Carelink cost

Both of my kids have pacemakers and we do a routine Carelink check every 3 months, plus as needed if something seems off. On my old insurance, I never saw a charge for Carelink - not in a hospital bill or even on an Explanation of Benefits from insurance company. With my new insurance (still Blue Cross PPO but different plan through different employer), I have co-insurance obligations of 15% and I'm seeing Carelink bills. The hospital is charging $980 (per child) for each Carelink reading. I do not understand why this is so expensive - an in-office pacemaker interrogation and adjustment is billed at under $200. The few people who use Carelink that I have asked have reported lower costs on their EOB or not being billed at all for it.

I know that health care costs differ greatly from hospital to hospital but I am wondering if this is being coded or billed incorrectly. When I call the hospital billing office there is a total disconnect b/c the operator doesn't really understand what the test is or what I am asking. I'm not sure who at the hospital can answer the question. I'm tempted to refuse to do the Carelinks and take the kids to the clinic for pacemaker checks instead as my out of pocket is about 70% lower in that case.

If you know, what does your hospital or doctor bill you or insurance for Carelink checks? Thanks.

8 Comments

carelink

by slarnerd - 2014-08-15 02:08:31

Thanks for that reminder Ian. Carelink is a remote pacemaker checker that Medtronic provides to patients. It's a small computer that you connect to a phone and a small wand interrogates the pacemaker, sending the data to a Medtronic computer that your physician can read.

slamerd

by IAN MC - 2014-08-15 02:08:48

Do not assume that the other 39 people are American !

This is an international site; I have never heard of Carelink and haven't a clue what it is !

Ian

hospital

by slarnerd - 2014-08-15 03:08:41

Thanks for your reply Sheila. Do you mind telling me what hospital you use, what city? We are at Lucille Packard Children's Hospital in Palo Alto, CA.

carelink cost

by bluebowtye - 2014-08-15 03:08:41

Hi,
That does seem really high. I have a Medtronic Carelink home monitor and have only used it once so far. My insurance was billed $165 (which is the same as an office visit at my clinic) and I only had to pay $11.39 since I had already met my deductible. Good luck to you.

~Sheila .

thank you

by slarnerd - 2014-08-15 12:08:43

Thanks for your reply. It is helpful to know that this is a shared frustration. I wish the other 39 people who have viewed this post would respond with their cost for Carelink use, if any, so I would know what the norm is.

I am very familiar with the appeal process with insurance but I think insurance is paying at an adequate rate (leaving me with 15% for the diagnostic test) in this case. They don't think the charge is unreasonable and they believe the code is correct.
The hospital's itemized statement indicates the fee is just to read the Carelink in this case - but since I own the machine (as it is considered part of the cost of the implant), I don't see how the reading could cost so much. Do you think your $450 charge is high?

Maybe it seems I am making too much of this - but it's sort of the final straw. I received 11 different bills for a single regular/routine cardiology check-up at Stanford for the kids ... for echoes, ekg, clinic testing and then a separate bill for each doctor and specialist who looked at the results. Maddeningly inefficient.

Thanks for listening and for your input.

Outrageous

by Gotrhythm - 2014-08-16 01:08:52

Although St Jude has something similar to Medtronic's Carelink, I have never used it.

But I pay no out of pocket at all for PM checks at my cardiologist's office. I think $980 for what doesn't amount to a half-hour's work is beyond outrageous.

My clinic...

by bluebowtye - 2014-08-17 09:08:59

Hi Slarnerd,

I go to McFarland Clinic in Ames, Iowa. The hospital where I had my implant is Mary Greeley Medical Center also in Ames. They work together. I was actually surprised when I got my bill and it was only $11.39 because they told me I would just have to pay my regular office visit co-pay which is $20. I do my next remote transmit next month so will be curious to see what they charge me for that. Good luck to you, I really think something is not right with you being charged so much and I hope you can get it figured out.

Take care,
~Sheila

Cost of Carelink Transmissions

by Ann54 - 2018-10-09 21:50:30

Dear Shelia I was checking on new insurance today and my one of my questions as yours  was about the cost of transmissions made from home every 3 months In the beginning several years ago were (as you)  cost  was $0  and never billed transmissions from home Then I beleive last year my husband was billed almost $40 for each transmission we sent from home Which was very odd after 3-4 years I called the insurance they said it (transmission) was covered under durable goods   I dont no much about techical terminlogy but felt durable goods was the pacemaker, leads, or battery The transmission by phone at home would be something else   When I talked to the insurance rep today he thought the transmission would fall under diagnoistic testing which our insurance is $0 to 20% Being charged $40  would mean were were billed about $200  if you figured 20%  anyway our co-pay for a office visit is only  $45  twice a year when we see the pacemaker nurse 45 minutes she takes a transmission and we see the doctor about 15-30 minutes 1.5 hours total for both visits for $45  When my husband received his pacemaker they ordered the device for us to scan at home every 3 months they  told  us transmissions from home would be cheaperbut see this not to be the case anymore I am going to try calling the insurance as it would seem diagnostic to us If I find out anything I will post again 

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