Sickened by Doctor's Office Charges

[Deb in IA]

Ok, lets take this slowly. I NEVER said that they did not have bills. I said THEY MAKE MORE THAN ENOUGH TO PAY THOSE BILLS.

Really? You might want to tell that to this doctor:

http://money.cnn.com/2009/09/14/news/economy/health_care_doctors_quitting/index.htm


Rx for money woes: Doctors quit medicine
Some physicians, fed up with the costs of their practice, are ready to hang up their stethoscopes and shift careers.
By Parija B. Kavilanz, CNNMoney.com senior writer
Last Updated: September 30, 2009: 3:17 PM ET

Dr. Tara Wah closed her ob/gyn practice in Tallahassee, Fla., last year, saying that she could no longer "afford" to stay in business. Wah currently is not practicing medicine.

NEW YORK (CNNMoney.com) -- Some 5,000 patients suddenly found themselves without an ob/gyn last November when Dr. Tara Wah closed her practice in Tallahassee, Fla.

Wah, 55, informed her patients in a letter that she could "no longer afford to make ends meet."

After 24 years, "I'm working longer hours than ever," she wrote. "Insurance payments for patient care have stayed virtually the same for the last 15 years, while the cost of doing business, including health insurance, staff salaries and supplies have risen."

The rising cost of malpractice insurance, particularly for her specialty, was the straw that broke the camel's back.

"My malpractice insurance was $125,000 a year, and going up," said Wah. "The only way to get the extra money was to cut back on my salary."

But it wasn't always like that. Being a doctor was once thought to be a path to a cushy lifestyle. Six years after she started practicing, Wah hit her "peak" income year in 1990. Then she took a pay cut every year from 1993 onward, to eventually take no salary for two months prior to permanently shutting her office.

Wasted skills
Wah no longer practices medicine. Instead, she designs and repairs jewelry. "I feel guilty. I dream about [medicine]," she said. "[But] I am so angry. I think, 'What a waste of my training.' "

Wah's situation sheds light on a troubling trend of physicians leaving medicine for a career outside of health care, said Kurt Mosley, a staffing expert with Merritt Hawkins & Associates, a physician search and consulting firm.

A first-ever survey of 12,000 primary care physicians conducted last October by Merritt Hawkins and the Physicians' Foundation, an organization that represent the interests of physicians, showed that 10.1% of respondents planned to seek a job outside of health care in the next one to three years.

"That is a big number. It's just very sad," said Mosley, especially in light of the shortage of primary care doctors in the United States today.

 

[eliza61]

Ok, lets take this slowly. I NEVER said that they did not have bills. I said THEY MAKE MORE THAN ENOUGH TO PAY THOSE BILLS.

To act as though doctors are not very well paid is just ridiculous. I have yet to meet one that wasn't. Do they deserve it? Most do, yes. But, they are well compensated and can certainly pay their staff, their insurance and everything else.

so then if they deserve it, what's the problem?

 

[wdwcoltsfan]

Ok, lets take this slowly. I NEVER said that they did not have bills. I said THEY MAKE MORE THAN ENOUGH TO PAY THOSE BILLS.

To act as though doctors are not very well paid is just ridiculous. I have yet to meet one that wasn't. Do they deserve it? Most do, yes. But, they are well compensated and can certainly pay their staff, their insurance and everything else.

I think the problem is you seem to making the assumption that all doctors are paid like the 2 in your neighborhood--they aren't. I think many people would be surprised at the income of pediatricians, internal medcine docs, family practice docs, etc., especially those with their own practice. There are specialists who make very healthy salaries, but that isn't the norm across all of medicine.


Rachel

 

[luvsJack]

so then if they deserve it, what's the problem?

I never said there was a problem with the amount they get paid, I only said that it is apparent by the many doctors around here that they make plenty to pay the bills. Doctors are well paid. Period. I made no judgment on whether they deserve the money or not. Some professions are well paid. Its just a statement of fact, not a judgment.


For instance, I have a niece that makes well over 100,000 a year in her profession (in this area that = well paid). She has to travel, she works long hours, can't always be with her kids and its very stressful. I believe she deserves the large paycheck but otoh I don't want to listen to her tell me that the reason she charges large fees so that she can pay the office light bill.

 

[erincon23]

ON THE OTHER HAND... my DS14 has been having major back problems. A couple of weeks ago, he had a second cortisone injection. We got the insurance statement yesterday, and it showed that the doctor had charged $278, and the insurance discounted the amount allowed by $277.60. You read that right, the insurance company paid him 40 cents, and we don't owe anything. We had already paid a $30 copay, which, if the office accepts this payment, they owe us back. I can promise you, this doctor did well more than $30.40 worth of service. I feel like we ought to be sending him a check. (you never know, we still might get a bill for this service.) If I were that doctor's billing office, I'd be jumping up and down mad at the insurance company (Blue Cross!) and wondering how I'm going to pay anyone involved in that service for that time. Of course, we've had quite the opposite -- nearly no discount and next to no coverage for something (like an MRI -- even though we had hit our deductible, after the discount and insurance payment, we still owed $600), and we owed a ton.

I'm sure there are some doctors who find every way to scam the system, double charge, overcharge, and underprovide, and there are many going broke because they care more about the health and pocketbooks of their patients than the insurance companies do, but I'd like to believe that the majority of doctors are adequately and appropriately compensated for their education, dedication, staffing, facilities and service.

 

[usnuzuloose]

I understand that the charges are getting worse. But My husband and myself do not have any ins, I need to go for something and I called a few of the urgent cares and asked how much for a test of what i needed would cost. They can not tell me until I come in. Just to see a doctor starts around 100.00 and up. Im just trying to see how much I may have to pay. Is this really true they can not tell you an approximately how much? I find that hard to believe. But what can I do? Thanks for any one who may be able to answer this question Jo

 

[kamik86]

I understand that the charges are getting worse. But My husband and myself do not have any ins, I need to go for something and I called a few of the urgent cares and asked how much for a test of what i needed would cost. They can not tell me until I come in. Just to see a doctor starts around 100.00 and up. Im just trying to see how much I may have to pay. Is this really true they can not tell you an approximately how much? I find that hard to believe. But what can I do? Thanks for any one who may be able to answer this question Jo

Without knowing what you need I can't be sure this is the case but I know sometimes they are reluctant to give you a price because the price may go up when you come in for complications.

Think of it as you paid an electrician to redo some wiring in a wall. They can give you a base price but once they open that wall they may find some MAJOR problems or bad wiring that requires them to do alot more work to get to the end result you wanted. This makes the price much higher.

This could be the case or if this doesn't apply to your case (since you said it was a test and not a procedure) maybe the people you spoke to are told not to give any prices in case that is the issue? In that case maybe a supervisor could tell you?

 

[WL Fan]

I understand that the charges are getting worse. But My husband and myself do not have any ins, I need to go for something and I called a few of the urgent cares and asked how much for a test of what i needed would cost. They can not tell me until I come in. Just to see a doctor starts around 100.00 and up. Im just trying to see how much I may have to pay. Is this really true they can not tell you an approximately how much? I find that hard to believe. But what can I do? Thanks for any one who may be able to answer this question Jo

Our standard answer, when a prospective patient calls in requesting information about costs or wait times or what doctor is in, is to not answer. We can't tell over the phone what the patient might need, and what they think is the problem is more often than not NOT the reason they're feeling the way they are. No sooner would we give out that information that it would change, and then the patient would be angry they'd been "lied to" over the phone. Giving out that kind of information leads to too many bad feelings, besides, most people who work in those environments have no idea how much various procedures/tests cost, anyway.

Once you're in the office/urgent care, you can ask how much the procedure/test is going to cost. All of our doctors ar really good keeping cost in mind if the patient requests it.

 

[MIGrandma]

Our standard answer, when a prospective patient calls in requesting information about costs or wait times or what doctor is in, is to not answer. We can't tell over the phone what the patient might need, and what they think is the problem is more often than not NOT the reason they're feeling the way they are. No sooner would we give out that information that it would change, and then the patient would be angry they'd been "lied to" over the phone. Giving out that kind of information leads to too many bad feelings, besides, most people who work in those environments have no idea how much various procedures/tests cost, anyway.

Once you're in the office/urgent care, you can ask how much the procedure/test is going to cost. All of our doctors ar really good keeping cost in mind if the patient requests it.

So if I call other opthalmologist's offices to ask what they charge for an eye pressure check, they're not going to tell me? Great. I would think there should be a standard charge for certain procedures/tests, then if something more is needed that can be discussed with the patient. I should be able to find out how much a pressure check is, then if the doctor wants to run another test, be able to find out how much that is going to cost as well.

You say your office doesn't give out cost info on the phone, but if the person actually comes in then you can tell them? Why? Just so you can get that office call charge out of them?

 

[Mermaid02]

Probably when the doctor doesn't have to pay his staff or give them annual raises, or buy new equipment, or pay for overhead, or pay for his malpractice insurance, or pay for his license or DEA registration, or buy supplies, or get less and less from third party payors . . .

You are not getting my point. I don't care how much money they make. Making money is the American way, is it not?

Just don't tell me that they charge such high prices because of having to pay overhead for thier offices or for malpractice insurance.

You think those office suites are cheap? You think malpractice insurance is cheap? ONE successful lawsuit and a doctor could be wiped out forever- those premiums are HIGH. Are you a saying a physician should pay the office overhead and then drive a 1998 Saturn and live in a $75,000 house because YOU think that is sufficient? Deb is a doctor, yet you think she doesn't know what she is talking about. Doctors work LONG hours, take phone calls from nervous Mom's in the middle of the night, work weekends, holidays and nights. They deserve to be paid well.

As far as the OP goes, maybe the doc just bought a new machine to check that pressure

 

[OceanAnnie]

I question any type of service fee that has that kind of leap. It might be warranted. It might be a mistake. I have called about that kind of discrepancy and found it was a mistake in billing. I think it's prudent to review bills.

 

[daughtersrus]

Think of it as you paid an electrician to redo some wiring in a wall. They can give you a base price but once they open that wall they may find some MAJOR problems or bad wiring that requires them to do alot more work to get to the end result you wanted. This makes the price much higher.

Based on this analogy, should the office be able to tell you what the office visit charge is and then anything else that is needed during the appointment would be an extra charge?

Once you're in the office/urgent care, you can ask how much the procedure/test is going to cost. All of our doctors ar really good keeping cost in mind if the patient requests it.

Once you're in the office/urgent care, it's too late as you're already going to be billed for the visit.

Doctors only keep cost in mind if the patient requests it? With cost of health care as it is now, why not keep the cost in mind for all patients?

 

[Mermaid02]

Based on this analogy, should the office be able to tell you what the office visit charge is and then anything else that is needed during the appointment would be an extra charge?

Very often the office does not know what the final charge will be because it has to go to the coders who apply the correct codes to what was done, what supplies were used and the length of the visit and a bill is generated from that. One size does NOT fit all in the medical setting.

 

[jodifla]

This leap is TOO MUCH without some sort of explanation of the costs. If it's because of some sort of change in their insurance, they should DETAIL that in a letter upfront to their patients.

Doctors create their own troubles when they do this sort of thing. A trip to the doctor is the only one where you walk in, and are completely at their mercy financially. You have no idea what they are going to charge you. You basically have to offer them a blank check whenever you walk into the room.

And THIS drives away people from seeking timely medical advice, which creates health problems, which leads people to ERs, which drives up costs.

 

[OceanAnnie]

This leap is TOO MUCH without some sort of explanation of the costs. If it's because of some sort of change in their insurance, they should DETAIL that in a letter upfront to their patients.

Doctors create their own troubles when they do this sort of thing. A trip to the doctor is the only one where you walk in, and are completely at their mercy financially. You have no idea what they are going to charge you. You basically have to offer them a blank check whenever you walk into the room.

And THIS drives away people from seeking timely medical advice, which creates health problems, which leads people to ERs, which drives up costs.

I would want some sort of explanation. Form letter. Something. I don't think it's unreasonable to expect an explanation for a leap like that of any service fee.

 

[DisneyBamaFan]

Based on this analogy, should the office be able to tell you what the office visit charge is and then anything else that is needed during the appointment would be an extra charge?...

When looking for a new doctor, every doctor's office that we called gave us this information - standard fees for well visits, sick visits, physicals, etc. Not sure that just a general call of inquiry would have had the same results, but doctors looking for new patients share this kind of information up here.

 

[DisneyBamaFan]

I would want some sort of explanation. Form letter. Something. I don't think it's unreasonable to expect an explanation for a leap like that of any service fee.

IMO, it is none of our business why they charge what they charge. Either accept it and pay or find another doctor who charges less.

 

[OceanAnnie]

IMO, it is none of our business why they charge what they charge. Either accept it and pay or find another doctor who charges less.

I'll agree to disagree with you.

Like I stated earlier sometimes it's a mistake with billing. If it's coming out of my pocket, I'd like to know the charges are legit not a mistake. If it's twice what it cost before I'd like to know why. I have had an explanation about charges before. If it makes sense, I'll go with it. If not, I'm on my way. Just like any other business transaction.

 

[DisneyBamaFan]

I'll agree to disagree with you.

Like I stated earlier sometimes it's a mistake with billing. If it's coming out of my pocket, I'd like to know the charges are legit not a mistake. If it's twice what it cost before I'd like to know why. I have had an explanation about charges before. If it makes sense, I'll go with it. If not, I'm on my way. Just like any other business transaction.

It is your right to ask, and theirs to answer or not, as they will. I have verified charges, but never asked for justification for a charge that is confirmed as being correct. Then again, I have never felt that I have been taken advantage of by a doctor. I have watched several doctors save my wife's life on no less than 4 occasions. They could take everything that I have and I would still be in their debt.

 

[MIGrandma]

I would want some sort of explanation. Form letter. Something. I don't think it's unreasonable to expect an explanation for a leap like that of any service fee.

The only "explanation" I got on the phone was "yup" when I said in reference to the eye pressure check going from $90 last time to $210 this time, "it's come up THAT much since the last time I was there?!" Certainly no explanation there.