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Old 04-21-2006, 05:21 PM
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I received the explanation of benefits today from my insurance (UHC).

My initial "office visit" the doctor charged $1,100.

Can you believe that?

Maybe this is the going rate? My husband and I are just shocked!

My insurance only allows $295 and they can't bill me the difference, but this makes me real sad for those who don't have any insurance or have crap insurance (they're all crap, just didn't levels).

No wonder people are going to other countries to have their surgeries.

Maybe I should send him a bill for the two hours we sat there past my appointment time?

Another doctor came in after 90 minutes of waiting to tell us that our doctor was tied up and explained my MRI to us. My face must have showed how preturbed I was because he promised that the other doctor would still "pop his head in".

The US really needs to do something about this health system, we're not even close to the top anymore. Receiving this statement today really made me feel sad for those who might be in my condition and just can't afford the doctor.

Thanks for letting me vent.
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Old 04-22-2006, 01:43 AM
Dale S Dale S is offline
Join Date: Jun 2005
Posts: 236

Yes, by all means, bill your doctor for any wait time longer than 1/2 hour. Anything more than that, other than for emergency purposes, shows a contempt for his patients who should have been otherwise notified for their decision of rescheduling or waiting.

Good luck in collecting!

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Old 04-22-2006, 06:10 AM
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I agree with Dale. That bill is obscene. From your post,I gather you didn't even see the doc you were supposed to, or only briefly? And you waited two hours? How much time did you actually spend talking to a doctor about your case?

How is the bill broken down? Depending on how much time and strength you have to make noise about it, I'd urge you to try to get it knocked down--the sad thing is unless they immediately agree (yeah right) you'd might end up paying the difference to some sort of lawyer.

It's absolutely obscene, and one of my pet peeves, that the lines of an altruistic profession such as medecine have over the centuries been warped and inextricably blended into a vehicle for human and corporate greed.

Even here in France, where insurance coverage is expensive but extensive, some of the 'best' doctors still take an envelope under the table
for the honor they bestow in operating on you.

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Old 04-22-2006, 11:05 AM
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This info might be useful to some of the US members:

When you have insurance and a doctor accepts that insurance, they are NOT allowed to bill you for the difference between what they charged and what the insurance covered.

I had a previous doctor trying to pull this and my insurance company told me to write them a letter and say "you are not in compliance with your agreement to (insurance company name). When you accept their agreement, you are accepting what charges they have allotted for certain procedures.
You are NOT allowed to bill for patient for the difference in the amount of what you submitted to the insurance and what the insurance covered.
This would make you not in accompliance with your agreement with (insurance company name).
Please adjust your actions accordingly."

I sent this to the doctor and magically, the next bill showed that I had a zero balance.
I didn't know that until the claims person told me this. She also explained that if you have a deductible to meet, then you might have to pay that but they can still only charge you the amount that the insurance company you have allots for that procedure/visit. Example: if you have a $500 deductible, they can still only charge you $295 if that is the amount your insurance allots for what the doctor submitted on the claim.

If you go to the doctor with no insurance, well then he can charge you his full ridiculous price.

I'm guessing that people who just can't afford medical insurance are just suffering with whatever ails them. How sad!


I only seen the doctor I had an appt with for 3 or 4 minutes. He came in (never apologized either) and said Dr. $#%@ went over everything with you, did you have any other questions? (the other doctor told me that my MRI showed that I have DDDL5 stuff I already knew from my previous doctor).

I asked him what do we do next.
He said we'll set you up to give you two injections to see if the pain is coming from the facets as well and we'll see what your insurance covers as far as your next options.

That's the amount of time I spent with him after waiting TWO hours. My husband wasn't at work so he could be there with me. Sorta makes you feel like only their time is valuable.

By the time I left the appt, all the girls up front left for lunch. I asked him, "how do I make the appt to come back now" and I was told "the girls are all at lunch now. I will leave a note for the scheduler to call you. If you don't hear from her within a few days, then call her back".
This was a Friday. On Wed., I stopped in and made the appt myself since she never called me.

This is the part that worries me.
Imagine if I have him do my ADR and I have a problem after. I won't be able to get in there to see him. They will put me with another doctor.

I hate that. I went to him because he's supposed to be very good. I don't want to see the other doctor's he has trained to do this. I want to see the teacher....not the students!

Again, thanks for letting me vent.
Maybe if someone else is going through some frustrations too, this will show them that they are not alone and feeling Charlie Brown.
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Old 04-22-2006, 12:15 PM
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Thanks, Vicki--I didn't absorb the 'they can't bill me the difference' first time around; was too busy coughing up a hairball over the bill itself

But Lord, what they try to pull. You're right, it's sad--for starters. The adjectives get more violent from there on.

And this is getting dangerously close to a natural segue into Health Care in the US, which could turn into a political debate, which would then go waaaaaay off topic, so I'll take the neutral way out and say, 'gosh dang it Vern, somebody oughta do somethin', and wish you better treatment in the future

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Old 04-22-2006, 12:41 PM
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I had a doctor like your's in TX a while back, things went from bad to worse and I ended up getting sub-par treatment and I found someone else. I wrote the doctor complant letters and physically handed them to the doctor. This helpped a little.

I've found that Doctors need a little constructive critism too b/c they don't get the feedback that we get at our jobs. It helps to bring them down to earth a little. Since then I thank my doctors when they are on time and sometimes send thank you notes. I also remind them that I have a job and responsibilites too when they run late and/or are rude and let them know that I understand the ER's happen, but I won't put up with waiting 2 hrs everytime I have an appointment.

That experience taught me that if a doctor doesn't respect my time, my questions and care enought to have office staff that are competant then he is not the best person for me or anyone else. I've seen some of the best and they are always respectful and caring. If you can, I would find someone else. If you can't, I suggest calling his office before your appointment to see if their running late, if so you can wait at home and avoid a long wait reading "Time" or "Modern Parenting" or worse yet "ESPN Mag"

BTW I just saw my bill for a one night hospital stay last week.... $13,163!!!! That is without the 3 doctor's charges.... (I'm betting it will be close to 30K when it's all said and done) THANK GOD for insurance! My boyfriend Jeff nearly fainted when he thought we'd have to pay.
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Old 04-22-2006, 01:11 PM
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Originally posted by Texas-T:
[qb] BTW I just saw my bill for a one night hospital stay last week.... $13,163!!!! That is without the 3 doctor's charges[/qb]
Holy COW, one night ?? What did you have put in, a solid brass set of EVERYTHING??

How can they possibly claim to justify that?

Off to cough up more hairballs....
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Old 04-22-2006, 01:57 PM
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Lol, you're telling me! I can't wait to see what the bill for the ADR will be..... I've hit my catastrophic limit on my insurance so at least I've stopped having heart palpations when I open a bill... before I had to pay 10% of everything.
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