You've all seen the commercials or the billboards or the Google Ads when you search for anything cancer related. You can't spell the word "cancer" these days without coming across the Cancer Treatment Centers of America, CTCA for short. For those of you how don't know about them: they are a for-profit corporation that specializes in cancer treatment. Obviously the "for-profit corporation" is where the trouble comes in.
Before I get into the reasoning here is my plea to you. If you or someone you know is diagnosed with cancer, do NOT, under any circumstance, send them to CTCA. They are a total scam and a fraud. Stick with the reputable cancer facilities that are associated with a university like MD Anderson (UTexas), Hutchinson (UWash), Penn, Temple, Hopkins, etc. I can't speak for CTCA's level of care but I can guarantee they will try to take you for all the money they possibly can. They are trying to stick me with a bill for $2800 for what amounts to a very fancy a second opinion visit. Can you imagine what an actual treatment bill would look like??? They pride themselves on the "mother standard of care" but my mother never tried to steal from me like this. Cancer treatment doesn't have to cost tens of thousands of dollars...unless you go to CTCA (or have no insurance).
I suffered a relapse of Hodgkins lymphoma (my second), just two months after going through an autologous stem cell transplant. While there was 30-40% chance I would relapse within two years of the transplant, within two months is extremely rare so there was obviously a high level of concern. Since I was on the east coast, I decided I was going to solicit as many second opinions as possible for continuing my treatment. At the time, I was getting my care from Temple University and I immediately added Penn and Columbia with it's center specifically for lymphomas to my list. Since it was just 25 minutes from where I was staying, I figured it couldn't hurt to check out the CTCA facility in Philly to see if there was anything worthwhile behind the advertising machine.
I did a bit of research before my visit and determined that they had a reputation for cherry-picking patients with good insurance that would improve their survivability statistics. They were also not highly thought of amongst oncologists at the university-based centers. A final red flag was that they were known for billing a LOT to insurance.
Still, I figured it couldn't hurt to just go there for an opinion. I do have good insurance and I've received care in so many places at this point that I don't factor into any one institution's survivability statistics. It seemed like I'd be the goldmine patient to them.
They didn't make it easy. They first had to do a thorough insurance review and get pre-authorization from my insurance for the visit. That's fine, I actually prefer it that way as it assures my visit will be covered. Then you can't just go see an oncologist, oh no. You have to go through a 3-day new patient orientation that includes visits with the oncologist, naturopath, dietician, financial counselor, chaplain, psychologist, and a bunch of other crap you don't care about. The most interesting meeting was with the financial counselor where I informed them of their reputation and they assured me that I would be taken care of and that out-of-network differences and things not covered by insurance would simply be written off by CTCA. No expense to me.
My take away from this 3-day session was that 1) they didn't have anything different to offer as far as treatment options from the other facilities, 2) I did like their idea of incorporating diet, naturopath, and mental services into the core treatment, 3) they had a REALLY nice facility. The lead oncologist agreed that the next step of my care could be accomplished at any facility and after speaking with me acknowledged that there was no reason I couldn't do it in Alaska and that would actually probably be better for me from a mental perspective. I left there knowing I wouldn't be going there for the next step of my treatment but considering it if I needed a second transplant because their transplant facilities were superior to anything I'd seen so far.
Fast forward two months, and I get my CTCA bill. What would you expect to pay for a second opinion if you had good insurance?
$65? That's what it cost me at Temple.
$74? That's what it cost me to see the preeminent expert in the field of lyphomas at Columbia
$115? That's the combined cost to see the head of the lymphoma program at Penn as well as their proton radiation oncologist
NOPE, not even close. At this point, the bill for my 3-day orientation is at $2800. That's right, $2800 for a second opinion. How the hell did it get to that level you ask? Pretty quickly when you figure in the CTCA math. Of that $2800, I acknowledge $450 as "valid" co-insurance charges (insurance pays 80%, you pay 20%). The rest comes from CTCA's particular brand of accounting.
Here's the basics: All facilities charge insurance way more for their services than they will ever get. You may remember the $15,000 shots I was getting at one point. Insurance set the rate for those shots at $5000 so that's what the facility got and they accepted it as such. I no way, shape, or form was I responsible for the $10,000 that was written off. This was consistent at all 8+ of the facilities I've been to across the US. In network, out of network, it didn't matter...until CTCA. In addition to the standard co-insurance, CTCA is billing me for 100% of the difference between what they billed insurance and what insurance set as the acceptable rate. For comparisons sake: In 2013 alone, my insurance was billed for $1.2 MILLION of which their combined allowable rate was 525K. If all facilities followed CTCA's accounting practices
- $1300 in mostly unnecessary lab work. Despite the fact they had the results from labs taken at Temple just 2 weeks earlier, they insisted the consultation could not proceed without the lab work. SCAM
- Analysis of tumor tissue samples that 1) I did not authorize them to have (FRAUD), 2) was from tumors that had already been treated to remission (FRAUD), and 3) they never told me they were going to do it
- Administering of sedatives a week after my visit. I suppose since it was sedatives they could have come to my home and sedated me and I would never remember it. Was I roofied?
I have been battling them since receiving the bill and they are insisting that the difference in bill vs insurance rate is my responsibility. They will never see one cent of it. They don't know what they started. I can't believe how many people they must be screwing right now. It won't be easy to overcome that level of advertising but I am making it my new mission to expose CTCA for the FRAUD that they are. Stay tuned.....