Alta Bates Labor & Delivery Billing

Berkeley

Parent Q&A

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  • Our second child was born last month at Alta Bates in a straightforward delivery. We have a Blue Shield PPO policy with 20% coinsurance.

    The hospital bill was $19k and the physician's bill was $8k.

    Blue Shield made almost no adjustments to these bills and apparently paid over $20k.

    Our responsibility is about $5k.

    Does anyone else have a similar experience? Is it normal for Blue Shield to pay the full billed amount, rather than having a better negotiated rate (which would reduce our coinsurance)?

    I had the same experience in 2019. Same hospital and insurance, straightforward delivery. We paid 5k out of pocket without negotiating. :(

    Call your insurance to find out what your out of pocket max is for the year. I delivered at UCSF with anthem PPO and paid about $5000 unfortunately.

    This was what it was like for us with our first kid. We were able to work out a payment plan with Alta Bates and paid off the amount over several years. 

    Same situation as you but probably different insurance plan (though we also have a BlueShield PPO). Hospital bill was $27K, physician's bill was $8K. The EOB only lists the amount billed and they paid all of the hospital bill. It doesn't list an Amount Allowed or BlueShield Responsibility, etc, which seemed weird to me - I also expected there would be a negotiated rate. 

    In the end we were responsible for about $1K to the physician. TBH I don't totally understand how this was all calculated but was happy to pay the physician and be done with it. I hope you're able to get to the bottom of this without too much annoyance... and congrats on the new baby.

    I had vaginal birth, no interventions or medication beyond motrin and stayed a total of 30 hours from intake to discharge at Alta Bates in late 2020 and have UnitedHealthcare PPO. Here is a very loose breakdown based on claim summaries I just skimmed:

    Alta Bates - billed $15k, the plan discounted $1k, insurance paid $13k and we paid $1k

    Delivering Dr - billed $7.5k, plan discounted $0, insurance paid $6.5k and we paid $1k

    Baby Drs - billed $1.5k, plan discounted $0, insurance paid $500 and we paid $1k

    I have heard that you can call the hospital and negotiate down the amount you owe, but it's not something I've personally tried to do. I hope this helps!

    I have worked in provider contracting in other markets and I’ve found the discounts on Sutter’s rates horrendous across insurers in no cal. They’re essentially a monopoly in many places and no one seems to be getting good discounts from them. I paid double for an anatomy scan at Sutter what I did at a teaching hospital in Boston. It seems like a systematic problem. No advice just confirming your read of the situation. 

    It depends on the contracts in place behind the scenes.  Is Alta Bates a preferred provider for your insurance?

    If not, the limit for each billable item may be limited by BlueCross's interpretation of "usual and custom ary".  Call the customer service department of BC, or get a person from your employer's liaison engaged to have a fully itemized bill shared with you, and then an explanation for all the reimbursements.

  • How long does it take to get a bill from Alta Bates for labor and delivery? We had our son over 6 weeks ago and and haven't heard a thing online or by mail. Is this usual?

    We delivered last year at Alta Bates, and had a bit of a mess with their billing department.  We actually pre-paid in total (3 months before due date) for our delivery, since our insurance had a set out-of-pocket limit. Then, we got a bill (online) about 7 weeks after delivery, saying that we never paid, and that our bill was overdue. It took them almost 3 months to sort it all out. This was all through Sutter Health, my provider's network... I guess their billing departments don't interact well. So 6 weeks doesn't seem out of character, but I'd recommend contacting the Alta Bates billing department anyway to make sure that something screwy isn't going on. 

    Yes. I think my bill took more than 6 weeks as I remember it arrived after my post-party’s visit. If you have insurance they will bill them first and then send you a bill for copay or the balance. You’ll also get a separate bill from the doctors’ group that delivered you. 

    My son was born in January, and I didn't get the bill until October. Apparently they were working out some dispute with my insurance company. 

  • Has anyone delivered at Alta Bates recently with a Blue Shield HMO or PPO plan? If so, how much did it cost? On paper, the HMO plan appears more cost effective since all childbirth professional and facility services are covered (as long as you are in network). But we've heard that anesthesiologists at Alta Bates are not covered by Blue Shield, and so we will have to pay the full cost of any anesthesia (e.g., epidural). Thanks!

    I gave birth at Alta Bates about 9 months ago, had an epidural and various other interventions, and have a Blue Shield PPO; I believe our total costs were somewhere between $2-3K. $1000 flat fee plus some miscellaneous charges.
     

    Look at your out-of-pocket maximum. That is probably what you will end up paying. Every provider and facility has its own separate billing system. For example, the hospital bills separately from the physician. If more than one physician attends the delivery or checks in on you during recovery you will receive a separate bill from each of them. Many will be out of network and you will have no control over that. Hope that you don't deliver close to the end of the calendar year because then you have to pay the out-of-pocket maximum twice. That was my experience.

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Questions  

 


Cost of Labor and Delivery at Alta Bates

Jan 2008

Has anyone had a natural birth at Alta Bates in the last year or so and knows about how much it does cost to have you baby delivered at the facility? I currently have Blue Cross PPO 2,500 and know that I have to pay $ 2,500 out of pocket in January, when I'm scheduled to deliver. Also have heard that there are obgyn fees, anesthesiologist fees, hopital fees, etc.Thank you.


My son was born ab ABMC naturally. The *retail* bill was about 40K with all services included. The *real* bill was the price our insurance (Cigna HMO) had negotiated with the Hospital. That was $8500. We paid $800 out of pocket.

My son spent 24 hours in the NICU. All of those costs were covered without a copay, despite being billed from several different entities. Wait for the negotiated rate bills before you pay anything and ask your insurance company about their negotiated rates for hospital delivery.

Epidural, complications or no, it's likely to be the same figure it it's a vaginal birth.

Your birth will likely cost you exactly $2500. That's my guess. Happy Delivery. Wendy


Can't say exactly but I also had a high deductible with Blue Shield - you will probably end up paying the full $2500 - the bill and the rate your insurance negotiates are very different - but its unlikely that it would be much less than $2500 (my bill was $17K - the insurance settled for about $2k). The good news is Alta bates gave me a very big discount for paying on time(about $600) - I didn't even ask for it. So its hard to get to these things when you have a newborn but call them as soon as you get that bill and inquire about early payment discounts. Good luck. anon


I know this is longer ago than you asked for.. but my son was born at Alta Bates in Sept 2004. The bill they sent us totaled just under $20,000. I was in the labor room for less than 8 hours, and stayed in the hospital two nights. I had no epidural/drugs, pitocin, etc.


A Certified Nurse Midwife delivered my 2nd baby in May 2007. No epidural and no other medical intervention. $25,036 for staying 2 nights. $9k for OB, $7k for delivery room, $4k for labor and delivery and lots of smaller fees like clinic, lab, rx. Good luck with your pregnancy! mom of 2


In December, I labored at Alta Bates for 18 hours with no meds, was charged $900/hr for L, plus $2K for various other stuff and $4200/day for room afterward. Ended up with C-section so other charges brought bill up to $43K billed to insurance. anon


Three months later, still no bill for L

March 2003

It's been almost 3 1/2 months since I delievered my baby at Alta Bates. How long does it take them to send me the hospital bill?? I'm very curious on the cost, but then again it's been nice not to have to pay right away.


Alta Bates will likely send you a bill about four months after your baby's birth. Once you get it in the mail, you will also likely get a call from their collections department within a day or two rather rudely saying ''where is our money?'' To which you should say, I will pay the bill within 30 days which is standard practice, and if you are so anxious to get paid, you should send your bill and the implication that you need to call me as if I am deadbeat is very annoying.'' This is the experience of at least two people I know of recently having babies at Alta Bates.

Steve


I just received my bill last week and my baby was born in June. I know people who have waited longer. I even know people who have called to get their bill and couldn't.

I would just tuck some money aside (whatever your co-pay is + any extras such as private room.) and forget about it. My experience is their billing is very S L O W... anon


It took 8 1/2 months for me to get my Alta Bates bill. First they secured payment from the insurance company and only then they billed me for the rest (my single room).

It's also taking FOREVER to get Alta Bates to send me a receipt. I've asked for it almost 2 months ago (and have called many times) and they still haven't send it! anon


It took Alta Bates 11 1/2 months to bill us for our private room (Jan,2002 until December, 2002). We didn't pay right away after we got the bill, just to see if they'd be similarly lax on follow-up. No such luck. Lots of phone calls, more bills, so we paid. anonymous


It's been 8 1/2 months for us and still no bill. We're thinking that maybe since it wasn't crowded, we didn't get charged for the private room and insurance covered it all--either that or thay're just way slow to get the bill out to us. anon


I delivered in January and I paid my bill in August Jill


Not sure if I'm typical, but I believe it took about 8 months to get the initial Alta Bates billing and then, amazingly enough, 13 months before I got a final bill. I was a bit frustrated about the bill that arrived when my son was 13 months, as I had been under the impression that we were all paid up. So, once you do get a bill, you might want to confirm with them that it's the *final* bill.

Stephanie


I delivered my now 9 1/2 month old daughter at Alta Bates at the end of last May and just received the bill at the beginning of February. So in essence it took 8 months to get the bill, which I sense is not unusual. Just a tip, look over the bill carefully and question things that look funny. I did this and through questioning some items, ended up shaving 30% off the total! Also, you will probably get an invoice stating the amount you owe without any corresponding detail. This happened to me and so I requested a detailed summary of charges which they were happy to supply. During the time that we were going back and forth about the charges, they were very professional and did not code my bill as past due. anon


Alta Bates billing is a disaster. After the birth of our son a year and a half ago, we started receiving bills in about a month, which we then forwarded to our insurance company. The bills kept coming. The bills were not itemized, so there was no way to know if we had already paid for the services on a bill. My husband had many conversations with them trying to straighten this out. Finally after about a year, my husband told them he would not pay or respond to any bills which were 1) not itemized and 2) did not explicitly state that this was the final bill - total we owed for my son's birth. (We thought that one year was enough for them to calculate a total.) These conditions were never met. We ignored bills for a while after this, and billing has now ceased. We had health insurance that fully covered the birth.

On the positive side, my daughter was born 3 1/2 years ago also at Alta Bates. We haven't received a bill yet ;-) (Her birth was also covered by insurance, so maybe the insurance was billed directly.) Karen


I think it was 7 months before we got our Alta Bates bill. Pretty ridiculous, huh?


My daughter is 18 mos. old and I still haven't received a bill! I have even spoken to them over the phone about it. I figure until I get one, I don't have to pay it....and I haven't received a collection notice that says that they have sent one either. I know some other mom's who didn't get one until at least a year had passed.... anon


I have Kaiser insurance and gave birth 2 months ago. Alta Bates just sent me a statement saying Kaiser had paid them $17,377. I was shocked at the cost. I had a vaginal delivery with an epidural and stayed 2 days in a pvt room. The pvt room cost us an extra $600 out of pocket and I have not received that bill yet... anon


About 10 months after the birth of my baby, when I had almost forgotten that I would owe Alta Bates $2000.00, they called and said that I still owed them money for the delivery. I said, ''I'd be happy to pay, if you'd send a bill.'' They were very polite, but I thought it was annoying that they'd call before they even billed me. They sent the bill and we paid. You can pay by credit card, fyi. I had a emergency c-section, and the total bill was over $20,000, of which we owed 10 percent. LK


We have not been billed for our private room at Alta Bates and my son is now 21 months old. I don't know if this is true, but I heard that they have to bill you within a year or you don't have to pay. anon


I just want to give a word of warning about the medical billing in general. We were never billed for an ambulance ride my daughter required. At the time, we lived in Fairfield, which contracted with various service providers to provide ambulance service. I assumed that there had been a miracle and our insurance had taken care of it. To make a long story short, Medic-Ambulance sent both my bill and the bill to the insurance to the wrong address. About four months later, they turned us in to a collection agency for collections. The collection agency made no effort to find us and went ahead and reported us to the credit reporting agencies. The first we knew of it was three years later when applying for a home loan. The lesson is, don't assume that because you weren't billed you aren't responsible for the bill, the law says that in many cases you are. Also, don't count on being contacted by the collection agency if it goes to collections. Finally, keep a very close eye on your credit reports (Experian, TransUnion, and Equifax) to make sure there are no mistakes on them. We are still trying to get it off of our Experian credit report.

Julie


I worked briefly in the Alta Bates billing department, and thought I would share what I discovered about the procedures.

Basically, the hospital first bills any insurance company. The insurance company reviews it, and if there is any little thing wrong they send a letter stating the error and won't pay anything until it is fixed. By the time the hospital gets the letter, or checks again to see why the insurance company hasn't paid, fixes the bill, and sends it back, it can be quite a while later. It might go through repeated rounds of this process. The hospital may have sent it to a collection agency in the meantime to have them deal with the insurance billing, so they will be the ones the insurance company will deal with and you will deal with if you call about your bill. If you have a secondary insurance, then they have to go through this same process with that insurance company.

The patient will usually not be billed until the insurance company pays (or doesn't) and sends the hospital an explanation of benefits saying how much the patient is liable for. If you don't want to remind Alta Bates about your bill, you might try contacting your insurance company to see if they can give you any information or send you an explanation of benefits telling you how much you will probably owe. This was what surprised me most, that it is the insurance company who tells the hospital how much they are allowed to bill you for.

Once you get your bill from Alta Bates, you can usually call the billing department to set up a payment plan, or to see if there is any way they can reduce the amount. Sometimes they will give you a reduced amount if you agree to pay in full right then. Or if you feel you are being overbilled, ask them to send you the itemized statement and the explanation of benefits from the insurance company. Then you can send them a letter, or let the insurance company know and they will deal with it (if there is a mistake, they will be very aggressive in getting their money back!)

Hope this helps people understand the mysteries of medical billing...