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Lakers Fan November 25th, 2012 05:05 PM

$400-outrageous
 
I received a bill yesterday from one of my doctors for the balance after my insurance carriers . My visit to the doctor consisted of a 5 minute exam .He billed the insurance company $400.00 .

Donna November 25th, 2012 07:02 PM

LF,
And we wonder why health care is so expensive....YIKES...

ToddDH November 25th, 2012 08:44 PM

WOW! Eight hundred dollars for a five minute office visit? Absolutely out of bounds!

We all have deductibles. As I am on Medicare, my NYS Insurance is in effect my Medi-Gap policy although they will pay for some things Medicare won't. Also, if you're on Medicare the only thing you pay is the deductible on your insurance and possibly a deductible on Medicare (I only pay one and I think it's off the grand that the state pays). If the physician accepts Medicare he/she accepts Medicare limits which are much less than what some (obviously including this physician) charge. Inasmuch as you, if I'm not mistaken, have also retired with similar insurance, with all of your health situations over the past year, you have to have more than fulfilled your deductible(s). Therefore by this time of year, if the guy's bill was 800 bucks which I question, you should still never have paid over $160.00!! Again, however, it is all dependent upon whether the Doctor accepts Medicare Assignment and you have met your deductibles and then if he pulled this, he could (note the italics) be in big time hot water! Also, you should have received a notice or a rejection notice as to why your insurance didn't pay more.

I would not pay the $400 until I had researched it 6 ways from Sunday including a consultation with my medi-gap insurance!

I of course don't know whether or not you do, but if I'm sent for a visit to a physician with whom I'm not familiar, I'll make it a point to ask if he/she takes Medicare assignment.

Good luck!!!

Luanne Russo November 25th, 2012 09:07 PM

Ari,

I am so sorry, and I hope you can get it worked out. I am afraid we are going to hear more and more of this type of thing.

Good Luck

Lakers Fan November 26th, 2012 06:15 PM

Thanks ,Luanne

Ron November 26th, 2012 11:52 PM

Not siding with the Doc, to be sure--but this reminds me of a cartoon / joke I once saw:
This guy had called a plumber--the plumber pulled up in a stretch limo with a driver--got out with his little bag of tools and went in-- then it showed the homeowner looking at a $200 dollar bill with the " I can't believe it " look--the bill said :
Tapping on pipes ------$ 50.dollars--
Knowing where to tap- $ 150. dollars
_____
Total-----------------$200 dollars ;)

Kuki November 27th, 2012 10:53 AM

I may be the only one mis-reading Lakers post, but I don't see where he is saying he paid $400 for the Dr.'s visit.

To me, it reads that the Dr's billing was $400 total; the insurance company paid a portion of that bill (how much was not stated); and LF paid the balance (also not stated).

Am I reading that wrong?

I would also suspect that Doctors don't charge by the length of the appointment, like a taxi meter, but rather by how much time they have alloted for an appointment.

Lakers Fan November 27th, 2012 11:44 AM

correct
 
Quote:

Originally Posted by Kuki (Post 1456545)
I may be the only one mis-reading Lakers post, but I don't see where he is saying he paid $400 for the Dr.'s visit.

To me, it reads that the Dr's billing was $400 total; the insurance company paid a portion of that bill (how much was not stated); and LF paid the balance (also not stated).

Am I reading that wrong?

I would also suspect that Doctors don't charge by the length of the appointment, like a taxi meter, but rather by how much time they have alloted for an appointment.


Actually my portion after insurance was $3.22 ,however ,my point is that doctors rip off insurance carriers . The doctor billed with a procedure code that states that the patient was treated for 45 minutes .

ToddDH November 27th, 2012 01:23 PM

I got the wrong inference from Lakers Fan's letter. I can see what you mean Kuki and I also can see where one could draw the inference which did I.

The fact of the matter is Lakers Fan is still right. I personally learned just how much from a CBS 60 minutes presentation probably over a decade ago! To just give an overview, a woman went to 60 minutes following her husband's death to find out just why her insurance company paid so much even though she was "well heeled" (meaning why would she care?). Originally, she had gone to the hospital for a copy of the bill which they gave her. She realized that what they gave her could not have possibly have been less detailed! She went back, frequently, for I think it was close too if not a year to see a specific individual who handled the billing. Everytime she went back the person whom she had to see was "out of the office," "on vacation," "out sick," etc., etc. etc.

CBS I think rigged her with a disguised camera. If I remember correctly she kept going back until finally, the woman was "in." She demanded a TRUE itemized bill and so she was provided one and it stunned her and CBS. No one could figure out as an example I remember, even though listed, what a "Mucus removal system" was and why it cost so much. I really hesitate to say because I honestly don't remember the figure but I THINK it was well over 100 dollars. You know what it was? TISSUES!!! Turned out the bill was crammed with such misleading terms and over charges. So CBS went to the carrier and asked if they knew that for which they were paying. An executive said that they did. Then why, 60 minutes asked, did they pay such outrageous charges. He replied that they receive so many bills that they don't have time to closely audit each one so they just pay the claim! When the insurance exec had the bill audited it showed that the insurance carrier had overpayed in the THOUSANDS of dollars, which in that instance of course, was returned to the carrier.

I have no idea whether or not there were industry wide changes to corral such flagrant abuse by, I remember a well known NYC Hospital but forget which one. I leave it to you to draw your own conclusions. I shall never forget that episode.

'Nuff said.

Chuck Palm November 27th, 2012 01:39 PM

Two years ago after returning to Mexico from our transatlantic cruise, David had pneumonia in both lungs. We called our doctor and he arrived at our house within 15 minutes. He spent thirty minutes with David and then went to the pharmacy to get him three shots and some pills. He was treated with steroids. antibiotics etc.

He came back to our house and spent another thirty minutes with him for treatment and returned the next morning at 10:00 A.M. sharp with an additional steroid injection and to recheck Davidīs progress.There was a thunder storm so he stayed an additional 45 minutes and drank some tea and ate cookies with us.

The entire bill when translated from pesos into dollars was about $88.(Including all injections and oral meds)

Now that is dedication.Itīs just some food for thought!

Lakers Fan November 27th, 2012 05:01 PM

I was not insinuating that all doctors inflate their bills ,many do not .As an example ,when my father passed away not only did his doctor not bill Medicare but he made a donation in my fathers name to a cancer organization.


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