$39.35 to hold your baby after giving birth?
The impossible, laughable idea appeared to be the case for a Reddit user, whose late September hospital bill and story went viral on Tuesday.
The charge in question was for “skin to skin after C-sec,” according to the bill, which the user interpreted as payment “to hold my baby after he was born.”
The nearly $40 charge, standing out in a sea of routine medical line items including the caesarean section itself and a “lactation consult,” appears to represent something a little more complicated, experts say. Still, the episode speaks to larger, persistent issues in hospital billing, particularly its lack of standardization and general opaqueness.
Letting mothers hold their children, or skin-to-skin contact, should be standard after birth, but the maneuver gets more complicated after a caesarean section.
It’s “a hard thing to do in an operating room,” since the surgical area needs to stay sterile and requires an extra nurse for supervision, according to Dr. Neel Shah, an obstetrician and professor at Harvard Medical School.
“The hospital probably had the right idea” in doing that, said Shah, especially since most Americans are born in small hospitals with staffing limitations. “It’s a big resource commitment to put a nurse in an operating room… I don’t think it’s standard.”
Still, it’s an bizarre line item to see because hospital bills don’t typically itemize every cost associated with a hospital stay, Shah — who was “dumbstruck” when he first saw the bill — said.
And it speaks to a larger “absurdity” too, he said: that the way billing is done can vary widely between different hospitals, especially when it comes to the final number dictating how much patients will pay out of pocket. Patients typically don’t find out how much they’ll owe for a procedure until they’re faced with the bill.
The fee is also unusual since most hospitals use bundled payments, charging one fee for something as common as a C-section, said Dr. Stephen Patrick, assistant professor of pediatrics and health policy at Vanderbilt Medical School and a pediatrician who specializes in training and care for sick newborns.
“Most insurance plans would say, ‘Here’s the fee, that’s it,’ even if there was a line item charge like that,” Patrick said.
Dr. Ateev Mehrotra, an associate professor of health-care policy and medicine at Harvard Medical School, agreed, saying that there’s no need for an itemized bill. The insurance plan pays a fixed amount, which is all that should be shown on the bill, he said.
Other numbers on the bill are also concerning, Mehrotra said.
The charges totaling more than $13,000 for the birth are “made up numbers and then the ‘adjustments’ are where the reality comes in,” he said. The charges “should be removed from the bills. All they do is anger patients and add to confusion.”
Skin-to-skin after a C-section isn’t as hard as it seems, Patrick said, though it does require going around the sterile field.
It also has many benefits for the child, including bonding with the mother and keeping the child warm, Patrick and Shah said.
But it makes a lot of sense that the Reddit user saw the line item as a charge for holding the newborn, Shah said.
“It would make it easier to interpret bills if everyone had a standard way of billing and a standard way of representing charges, but that’s typically not the case,” he said. “We have a truly insane way of billing patients for services.”
This article was originally published on Marketwatch.