To be slightly more honest: he wasn't the doctor assigned to me on intake, he was another doctor from another hospital across the street as a consultant IMHO trying to get onto my case so he could bill me.
The next day had a chiropractor treat it and shoulder was fine. $25 with coupon. Funny part is, as it was new insurance, I spent over 30 minutes with insurance rep in advance on phone going over options and trying to get an idea of likely costs.
When I had a heart problem and no insurance, we called providers all over town (Minneapolis) to try to get prices in advance. Most would only give estimates over a wide range. Some flat out said it was there policy to not give estimates. Eventually found a cardiologist who worked basically free ($30 plus donation). I bought a Kardio to record my own ECG so I can have more data to improve my communication with cardiologists, who are (understandably) a bit alarmist about what can go wrong and tend to err on the side of (expensive) caution without sufficient data.
Feels like a broken system.
I'm already getting angry here to be charged $50 instead of $25 when the doctor "touches" you during some basic evaluation. But at least they tell you about any massive amounts coming up before any treatment happens.
I eventually left "against doctor's advice" though there was a doctor there that agreed with me leaving. Pursued lower cost versions of remaining tests recommended on outpatient basis.
The funny part that time was there was a "patient billing advocate" in the hospital, who was magically never available over the three days I was there despite repeated efforts by us each day.
Please tell me you didn't have to pay the ~$45,000 personally?
There was a substantial upside. The cardiac event happened early in the year, and everything covered by insurance for the rest of the year was 100% free. We were able to pursue some things we probably wouldn't have otherwise. Simple things like having more cough syrup on hand became a no-brainer as cost of visit and prescription was guaranteed to be $0
This is one of the big upsides of always free at the point of access healthcare like we have in the UK. Although there is some inefficiency, in practice I beleive it actually lowers the total cost of healthcare as people seek treatment/diagnosis earlier and avoid getting as sick in the first place.
https://www.theguardian.com/science/occams-corner/2014/may/1...
Note: I'm from the UK and find the stories about US healthcare insurance grimly fascinating....
Basically, it depends on how the provider "codes" the treatment. You can contest the code, i.e. say you should have been billed for something other than what they are calling it. There is apparently a very wide range of things similar visits could be coded as.
Spent a total of 36 hours on the phone with the hospital to figure out how much something would cost because I knew I had to pay out of pocket. And they weren't even right when they finally gave me a number.
Had a doctor remove a cotton ball from my ear in the hallway. Charged me 2.4k for that. Didn't have insurance either.
My wife's friend delivered her own baby in the hallway and they still sent her a bill for delivery.
My wife had her gall bladder removed, supposedly the most common surgery. Surgeon charged 25k, hospital charged 65k, anesthesiologist charged 3k, and a doctor that talked to her for 25 seconds charged 1.5k. Insurance and the hospital argued over the bill for almost a year, during which time the hospital kept sending me payment due notices.
No one in this industry has my sympathy.
I'm currently fighting insurance because they won't cover a GI tract test without "proof" from another test first.
OK that's understandable. You don't want random people asking for tests all the time, but the Dr already saw me, and gave me meds to fix the issue that would give the insurance company "proof." There's just new complications now.
So I get to wait until everything comes back in full force. Last time I couldn't work for a few weeks, but hey at least they're saving a few hundred at most now....
This is still a better experience than the issues I had with my jaw. The jaw issues are the only pain in my life that was bad enough I blacked out twice from it. But insurance won't cover that because they think it's a dental issue, dental won't cover it because it's the jaw.
The only treatment for the jaw I got was because a jaw specialist lied on the insurance papers. He said he wrote down headpains, not jaw issues. He said he learned that telling insurance companies the truth is not what gets them to cover their clients.
/sidenote that jaw pain is second to none. It runs circles around any migraines (the dark room, no sound kind) I've ever had. Never knew there was such pain before.
https://www.thebalance.com/medical-bankruptcy-statistics-415...
They aren't directly comparable, but I wanted to point out treatment vs. evaluation costs experienced. Chiropractor was evaluation and treatment, PT was evaluation only.
I had to assume there was some kind of error, but contesting didn't help. Probably could have contested harder/smarter, but decided instead not to pay. This provider does not turn non-payers over to collections (no credit impact), and does not refuse later service to non-payers. This was the only item I refused to pay via this provider over years going through them.
Agree with the ethics, but if someone presents with a broken leg do you xray it (cheap) or mri (expensive)? For anything vaguely complicated the Dr is basically just eliminating likely culprits. Its preferable for everyone (that doesn't have a profit motive) if they try the cheap/quick ones first.
Even my dentist in a private practice often doesn't know "Well, we'll bill this to the insurance company, but they might not cover it all so we'll have to bill you"
In my experience, staff generally know how to code referrals for lab work and specialists so patients' insurance will cover it. But sometimes they screw up. So for example, I've been prescribed a testosterone supplement. But insurance won't cover testing for blood testosterone, level unless they use the right diagnostic code. Also for prostate-specific antigen checking. They have to code "enlarged prostate" in order to have it covered. There's another code for routine testing, but it isn't enough.
Its scummy and fraudulent, but issuing a large bill to an insurer, then getting a much smaller check back is how medical billing works here in the USA. Having your insurance pay for a trip to the ER after a car accident would be $7k for them, or $84k for your car insurance, hence why one should carry a car insurance policy with good driver/passenger injury coverage :P
Insurance should really be only high deductible plans, so the patient really looks into pricing for his general care/periodic care.