Fifty Plus (50+) - Doctor Bill ??!!??

OK, I don't go to the doctor often, and this was the first time since I've been paying individual health insurance, so I need to spend some large amount and then the insurance kicks in.

Anyway, I got this infection from a bite, and went to the doctor. They weighed me and took my blood pressure. The doctor came in 45 minutes late, and asked me what happened. She looked at the bite and prescribed pills. Then she talked to me about migraines a little because I was just starting to have one.

I got the bill today, and it was $200! The insurance company apparantly made the bill smaller...they said only $156 was "allowed". But she didn't do* anything but write me a script.

I'm kinda wanting to go down and ask them for a detailed billing. I think I have the right to know what the fees are for. Is it billed by the hour? Because then they're either charging $500/hour or I got charged for my waiting room time.

Should I go down there, or will I make a fool out of myself? If they bill according to time, how do you prove how long the Dr is with you?

One of the bad things that may have happened with the copay insurance we're all used to (if we're lucky) is that we've lost all control over how much things cost. You'd think the insurance company would control costs better than that, somehow.

You yada yada'd the best part....What kind of bite?

$156 is getting off cheap on a doctor's appointment. I believe that most have a minimum charge of close to that simply for them showing up at the appt, even for 1 minute.

'm kinda wanting to go down and ask them for a detailed billing. I think I have the right to know what the fees are for. Is it billed by the hour? Because then they're either charging $500/hour or I got charged for my waiting room time. No, you didn't get charged by the hour for time in the waiting room. If you do ask for a detailed billing, what you'll probably get is a list with one entry: Office Call.

I agree. It's not a 'per hour' issue. My understanding is it's based on how the treatment was medically "coded". It would be worth at least a phone call to see if the charge could be reduced. I did this a few years ago with what seemed like an outrageous bill for an allergy visit. It got the bill down. Goodluck!

You yada yada'd the best part....What kind of bite?

Mystery bite of the insect kind. Made my glands swell up my neck to double size. Wouldn't go away for weeks.

Sure it wasn't the bite of a drunken squirrel?

Hey, we have a $40.00 co-pay AFTER we pay something like $650/month in premiums.

I'm on Medicare w/Kaiser Part B while wife is still on Kaiser (not 65 yet).

They do keep the drug costs down though, and the computerized record system and ability to e-mail your doctor is great.

We definitely have a gold-plated medical care system in this country, and by that I mean it costs a bundle and many/most cannot afford it.

Makes for a lot of great architecture, though, like the Humana Hdqtrs we saw in downtown Louisville last year, as well as many here in the Portland Metro area.

The elevator refused to function in an apartment building. The elevator repair man came, fixed the elevator by tapping it with a hammer, and presented a bill for $156. Since he was only in the building for about 5 minutes, the manager asked for an itimized bill.

Service call $50.00
Tapping with hammer $6.00
Knowing where to tap $100.00

Doctor and hospital charges are always negotiable. My daughter was involved in a car accident a couple of years ago. The total bill was $18,500. The insurance company decided to pay them $11,500. And they accepted it.

I've read stories where people have negotiated the final payment to under 50% of the original charges.

I went to a doctor with a skin problem. He said he knew nothing of skin problems and told me a story about how he was confused by a bee sting on his son. He suggested I see a dermotologist. He sent me a bill, which I refused to pay. I saw him one day when he had a flat tire and I was called to service his car. He then agreed that I shouldn't have been billed for the bee sting story.

That's a pretty typical charge for an office visit when you're sick. Every type of visit has its own fee schedule with codes. You may even have had an extra code entered for your migraine discussion.

I had a plumber charge me $100 just for the trip. He ended up NOT fixing the problem, but his time spent not fixing the problem was charged too. & he didn't even have an office to pay for!

I had a plumber charge me $100 just for the trip. He ended up NOT fixing the problem, but his time spent not fixing the problem was charged too. & he didn't even have an office to pay for!

I told my plumber, "You charge more than my doctor does." He said, 'I know. I used to be a surgeon.'

I was seen by a PA and my insurance company was charged for a physician because the PA had to get a signature from the physician for a script. I never saw the doctor.

My oldest son who spent 5 years in Japan as a teacher heaps prase on the free Japaneese medical system. He keeps telling me its worth every penny.

Seriously, though, you are not paying for the doctors time. Your paying for the office, the malpractice insurance, the equipment and the time it takes for several clerks to research, code, send, collect and record the mass of paperwork involved. If you do not have insurance, you pay anyway as those costs have to be spread around to cover patients who have no money.

Well, I'm almost 50, how much does a colonoscopy cost?

root canals just don't seem so expensive now.

It is an odd system. Seems to have its own rules. I tend to write for explanations & argue persuasively. Gets rid of bills regularly. Separate lab bills are the weirdest ones. I approach all odd bills about the same. I call and ask what the bill is for (itemized) and how I authorized it. Sometimes it makes sense and I pay it. Often it doesn't and I get a runaround. Step 2 I write and ask for specifics and exactly how I authorized that I be billed. I point out that generally they'll be a signature or some other evidence of a contract. That usually gets me no note and a copy of a diagnostic sheet or lab sheet or something with boxes checked off and strange writings. None of it really seeming to tie to anyone. Generally the ordering doctor's name is either illegible or someone I've never heard of. Step 3 I write back with copies of all previous communications and a letter disclaiming responsibility for the bill because there's nothing showing I authorized it and nothing in English demonstrating I received any services. I rarely get a response, and after a few months the bills stop coming. Once I had a collection agency call and I faxed them a copy of that last communication with all supporting documentation, then called them. The guy I talked to cracked up and said his client should learn how to write a letter. They stopped calling.

Funny thing is, I've later found out some of these bills were legitimate. I just couldn't put the pieces together at the time. Lots of $$$$$ in lab work from some company based in NC I didn't pay. I finally got told I needed to talk to Dr. Murtha or something like that at a clinic I'd never heard of. So I blew that one off and they went away after a while. Their burden to show I owe, not mine to show I don't! Years later cleaning out old records I figured out that Murtha was a doctor at a clinic that operated the other facility and was over everything. His name was on all the billings. These were real tests (expensive) for my wife which were delayed in billing about 2 months. All they had to do was connect the dots for me! That was about $2000 I didn't pay and got my insurance company to turn down.

The pattern of asking a billing party to demonstrate that I owe works quite well. Few companies seem to know how to do that.

There is a new profession.............medical billing consultants..............? They make a living by taking a percentage of the money they save you by going over your bills and determining what is valid and what is not. It would appear that so much is not valid that they have the opportunity to make a very good living.

Perhaps at 50+ it would pay off to contract one of these.

They weighed me and took my blood pressure. The doctor came in 45 minutes late, and asked me what happened. She looked at the bite and prescribed pills. Then she talked to me about migraines a little because I was just starting to have one.

I got the bill today, and it was $200! The insurance company apparantly made the bill smaller...they said only $156 was "allowed". But she didn't do* anything but write me a script.

Interesting that you mentioned "they" when you were getting the service but only "she" when you questioned the bill. Presumably some of that money went to pay "them".

Yes, but I'd like to know how much I payed them (the receptionist and the nurse who weighed me and took my blood pressure and asked me what meds I was on). If it was more than $10, it was too much. For $200, they could have at least took my temp.

I don't know how much the support staff are paid. Presumably they get an annual salary and the MD has to recoup that out of her fee-for-service billing.
I'll try to look up what a similar service would have been billed to the Ontario Health Insurance Plan and post it later today. It's definitely not billed by time, but by service code. Some medical services, like counselling or patient education, are billed by time but the vast majority are not.

At the risk of starting a flame war, I've been having fun with the Canadian medical system, with several doctor visits (GP and specialists), two mammograms, one biopsy, one surgery, one MRI, one CAT scan and 16 radiotherapy sessions to come.

Cost to me: $0, and timing exactly matches that of a colleague in the States with the same diagnosis.

I don't begrudge the government one cent of my taxes on this one.

Well, I'm almost 50, how much does a colonoscopy cost?

root canals just don't seem so expensive now.

My last root canal was just over $900.

I'll try to look up what a similar service would have been billed to the Ontario Health Insurance Plan and post it later today.

I looked through the OHIP fee schedule, and there are a variety of family physician visit codes. Most of them range from $30 - $60 per visit. Most are non-overlapping, so there may be a few situations where the MD could double up and bill for more than one service during the same visit, but probably not too often. And even if they could bill for more than one, it's not likely to total $200 very often. And they pay most overhead costs (nurse, receptionist, rent, etc) out of that.

Of course, unlike some American physicians, they get paid for pretty much every visit - no defaults, few challenges - and always have a full day. Plus the billing submission to one payer is very efficient, and malpractice insurance is much cheaper.


My last root canal was just over $900.

My wife just paid the dentist $1500 and the private insurer covered half.

with several doctor visits (GP and specialists), two mammograms, one biopsy, one surgery, one MRI, one CAT scan and 16 radiotherapy sessions to come.

Hope all goes well from here on!

My last root canal was just over $900.

I had a root canal done (under a crown) a few months ago. It cost $375.

My last root canal was just over $900.

Every time I see my dentist for a check-up, I hope that he is still happy with the Lexus that I bought him.
If he decides he wants a new one, I could be in for some more root canals and crowns!:(

My last root canal was just over $900.

My daughter just had a root canal and it was $995....for crying out loud, why didn't he just charge $1000 and get it over with:mad:

Now that the specialist has finished the root canal she'll be returning to her regular dentist for a couple crowns:eek: More $$$$$$

Edit: My actual cost of the root canal was $199 as my dental insurance paid the remainder. The crowns are only 50% covered so they'll cost me more.

I'm one of those "problem" patients that *isn't*. I question it all and if I don't understand what they are doing and how it has to do with my visit I won't do it.

If they make me wait too long in the waiting room for my appointment, I complain on my way out and refuse to be billed. I shop for Doctors like I shop for auto mechanics. I'll pay for good quality and good service, everybody else gets fired.

I have my teeth cleaned every 6 months. I haven't had a cavity in my life. I tell them I'll do an xray series every other year or whenever I think I need it.

All service and goods suppliers get the same treatment. They all have to convince me that they have earned my business and charge a fair price, otherwise we part ways.

Doctors, Plumbers, Barbers, Auto Mechanics; everybody has to remember which one of us is the Customer.

Your lucky, my "insurance" company would not pay the $1500 MRI bill for my knee.

While on the subject, the whole system is upside down when they refuse to support preventive medicine and then pay up after you get sick.

[QUOTE=solveg;6899882]Well, I'm almost 50, how much does a colonoscopy cost?

$1800.
My Doctor, with NO Insurance charges $67 for a visit.
Your bill is Way to high.

While on the subject, the whole system is upside down when they refuse to support preventive medicine and then pay up after you get sick.

Want to know what's really funny? That was the original concept behind HMOs.

HMO stands for "Health Maintenance Organization". The whole idea was to stress healthy lifestyles and preventive medical care rather than cureing illness.

colonoscopy in my neck of the woods is just under $1000, and well worth it.

to the OP, the doctor interviewed you, examined you, and treated you.

i'm curious, what do you (or anyone else who would like to chime in) believe to be a reasonable charge for that service?

colonoscopy in my neck of the woods is just under $1000, and well worth it.

to the OP, the doctor interviewed you, examined you, and treated you.

i'm curious, what do you (or anyone else who would like to chime in) believe to be a reasonable charge for that service?
No doubt about it, that's worth $2 million. Easily.

colonoscopy in my neck of the woods is just under $1000, and well worth it.

to the OP, the doctor interviewed you, examined you, and treated you.

i'm curious, what do you (or anyone else who would like to chime in) believe to be a reasonable charge for that service?

I'm the OP, and I say a human general doctor visit is worth 2-3x a dog's general vet visit, so $70-$100 here in the cities.

They have some kind of clinic in Walmart or Target stores, where people can go for strep throat cultures and real basic clinic needs. If it costs $50, I now see the value in that.

I have people with stomach cancer and colon polyps on both sides of my family. But if it costs me that much to have a colonoscopy, I know that I'll wait longer than I should to have one. What I will probably end up doing is getting everything done in one year, so the insurance kicks in.

The thing about doctors is that once you get something worth checking out, you get sent to a zillion other people, and suddenly you have doctors appointments every single frigging week. I've seen it happen to my parents.

Your lucky, my "insurance" company would not pay the $1500 MRI bill for my knee.

While on the subject, the whole system is upside down when they refuse to support preventive medicine and then pay up after you get sick.

I'll bet all the money in my pocket that nearly 100% of us agree with this sentiment. Most of us have been taught that preventing something is always more cost effective than dealing with the thing after it's gotten bad.

While this is almost always true for individuals, the facts change when dealing with large numbers of people. I heard a podcast on "The End of Medicine" (http://www.andykessler.com/andy_kessler/2006/07/my_book_the_end.html) and the author explained why it was cheaper for the "Third Party Payors" to only pay bills for people that actually "get sick".

There is currently imaging technology that can detect just about anything that ails us. The problem is that it costs so much (e.g. a $1500.00 MRI on a knee). If you look at all of the people any particular insurance company covers, some number less than all (100%) of them will "get sick".

So what does a whole body scan cost? I don't have current figures, but let's say it's only twice the cost of a knee at $3000.00. If a particular insurance entity covers 100,000 people, that's $300 Million dollars for the scan *plus* they then have to pay for everything that is found.

According to the American Cancer Society the lifetime probability of a Man developing all types of cancer is just under 45% (for Women it is slightly lower at about 37.5%). A statistically important number of us die for other reasons whether we have cancer or not; like getting run over on a bicycle. (SEE I'm ON TOPIC!!)

The way the third party payors look at it, more than half of the lifetime full body scans were unnecessary; and at current costs it is cheaper to treat the cancer patients (that survive to diagnosis) even if half of them survive to file another claim (depending on what it is).

The actual incident rate in 2008, age adjusted for Men and Women is even worse at .47% (http://seer.cancer.gov/statfacts/html/all.html). That means only about 470 of the 100,000 people will be diagnosed this year. Cancer is expensive to treat, but it's going to have to cost well over $600,000.00 each before preventative care begins to break even. If I'm off on the cost of the scan (I'm probably too low) the break even point moves with the cost. How often did you want to get this scan?

It's a heartless attitude, but the numbers don't lie. It's cheaper (for the third party payors) to treat you when you get sick.

Now, if we can get the full body MRI (and other scanning technology) down to the cost of my 6 month teeth cleanings, then the world will change; but as long as the state of the art starts with a rubber hammer, a stethoscope, and the question "What *seems* to be the problem?", big improvements in cost and effectiveness will not be soon forthcoming.

And Preventative Medicine will never be cheap enough until you can afford it with, or without, a third party to pay for it.

The next time your in your doctors waiting room look around at the other people there and ask yourself what you would charge to see them with some or all of there clothes off.Then think about touching and examining them closely.I think I would have to get about $100,000 for prostate exams and a colonoscopy would require a second mortgage.

The next time your in your doctors waiting room look around at the other people there and ask yourself what you would charge to see them with some or all of there clothes off.Then think about touching and examining them closely.I think I would have to get about $100,000 for prostate exams and a colonoscopy would require a second mortgage.

Try the "Sports Medicine" clinic sometime. ;)

Ain't no one happy with the system, that's fo' show.

I'm guessing my take-home on a colonoscopy is around $125. I'm not complaining but it's not going to pay off ny Maserotti. The facility cost is of course much higher. Americans want a pretty clean facility with well-paid unionized nurses who can read and speak English. They also want that wonderful sedation.

You could trim a lot of money off the whole thing by having it done without sedation in the doctor's office, and by paying him cash. That's the way the rest of the world does it. It's also why you have to force most of the rest of the world to get these studies at gunpoint.

You might reach a different conclusion but these are the facts.

My colonoscopy was about $3000. The insurance paid all but the $20 office copay. While the procedure is almost universally accepted as a great preventive tool, I doubt I'd have had it done if I had to pay the full amount myself.

[QUOTE=WalterMitty;6902698And Preventative Medicine will never be cheap enough until you can afford it with, or without, a third party to pay for it.[/QUOTE]

So how much does Polio vaccine cost?

So how much does Polio vaccine cost?

About 10 bucks, why?

It still smells like a scam somewhere, though.

I was talking to my dental hygenist today and she had a cyst removed from her back. She pays $25 copays and she had $600 out of pocket by the time she was done. Every person she saw, or every person who did something got $25. I don't remember that when I had sinus issues in my early 30's. The only time I payed copays was when I checked into the doctor's office, and then it was $10.

Anyway, to remove the cyst, it was $3000. She finally became furious at the last appointment, post-surgery, when she had a follow up visit to see how it was healing. She flat out refused to pay for a visit to see if it was healing OK. It was a minor incision, and almost anyone can see if it's red, puffy or oozing. How much would that visit have cost the insurance company? $200, probably.

To sum it up, anyone who charges $200 to see if a 1/2" incision is healing cleanly is fleecing the customer.

Ain't no one happy with the system, that's fo' show.

I'm guessing my take-home on a colonoscopy is around $125. I'm not complaining but it's not going to pay off ny Maserotti. The facility cost is of course much higher. Americans want a pretty clean facility with well-paid unionized nurses who can read and speak English. They also want that wonderful sedation.

You could trim a lot of money off the whole thing by having it done without sedation in the doctor's office, and by paying him cash. That's the way the rest of the world does it. It's also why you have to force most of the rest of the world to get these studies at gunpoint.

You might reach a different conclusion but these are the facts.

If you're in the business you probably also pay more in malpractice insurance than most folks make in a year. That's buying some nice cars and houses somewhere...:notamused:

Sure it wasn't the bite of a drunken squirrel?


Or a two-legged horse on the rampage?

About 10 bucks, why?

You said preventive medacine will never be cheap enough to be affordable. I'm thinking that's a prefect example that proves that sometimes it is.

You yada yada'd the best part....What kind of bite?

Probably an infected pool boy hickey.:love:

My last root canal was just over $900.

Ditto, but mine is covered at 80% dental insurance.

Don't ask how much the insurance costs.

I hate it when the dentist starts telling me about flying his own private plane to some Caribbean Island where he goes scuba diving.

But, OTOH, he does really excellent work. We left a previous dentist because he didn't.

Want to know what's really funny? That was the original concept behind HMOs.

HMO stands for "Health Maintenance Organization". The whole idea was to stress healthy lifestyles and preventive medical care rather than cureing illness.

Yes, a great concept.

Now the whole idea is to make the management gurus rich.

Even "non-profits" contract with "management companies" to provide "management services" - which are, of course, not included in the salary figures of the non-profit sent to the IRS in their 990's. So, therefore, they don't have a problem with the IRS and unreasonable compensation.

I once worked for a NP, and this was their whole plan. Minor problem, though. The NP went bankrupt!

Insane! I went to the podiatrist to have a ingrown toe nail removed. A month later I receive a letter from a law firm wanting to know who the third part provider was that it should be billed to for an accident. I threw the letter away. Next month same thing. Threw it away. Third month I receive a letter from another attorney stating if I do not tell them who the third part that should be billed for the accident then they will cancel my insurance.

I looked up the attorney's name on the internet, called the number I found and "He" answered his own phone. I explained why I was calling and wanted to know what accident he was talking about. I had an ingrown toenail removed which was a result of living, which I was not going to quit doing anytime soon and therefore it was no accident.

I then asked what kind of idiot thinks that an ingrown toe nail is a result of an accident? I wrote a definitive letter to the insurance company and the law firm that they used as a subcontractor and demanded they quit harassing me for a ingrown toe nail.

All the attorney wanted to know was how I got his direct telephone number. My response: "I have my sources, which you would find absolutely unbelievable." I told him that he should probably call his local police department and ask them if they knew how I might get it.

Got a letter of apology from the insurance company who had made a mistake and coded the bill as "An Automobile Accident".

They would also go around in circles telling me that the doctor was out of network when it was the same Doc they had paid for in the past. I would have to take them out to their own web site, show them the Doctor in their "In Network Provider" list. I figured it was just a ploy to avoid paying for a bill and that most people wouldn't put up a fight.

Insurance companies are the worst!