Out of Line or Not?

[Coyote_Bandit]

So I got really sick with some upper respiratory crud that was turning into bronchitis. Made an appointment with the only clinic I could find that could get me in in a few days (as opposed to a few weeks). Was seen as a new patient. Saw non-specialized family practice doctor for maybe ten minutes. Had my blood pressure checked along with my pulse and oxygen saturation (finger clip). Doctor used stethescope to listen to my heart and lungs. He looked inside my mouth. Got a couple of scripts. Had a anitbiotic/steroid shot. Did not have any bloodwork or x-rays or other kind of diagnostc testing.

Now I have a bill for $558.00. Charges are not itemized to see how much is for new patient fees and how much is attribuable to services rendered.

WTF?

Yes, I am going to call and make inquiries, complain and negotiate. I have a high deductible policy so fee is all out of pocket. And the charges clearly seem excessive to me. Am I wrong?

[taterguy]

1. You're completely and totally wrong

[Coyote_Bandit]

2. And I'm poor and haven't been to a doctor in 15 years

Guess I'll die before I fucking go back.

Thanks for the reality check.

Yep. America sucks if you're poor.

[hlthe2b]

3. well, my plumber came by for 30 minutes, replaced a 3 inch piece of leaking PVC pipe...

and the total fees came to $550. It was an emergency (leak) but I waited to avoid the emergency after hours fee and each of the plumbers I called indicated it would have been that much or more (including the $29 itemized as "parts&quot ...

I've yet to meet a plumber who completed 8 years of college and med school, a minimum one year internship and from 3-5 years of residency. Even though I do believe we pay them for their specific knowledge, just as we do physicians, veterinarians, dentists.

So.... I'm thinking it was probably not unreasonable. Sorry, because I've been in the shoes of those who were uninsured and unable to see a physician as well. So please don't think I'm not sympathetic, but just as my call to the plumber was meant to avoid catastrophe, so too often are visits to a health care provider.

[discntnt_irny_srcsm]

5. I had a service come on a Saturday afternoon...

...to clear my main house drain, a very well known service. I waited about 3 hours. The plumber was there for 30 mins. The bill was about $480.

[leftyohiolib]

9. i would say that plumbing and health care are not apples to apples and not a fair comparison

[Coyote_Bandit]

11. You can get your hands dirty

and learn to do many of your own plumbing repairs.

Even if you study and learn medicine you still cannot legally obtain and dispense drugs even if only or your own use.

[leftyohiolib]

24. yes that's my point

[hlthe2b]

13. As my post clearly points out...

I've yet to meet a plumber paying for malpractice premiums & with 12 plus years of advanced education debt.

The fact of the matter is that health care is a necessity and ought to be a right. That we need single payer system is only underscored by these kind of stories. But that does not mean the poster is right that he is being overcharged for services rendered. I strongly suspect he's not had to engage an attorney lately, which in terms of advanced educational expertise might be a better comparison. But given most bill out at $250 (and up) per hour, it would take little to make the physician visit appear comparable or even a bargain.

The answer is single payer FOR ALL.

[discntnt_irny_srcsm]

14. ^^ Winner ^^

Need single payer system now.

[Coyote_Bandit]

16. Single Payer is a great theory

and I've no objection to it.

However, nobody seems to have the cojones to fight for it. Nobody in a position to do so. And all tte talk about it is cheap and worthless if it does not lead to meaningful change.

Without that people like me are fucked.

I expect to come into a bit of an inheritance when my father passes. Not a huge sum but enough to provide opportunities I have never had. I'm thinking my best use of those funds just might be to buy my way out of this fucked up country. Second world health care is far better than unaffordable and inaccessible first world health care any day.

I am a throwaway in this nation. It does not deserve my loyalty.

[hlthe2b]

17. Nearly all of us are "throwaways" under Corporatist policies in this Nation...

Most of us will never have the option to leave, though, and will have to stay and fight and I likely will be among those trying to survive on the "catfood" scraps the RETHUGS are fighting hard to leave us.

As to "no one will fight fo single payer", actually you are wrong... Fights to implement single payer in the states are ongoing. I fought for it in Colorado and though we fell short, we did make some headway on making the "exchanges" under ObamaCare far better than most. Vermont voted to initiate a "single payer" system in that state in 2011--so it CAN be done and may well serve as the model for other states in the future (something that could pave the way for such Federal reform eventually)..

[Coyote_Bandit]

19. Some of us do not have the luxury

of waiting for that reform to eventually possibly maybe be implemented.

And there are very very few elected officials willing to fight for single payer.

Although there have been some prominent candidates who have suported the idea as canddates only to lack the political will to actally fight for it.

I am grateful for the indvidual citizens who are willing to fight for and suport single payer. It is really to bad that we canot seem to elect candidates willing to do the same.

[hlthe2b]

20. Luxury of waiting ? Most of us will never have luxury of being able to leave or make that choice.

I know I won't... So, I am left with the fight...

[Coyote_Bandit]

28. And just because I want to leave and am willing to

give everything I might eventually have to get the fuck out of here doesn't mean I will be able to do so.

I am grateful for those individuals who fight.

I regret that we have very very few elected officials willing to take up the fight. That does not make me hopeful for meaningful change in my lifetime.

My first loyalties are to myself and my family. I think perhaps our most basic needs and interests - our physical well being and health - might be better served elsewhere.

[leftyohiolib]

25. the dr's debt is not my problem (or shouldnt be) and he is being overcharged

i understand what you're saying but for what he got 550 is criminal - it would be different if i could do this myself (like a plumbing job) but i cant so charging me (OR ANYONE) that amount is ridiculous.
single payer for all!

[hlthe2b]

26. Single payer yes...

But, yes, We DO ALL pay for the expenses incurred by those providing us a service--whether it be educational debt, malpractice premiums, business insurance premiums, cost of building and maintaining a clinic, staffing costs, equipment, legal and accounting consultation fees, licensure, and Federal, state, and local taxes.

Whether it is a plumber, an attorney, or a physician, those indirect costs ARE your problem--just as they are mine.

[SwissTony]

15. Old joke...you've probably heard it.

A cardiologist calls out a plumber for some emergency work. The plumber comes and solves the problem in 30 minutes. He presents the cardiologist for a bill for $600. The cardiologist is furious. He says "I only get paid $500 per hour" to which the plumber replied "Yeah, that's what I used to get when I was a cardiologist".

More seriously, you have my sympathy. That sounds like a complete ripoff.

[discntnt_irny_srcsm]

4. It's insurance that has done some of this

Frivolous law suits have added. Clinic/urgent care centers generally have fees equal or close to ER amounts. These centers are generally staffed with doctors like a regular office but also have nurses, maybe PAs and others that cost a lot more than medical assistants. Add to that the equipment they maintain which is available but generally underutilized and therefore become part of the burden rate that a simple visit will cost.

The best advice is to have an established relationship with a family doctor and see him/her at least once a year even if you're healthy for a checkup. This is especially important if you live somewhere with a limited number of doctors. I lived for a bit in Western New York State not far from the Seneca Nation's Allegheny Reservation. There was about a 4 month wait to get an appointment as a new patient and several doctors were just not accepting new patients at all.

People have been conditioned to better accept $500 of insurance fees a month than an ER bill for $2,000.

[Coyote_Bandit]

6. My appointmwnt was with a doctor in his office.

I did not go to an ER or to a minor emergency or walk-in clinic. Anyone who has an established patient relationship with this doctor sees him in his clinic where I saw him.

I wonder if all of his new patients have an initial charge of $558 for their first visit as a new patient.

[discntnt_irny_srcsm]

7. Is he a family doc or any type of specialist? n/t

[Coyote_Bandit]

10. He is not a specialist of any kind n/t

[discntnt_irny_srcsm]

12. If he maintains and works from a clinic...

...(which is more than an office) that maybe the issue. New patient fees are generally higher but not that high. Clinics may have some of the extra equipment like x-ray machines, oxygen... that you wouldn't see in a simple corner office. Whether you used that equipment or not, if it was there then you're paying for it.

My short answer to "is this wrong" is: sure, you bet.

[Helen Reddy]

8. My vote is...

Out of Line in my planet of morality.

Totally in line, on THEIR planets of avarice and immorality.

[LadyHawkAZ]

18. Office visit fee at the local walk-in here, minus the shot

but with the same procedures, ran me $138. Unless that was an incredibly rare antibiotic they gave you, the fee does seem excessively high. You might ask for an itemized bill when you call.

[Coyote_Bandit]

21. I was expecting a bill of about $300

for office call, shot and new patient set up.

Didn't expec it to be low cost. But this seems excessive to me.

[LadyHawkAZ]

22. $300 with the shot would seem reasonable to me too

I'd ask for an itemized bill.

[libodem]

23. That clearly seems excessive

Should be a tenth of that, as far as I'm concerned.

[Hoyt]

27. Did you or clinic submit the bill to your insurance company?

Depending upon the insurer and doc's relationship with it, the insurer's allowable might reduce your responsibility substantially.

Anyway good luck.

[Coyote_Bandit]

29. I have high deductible health insurance

$10,000 plus a co-pay above that.

I am a sole caregiver for an elderly family member and am not currently able to work because of those responsibilities. This affords me affordable coverage for catastrophic medical needs. Nothing more.

[Hoyt]

30. I get that, but the insurer may have maximum allowable fees such that clinic cannot collect more.

Depends on insurer and whether they have a contract with the clinic.

[Coyote_Bandit]

31. UPDATE: Seems that bill should have been for $257 not $558

Something was double billed and my payment was entered as a charge against me not once but twice.

$130 for the office call plus $250 for the medication and injection I received.

Next time I will refuse the shot and ask for a script instead. The fee for the injection (not the meds in it) was $100. I'm guessing a round of oral amoxicillian and some dexamethasone would cost half as much and work just as well.