Surprised by recent medical bill

[LearnMS]

Not sure if this is the correct thread, but thought of some relevancy for PF/budgeting.

My DS had a pain under the foot due to some blisters, but appeared to be plantar warts. So we went to urgent care center (not emergency) and met with the physician on duty. He examined for about 5 mins and left the room only to return after 40 mins. Showed it to another physician and recommended a Podiatrist.

A week later, we received a bill for $259 after insurance. Description said - office visit, long. I inquired why this is so expensive and I was told that it is because of the patient's history and the medical decision taken for this treatment. Hence, its billed based on the treatment given and not on the time spent with the physician.

We then went to see a Podiatrist. Cleaned the area and applied a cream and band-aid. Something I was guessing I could've done by purchasing OTC medicine from CVS and do this ourselves. Anyway, the foot pain and issue went away after a week and then came the bill. It is whopping $375! Half of it was for new patient establishment. And this is after insurance again.

I am on HDHP plan with family deductible of $7400. And it has HSA acct that I contribute to. My issue is:
1. Are the bills for real?? (we haven't been to physicians for years, except for annual physicals).
2. Is there any way I can negotiate these bills? Urgent care bill is already nonnegotiable, I was told.
3. I have an option to dispute these charges. Not sure if I want to take that route.
4. Am I acting too anal about these bills?

I am unable to digest these hefty charges (it's worth one way trip to Southeast Asia in economy ). Did anyone encounter similar instances and what actions you took? Ofcourse, prevention is better than cure!

TIA.

 

[Josh F]

1. Yes - although the rates seem a bit higher than our area
2. You can always ask, but probably not. Your insurance company has already negotiated a much better rate than if you were completely paying out of pocket (e.g. uninsured)
3. I wouldn't recommend this unless you were billed for something that wasn't actually provided, you probably won't win
4. It's a lot of money, so I don't blame you, but healthcare is absurd... The only suggestion for next time would have been to see if you could have waited to make an appointment with your Primary (cheaper than urgent care and cheaper than a specialist... although they may still have referred you to a specialist).

Just my personal thoughts.

 

[janetdoe]

A week later, we received a bill for $259 after insurance. Description said - office visit, long. I inquired why this is so expensive and I was told that it is because of the patient's history and the medical decision taken for this treatment. Hence, its billed based on the treatment given and not on the time spent with the physician.nal about these bills?

If that's the case, they should have billed you for "patient visit - complicated" not "patient visit - long" which certainly was NOT provided.

You might try contacting your medical insurance company ombudsman and ask if they can help you negotiate with the doctor, and say you suspect they are padding the billing.

I don't think you are being too "anal" or even overreacting, but I do think that you may have to let it go and chalk it up to a lesson learned - because whatever success you have will probably not be worth the time and heartburn. Consider that you probably saved well more than $600 in premiums by going with a high-deductible plan. <shrug>

For future knowledge, if the doctor knows you have insurance, then they are forced to charged the insurance negotiated price. So it may be significantly cheaper to not admit you have insurance and negotiate your own price prior to service. Most health care providers also offer some sort of 'prompt pay' or 'cash pay' discount where you pay immediately.
http://selfpaypatient.com/2014/01/03/insured-patients-can-save-money-by-pretending-to-be-uninsured/

 

[LearnMS]

Thanks Josh and janetdoe,

Yes, I agree and learned the lesson the hard way. I did look up the treatment cost calculator for in-network services before we walked in. And I was assuming it will be in the lower end of the spectrum ~$200, if not more. This is because I wasn't sure how they'll code it when billing it. I can try disputing it, but as you echoed - may not be worth it.

I was talking to a colleague about this and he was surprised that I was surprised! He said he paid $500 in medical expenses for the delivery of first baby. Then $9000 for the second one in a few years......