Unfair doctor charge

So my wife is pregnant, took all the necessary blood tests and 1 test showed she had higher than normal chance of having a Baby with downs.

So our doctor suggests we drive down 2 hours to Burlington, VT to get this special advanced test done if we want to know whether our baby will have downs or not and it's a very accurate test done simply by drawing blood. It is much less invasive than an Amnio but it costs 500$.

My wife was a wreck, crying and worrying so I figure what's 500$ if it will save our sanity? We call the hospital, book the appointment, etc...During the call they confirm it is indeed a 500$ test.

We show up on that day and the doctor calls us into an office and begins to chat with us, ask us how we're doing, asked if we had any questions and this lasted about 20 mins. After that, he handed us a small box, we filled out the payment for the test which was, as stated, 500$. We went down to the lab, drew blood, they tested it. A week later we get a phone call letting us know everything is normal and the baby does not have downs and everything looks great.

We're obviously relieved and so excited to have another baby girl at the end of june...

Earlier this week I get a 200$ bill from the hospital for the consultation with the doctor??? I called and explained that the doctor was a very nice man and it was a pleasure to speak with him for 20 mins but we were never told there would be a fee for the consultation nor did we need one since all we wanted was the test. They're now offering to take 30% off that bill but I don't feel I should have to pay it, We never asked for anything other than the test and it was supposed to be a 500$ test, not a 700$ test.

Toughts?

 

My thought is: Be glad the test was negative.

Pay discounted bill, and congratulations!

You can never win against the machine and if you withhold payment, the damage to your credit report is not worth the few hundred $

 

Contact the BBB.

 

In my book, this is crooked. Extortion. Sock it to them.

 

I'm with Trent. They may not have told you the charge was coming, but I rather doubt there was wrongdoing. Sucks, complain, change doctors if you choose. But I'd just pay the discounted fee and then decide on a next move. Just what I would do.

 

I understand your frustration (I'm a doc, my wife is a doc, and sometimes in spite of our best efforts we end up with charges we don't understand). But, this may be an issue of you asking a specific question (but the wrong one) and getting a correct (but misleading, from your point of view) answer. The question should always be "What is the cost of the test, and are there any associated fees, other required charges, etc.?"

You could go down the billing code rat hole (meaning, what specific charge was levied by the hospital for the doc's time who talked to you, was that the right code, etc.). Likely your time is more valuable.

Congrats, even with the slightly sour taste, on the great news.

 

I'd *****, then I'd pay.

It's a good news- bad news thing.

Good news? Baby's fine.

Bad news - it's gonna cost you an extra $200.

Life is short. Take one shot at getting the charge taken off, if they balk, pay it. Or fight with the bill collector who will surely come calling in the next 60 days.

D

 

Thanks for the advice guys....the thing is that I had no need for a doctor, we have our own doctor already and our doctor made the appointment and sent us down there for the test telling us it was 500$, our doctor's secretary told us 500$. When we called the hospital they said 500$ and when we sat with the doctor he himself told us 500$.

So now, all of a sudden, it's 700$???

Sure, I should be happy the baby's ok but is that a valid reason to allow someone to get away with this?

 

Insurance involved?
Was doctor on your plan?

 

The Hospital system has replaced the Church circa 1955 as the untouchable sacred cow in our society. They are considered above reproach and can not be questioned in any way. This has led to out of control costs for lousy service and often unbearable attitudes.

Let's examine your $200.00 bill for 20 minutes "consultation".

We'll give the Doc a $150.00/hr rate which equals $300K per year based on 40hr work week. Much more than most are are worth. Most commuter jet pilots who work in lousy conditions (cramped quarters, always on the road) and have MANY lives in their hands landing in tough storms in pitch dark make $25K per year. Expert car mechanics who have to actually fix the problem charge $80+/hr while in a dirty uncomfortable position. Both of these professions are highly skilled and have years of training/knowledge. Fire and EMS also come to mind.

20 minutes @ $150 = $50.00 somewhat justifiable labor charge


Infrastructure charge - you occupied a room that was probably a little smaller than a room at Motel 6 where they also had to construct a large facility, staff it, clean it, furnish it, light it, and heat it, not to mention paying Tom Bodett to tell us about it. They charge $50 per 24 hours of use, heavy use.

20 minutes @ $2/hr = $.70


Total justifiable charge $50.70 + tax

As i already said they have become so smug and so arrogant that they basically steal from a lot of people that feel they can't fight back. It is highway robbery, daylight mugging, almost criminal. It must be stopped and a national ID card would stop most of it (ask for details). What that system is doing is wrong. And it is wrong to allow it to continue, and it is wrong to perpetuate it.

 

Who are you berating? The doctor or the insurance company?
Here we go again..............................

 

Actually neither although they are complicit to some extent in the mess. I am directly attacking the hospital "system" as it now exists mainly as a business versus the avocation it once was.

 

No insurance. This test is not available in Canada so we had to pay ourselves. We arrived there for our appointment to get the test done and they somehow lead us into a room with a doctor (who was very nice and very knowledgeable) and they sat us down for a 20 minute chat before sending us down to the lab for the test. We were clueless and just did as we were told.

 

Wait,

So they quoted $500

Then, charged you $700

And are offering to take 30% off (0.3*700 = 210) = $490 total?

Or 30% off only the $200 surcharge?

This is one of the worst parts of US health care. I wonder what your legal rights are? Do you have a copy of the original paperwork with the estimate?

I agree with telling them you are contacting the BBB and filing a complaint with whoever the regulatory agency is that they report to (look it up online and then tell them who you're calling).

This is one of the worst parts of US health care. They tell you they have no idea what they bill will come to, then tack on tons of crap expecting to get hammered down by the insurance co.

Oh, also, FWIW, the 30% off thing is no consolation - that's a standard discount all the hospitals I've ever dealt with offer for cash payment.

 

thats the facts of life(and death), that in order for the medical professions to absorb the huge discounted prices paid by hmo's, ppo's and medicare, medicaide, the cash patients( those without insurance) pay much much more than someone with insurance.

 

You need a prescription for medical tests. Could that be why you needed to see the doctor? If so, would that explain the difference between what you were told the fee for the test was and your total bill?

 

The discount is being offered on the 200$, thanks for informing me about the standard 30%, they were making it sound like they were doing us a favor.

Perhaps we did need a prescription from the doctor but I feel we should have been properly informed.

 

Sounds like you were just misinformed by the office staff. As salaries decrease, less qualified and dedicated people are applying for these jobs. Happens to us all the time when we call the insurance company on behalf of the patient. We are frequently told some procedure is covered, only to find out later its not. Then the patient blames the office, refuses to pay for the treatment. Real winners are the insurance companies. And its only going to get worse, much worse. Hold on, its going to be a bumpy ride.
Ed

 

US healthcare has really shot itself in the foot by allowing the opacity of payment/billing. I think it will actually get better with the ACOs that are coming, at least fewer bills, more consolidation.

As it is now, if the docs/ labs/ other services are not in the same company,they can't bill together or that would be considered fee splitting which is illegal ( except, oddly, it's not illegal for lawyers to do it).

The way it is now is stupid and I fell for the OP.

 

Another spin:

Your doctor in Montreal likely doesn't have a US license; the test readily available in Vermont is not in Montreal under Canada's "free" single payer health system. A US doctor then needs to order the test and assume the responsibility and liability for its performance and interpretation, as well as his time, which with documentation of your visit was in excess of thirty minutes. Mr. Bourne feels $200 is outrageous for this (and in fact if you had US insurance the payment would have been significantly discounted), which must also serve to offset facility overhead and insurance, clearly needed in the US because if the test had been run incorrectly through no fault of the ordering MD he would be on the hook for a likely multi-million dollar lawsuit.

 

It would be nice if in these discussions the MD side would not use the lawsuit boogeyman. Perhaps Doc's should ask prospective patients if they are attorneys or directly related to any. Not to mention the doc would be far down the list in the scenario presented here. Yes it is an outrageous charge for the time involved. Outside of the guy's holding scalpel's, it is just a job.

Many years ago I worked as an accountant for a large, high profile RE management firm. I handled the books for some skyscrapers and paid the bills for them. These were large amounts and the late charges were large. I was informed by the more experienced acct.s to ignore them and always pay late anyway. I was a little surprised at this and inquired how/why. I was told we, the large firm and property, were so big we didn't give a *****. They might hassle the little homeowner but not this big corporate entity.

Well the Hospital system has the same attitude, just worse. Obscene charges for little to nothing done. I know of many such instances.

It's broke and time to fix it and the only way is a well designed single-payer system (plus tort reform). Don't look elsewhere it can be done. Similar to Tesla vs all other EV's.

 

We had the same tests done with our son. Just pay the bill, you have no idea of the real expenses that are coming your way, this one is almost free in the grand scheme of things...

 

I just can't agree with this...we sat there with the doctor and he himself confirmed it was 500$ so they can't blame their staff...

In what other business would this be acceptable? Imagine driving somewhere for 2 hours to buy something at a set price and then, after the fact, have them tell you it's 200$ more.

 

vinny, how can you be an accountant and make post #10?
are you self employed or an employee of a large corp? big difference.
ed

 

From your posts they didn't lie to you. You confirmed on multiple occasions that the test was $500 and that is what you were charged for the test. I haven't read that you asked if there were any charges for the physician services.

Example: You go to the MD for an ultrasound. You are charged for the ultrasound as well as the physicians services. The $200 may have included his interpretation of the test.

I think you need to chalk this up to a lesson learned to ask the total costs for a procedure/test "X"

I do agree that someone should have disclosed the total costs as it appeared you were being diligent in questioning the cost of the test. Maybe a miscommunication or lack of in this case.

I am happy to hear your child is healthy which is the most important thing.