A resident of Florida received a bill of $ 48,5 thousand for treatment after a kitten bite

In the countryside, near the Florida Everglades National Park, Janet Parker noticed a kitten wandering along the road. He looked skinny and sick, and when Parker offered him some tuna that was in her car, the animal bit her finger.

Фото: Depositphotos

According to her, the kitten bit her skin, writes ABC News.

After disinfecting the wound, she did some research on the Internet and began to worry about rabies, because at that time in Miami-Dade County, there were warnings about this potentially fatal disease. She went to her home in the Florida Keys and called the health department, but it was closed.

So the woman went to the emergency room at Mariners Hospital near her home. She said she spent about two hours in the hospital, received two different types of injections and an antibiotic, she did not even talk to the doctor. She went home in high spirits. But then came the bill.

44-year-old Parker, a wildlife and fish biologist, is insured by the American Postal Workers Union (APWU) because her husband works for the federal government in Everglades National Park.

The total bill was $48, of which $512 was the cost of one preventative medication.

This bill was charged for such services: a Parker wound examination, a rabies vaccine (one of the four required), and 12 injection of milliliters of immunoglobulin, which activates a person’s immune system, providing protection against the virus before the vaccine begins to act.

The Centers for Disease Control and Prevention estimates that prophylactic treatment for rabies after infection, which includes immunoglobulin and four doses of vaccine administered over a two-week period, usually costs on average just over 3 000 dollars. According to CDC estimates, from 40 000 to 50 000 people receive such treatment every year after contact with potentially rabid animals. In addition, each hospital can set their prices for such treatment.

In the case of Parker, most of the account concerned immunoglobulin. Only for this injection, the hospital billed her and her insurer for an 46 422 dollar bill. This is much higher than what is considered average for the United States.

“I have never heard of the cost of immunoglobulin being so high,” said independent biomedical consultant Charles Rupprecht, a technical adviser on rabies to the World Health Organization who led the rabies program at the CDC for 20 years.

After receiving the bill, Parker decided to google the information about the preparations she had received.

“I saw that immunoglobulin was expensive, but not that expensive,” she said.

As a result, the woman went to the hospital, deciding that there could have been a mistake in the bill, but she was told that everything was correct.

Rabies immunoglobulin is a complex product made from blood plasma donated by volunteers who are immune to rabies. Three companies make the product in the U.S. and there is currently no shortage of it, according to Food and Drug Administration officials. Currently, the average wholesale acquisition price—the amount paid by wholesale buyers who then add value when they resell the drug to distributors or hospitals—is $361,26 per milliliter.

Thus, the cost of the 12 milliliter dose that Parker received would have been 4 334 dollars.

The hospital insists that there is no error in the bill. The amount in 46 422 dollars is listed in the price list, which was available at the hospital on 22 September 2018, when Parker was treated there. Simple math shows that the hospital billed for 7 737 dollars per dose per milliliter 2 (this is how often the immunoglobulin is packaged).

ЧA month after Parker's treatment, Mariners Hospital updated its price list—the hospital reduced its charge for rabies immune globulin to $1650 per 2 ml, so Parker's bill would have been about $9. It's still a lot, but not that much.

Hospitals periodically update their price lists. But it should be noted that this particular price reduction for 79% occurred shortly before January 2019, when new rules required all hospitals to publish full price lists for their services for the first time.

Prices in the price list, as a rule, are not the final amount that people pay with insurance. One of the advantages of health insurance is that insurers negotiate discounts on services in the network hospitals. And Parker went to the hospital of her insurance network.

But not every service has a negotiated discount, said two experts on medical billing in the United States. In the case of Parker, her husband’s insurance company paid 34 618 dollars on her total bill, including 33 423 dollars only for immunoglobulin.

ПAfter accounting for insurer payments, Parker had to pay 4 191 dollars plus 10-percentage of the costs incurred by its insurer.

“My funeral would have been cheaper,” she said.

Parker found out by calling her insurer that a cat bite should have been considered an accidental injury and, therefore, eligible for 100-percentage coverage in its insurance plan. She wants the hospital to re-submit the invoice to the insurer to see if he will take the rest of her 10-percentage share of expenses. The hospital did not offer the woman to lower the price of immunoglobulin to its current level.

Many public health services are available free of charge from local health departments. They range from vaccinations to rabies treatment. If possible, consult your health department to find out if it offers such treatment. But with such a serious illness as rabies, one cannot wait. If you can’t get free help quickly, go to the hospital.

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