Cardiology wars: patients' wallets are casualties (USA)

In August, Karen Carmel of Reno was told she could no longer get an echocardiogram of her heart done at the Reno Heart Physicians' office because the practice had been bought by Renown Health five months before. She said she was directed to the Renown Institute for Heart and Cardiovascular Health, on Renown's main campus, to schedule the routine test. "Your doctor says go there, you go," Carmel said. Her heart skipped a beat when she heard the price. "At Renown, they told me the test is billed at about $3,300 because it is being done in a hospital instead of a doctor's office and my out-of-pocket cost (based on the lower amount her insurance deems an "acceptable" cost for the test) would be $432," Carmel said. "I told them I can't afford that right now. I'd have to wait." When she told her doctor she wasn't getting the test, he checked her insurance plan and told her she could go anywhere for the procedure. She started shopping. "I wound up at Northern Nevada Medical Center," Carmel said. "They billed my insurance $2,241, and my portion was $244. People need to know they can shop around. If I had no choice (of providers), I wouldn't have gotten the test I needed. I think a lot of people won't get the care they need because these things are so expensive in a hospital." Previously, patients' out-of-pocket costs for the same type of echocardiogram were about $70 to $140, according to local patients' bills from 2009 and 2010. Depending on insurance plans, some patients' bills have gone from the hundreds of dollars to more than a thousand - RGJ