Budget Buster - Stupidity

[maleficentmom]

My kid had a 3 second spray of the freezing stuff on the back of her leg,done by a PA, for molloscum contagiosum....she said it might not even help,but we could try...she didn't mention the cost....my insurance called it a "surgical procedure" and it cost me $170...after the discount. Another time, my doc told me if i said my skin skin tags were irritated by my necklace that the insurance would pay,but not for purely cosmetic reasons...well honestly I wanted them removed for both reasons...they got irritated by my jewelry and collars sometimes,but they looked yucky too.I forgot to mention it again at the actual appointment..and my insurance said it was cosmetic and I would have to pay....but my doc wrote them a letter and they did pay.I am so glad I had it done though!

 

[nowellsl]

I had the same thing done a few years ago. I have a co-pay for my general practitioner, but have to pay when I go to a specialist if I haven't met my deductable. I remember it was higher than I thought it would be, but not too bad. Then, a few weeks later, here comes the bill from the lab I didn't realize I had to pay for that separate! Hopefully your labs were included in the amount you already paid!

 

[midwestdee]

The posters that encouraged you to call your insurance company are on target. Also, when you get your statement of benefits from those visits from your insurance - they should list a prorated amount you owe. For instance, a $3,000 charge may be reduced to $1500 based on an agreement with the doctor - so even if your insurance just counts it toward your deductible and you have to pay - you ONLY owe the $1500. Most doctor's offices are good about noting that - but not always. Your statement of benefits will clearly say you are only responsible for the prorated agreement of the $1500 - so don't lose that piece of paper. The same will be true for any lab pathology charges. I have had to send a copy of my statement of benefits to doctors/labs because even though they knew darn well I didn't owe the total initial charge amount - they tried to bill me for it anyway. You did the right thing by getting this done ASAP. Good luck.

 

[mdsoccermom]

I have a friend that died a week ago from melanoma. Melanoma that started with a small spot behind her ear that no one thought was any big deal.

You did the right thing in getting them removed.

 

[bellarella]

This doesn't sound like a case where the insurance company isn't paying -- it is just a case where the deductible needs to be met before it will pay. I always budget paying for the entirety of my deductible each year. If I don't have to pay that much, I count my good fortune two ways: 1. for the extra money and 2. for having not needed medical attention beyond the routine covered visits.

I do agree with the others to make sure that the deductible was properly calculated (sometimes there are different caps for family and individual that get messed up). I would also make sure that you are being charged according to your doctor's agreement with the insurance company.

Beyond that, I don't think it is bad to think of what else you might get done under the cap. It's pretty common to have nagging health concerns that you just put off. I tend to do this every year with my family -- once we hit the deductible, we chase after all the lingering issues.

 

[cvjw]

I had a basil cell melanoma removed from my face, and my dermatologist did not freeze it, they removed it with a knife. You have to test the roots to make sure that all of the melanoma was removed. It was $3000 just to have that one cancerous spot removed, but I know that it was removed properly and will not come back. FYI, they cut it off first for a biopsy and it grew right back. I would be more worried that your basil cell was not removed properly and will come right back, than about the money.

 

[merekc]

The posters that encouraged you to call your insurance company are on target. Also, when you get your statement of benefits from those visits from your insurance - they should list a prorated amount you owe. For instance, a $3,000 charge may be reduced to $1500 based on an agreement with the doctor - so even if your insurance just counts it toward your deductible and you have to pay - you ONLY owe the $1500. Most doctor's offices are good about noting that - but not always. Your statement of benefits will clearly say you are only responsible for the prorated agreement of the $1500 - so don't lose that piece of paper. The same will be true for any lab pathology charges. I have had to send a copy of my statement of benefits to doctors/labs because even though they knew darn well I didn't owe the total initial charge amount - they tried to bill me for it anyway. You did the right thing by getting this done ASAP. Good luck.

I agree with the above. I never pay the first bill I get from my doctor's office because it is always a full price bill. When the second one comes it then reflects the discount from the insurance. Possibly you might see something like this also.

 

[aprilgail2]

I am blown away by the 3,000.00 deductible! Is it because it wasn't a participating provider? If we use a participating Dr we just pay 20.00 co-payment if the Dr is not participating we have to pay a 200.00 deductible per year.

 

[SandrA9810]

I want to say it was only a $150 to have a mole removed from my neck. It didn't look suspicious, but it was bothersome. Since the doctor removed it, it had to be sent off to the lab. Insurance covered about half of it, and I paid $60 for the testing and $75 for the office visit.

I would talk to the doctor about paying it as if you were a customer without insurance. Sometimes they'll give discounts on that.

 

[Arielle22]

I am blown away by the 3,000.00 deductible! Is it because it wasn't a participating provider? If we use a participating Dr we just pay 20.00 co-payment if the Dr is not participating we have to pay a 200.00 deductible per year.

It depends on how the plan was written. The company can personalize the plan to lower costs. Some plans have only copayments while others have deductibles and copayments.

 

[IDoDis]

I asked my friend who just finished school to be a medical coder. While she hasn't had an official job yet, she's done some volunteer work at a hospital to get her foot in the door for coding and has had to code lots of things for her coursework. She thinks your visit was coded incorrectly since you never left the office and then returned. It should be one office visit but two separate procedures. The first procedure for the first mole since that's what the appointment was for, and the 2nd procedure to remove the other three moles since that's what occurred once you were in the office. Or she said it could be coded as 4 procedures, but should still be only one office visit.

She suggested to call back your doctor's office and inquire on why it was coded as three separate visits. Each visit has a minimum charge which you were charged for 4 times! They should adjust it. If not, call your insurance company and let them know what is going on.

 

[bumbershoot]

I pay $650.00 a month just to have the insurance plan and then I have crazy high decuctibles. Oye!

Holy moly, if I had a High Deductible plan there is NO chance I'd be paying that much for it! What do they charge for a PPO type plan?????

And to be technical, yes the insurance covered the mole treatment, even though it was applied to the deductible.. it was still covered.

That's how I look at deductible-visits, too.

If your daughter can handle it I highly suggest Endocrinology. There are a current shortage, there are a rising number of diabetics (who should all see one), and the majority of the "work" involves ordering and reading lab results.

My very good friend is an endocrinologist and has been able to write her own ticket as a doctor. She works 30 hours a week as a partner in a firm and is able to fully parent her 2 kids. Once her kids are a little older she will bump up her hours.

She has no call, and limited hospital visits.

An endocrinolgist is the one that finally figured out that DH had a pituitary tumor, after 3 years of ridiculous symptoms and every other doc REFUSING to do the bloodwork. DH said "xyz is happening, can you check my hormone levels?" and they'd say "you're just fat, that's why it is happening" and wouldn't do it.

This endo also FINALLY mentioned sleep apnea to DH, which caused him to have a sleep study last week...I've been telling him that he likes to hold his breath while sleeping for YEARS, and he's just been so worry about being "un-sexy" with a mask over his face, and now he has barely slept in the same room (b/c he feels bad for me AND because he gets tired of being gently kicked to either stop the snoring or jumpstart the breathing), so really, why not wear the stupid mask? The endo even *apologized* for taking two years to mention the possibility of a sleep study, and I can tell you we've never gotten an apology (despite going through things that desperately required one), which made us respect him even more.

So yeah, if ya gotta be an MD (or DO for that matter), go for that specialty.

But, helpful hint...make sure your scales are calibrated. DH's first visit with the endo, the scales were totally wrong, I mean big-time wrong, which he knew because of Weight Watchers. They resisted, but we stood firm (they tried to say that WW scales aren't set for higher weights, ha ha ha, no, wrong, and that they make money by having them wrong...yeah, again, no, if so, they'd have them set so you seemed *heavier* than you are), and they left the room then we heard them working on the machine and gently swearing, and every visit since then the scale has been correct. So keep those scales calibrated!

....my insurance called it a "surgical procedure" ...

The coding done by the office is what called it a surgical procedure.

I am blown away by the 3,000.00 deductible! Is it because it wasn't a participating provider? If we use a participating Dr we just pay 20.00 co-payment if the Dr is not participating we have to pay a 200.00 deductible per year.

Probably a High Deductible plan. Sad thing though is that those are supposed to have *lower* premiums, and the OP doesn't seem to have that. , OP.

 

[Poohforyou]

I wouldn't expect a dr to know whether my deductable was met. The procedure would have been met if you had met it. What you had was akin to surgery so I'd expect it to cost a good deal. It's a small price to pay to get something taken care of that could cost you a heck of a lot more down the road.

 

[Cindy B]

Here's a story that will help you consider calling the insurance company.

wI have an odd plan which is called a HRA. It is not high deductible, not a HSA or anything like that.

I got a breast MRI done in May. First my insurance stated that it would cost $5000 out of pocket... I nearly DIED! That was the first EOB. Then another EOB came the next day that said I only owed $46. The MRI facility first charged me the "out of network" rate, and then the second time realized that this facility was "in network" and too off most of the bill and the responsibiltiy for me is now only $46.

I didn't have to call, it just happened automatically. But for peace of mind, I'd do it that way.

 

[cassandrap83]

Chances are they put it in as 4 separate visits so that they could get the most money possible from insurance. Most people don't notice this because the insurance is covering it -- like they insinuated.

Talk to them. Get it fixed. It the derm's office won't fix it, talk to your insurance company. What they are doing is fraud.