

Of course, my insurance company did not pay Swedish that amount. The grand total for one afternoon's treatment was $43,681.23, and my insurance company paid $22,644.29. Because my insurance has a preferred provider relationship with Swedish, that's it. The rest of the bill is discounted and I don't have to pay it.

I wish I had a great punch line to end with here, or a "kicker," as we called it in journalism school, but I don't. I'm sitting here on the couch marveling at the ways I spend my time, now that I have cancer.

Read: The letter to Swedish Cancer Institute's executive director

@ Jeanne Sather 2007.

Comments

[Mauricee Amadi]

What is the average cost of treating cervical cancer in general? Just the average.

[jeanne]

Sorry, I don't know. Do you know someone who needs treatment? If so, I can try to find out.