questionsdoes this seem like an excessive dr bill?

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The labs are where they should be. They are always high no matter how small the test is and biopsies are worse. The specialist office visit rate is probably about right as well. IF you haven't met your deductable. If you've met your deductable you should only be paying about 20% of the charges.

I'm also on a HDHP and my deductable is $2k. I've never met it.

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@nmchapma: Maybe I'm just used to my general doctor. Last time that I had a general dr appt that required blood labs, it was about $115 for the Dr appt and $80 for the labs.

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@nmchapma: I'm in the same boat with $2K deductible I have never met. My company has met their goal of getting me NOT to use my insurance.
@efficience: Those prices sound like what I would expect. Yes, outrageous, but not uncommon.

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I switched to a high deductible plan last year so I could sign up for the health savings account. It was only available to those on the HDP. The first year the deductible was $5,000, but they lowered it to $2,500 the second year. That's pretty high, but our wellness exams (annual physical, pap, mammo) are free. In fact, we get a $60 rebate on our insurance premiums if we do all of our annual wellness exams. And we have access to a health clinic with nurse practitioner level treatment for free. It used to be right in our building and we could just drop in on our break, but our "wise" City Council blew it up so now we have to take time off and make an appointment, but it's still nice to have for the occasional sprain or flu. I am planning to retire next Christmas, and participating for three years will give me close to $10,000 in my health savings account that I can use tax free for health care expenses after I retire. Seemed like a good deal to me. Like getting 20% interest.

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I'm with most of the respondents here, HDHP. I pay in full for non-preventive, but the rate is "negotiated" so I'd pay the lowered insurance rate vs. the doctor's optimistic rate.

Personally, I think it's high, but doctors can charge whatever they want. Your insurance company will have a schedule of what this type of thing should cost (the negotiated rate), maybe they can help you make a case with the doctor. Ultimately, unless you can dispute the bill with the doctor, you're pretty stuck paying it.

j5 j5
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This is why I always get an estimate before the appointment. But the charges seem to be around what I would expect.

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a few years ago i was having sinus problems. my doctor told me he thought it was allergies, and recommended me to a specialist to get tested. I asked the office staff at the spcialists office what it would cost me. i was told $100 "processing fee" for new patients (that fee is such BS btw) and a $40 copay. that was when i learned not to trust the office staff, and to always call your insurance company to get details before a procedure. i got a $400 bill to find out i'm allergic to grass and tree pollen. the test cost $600 but my insurance only covered $200. all they did was jab me with about 60 needles, then look to see how badly i swelled up and they charged me $600. moral of the story, if its medical, it will cost a fortune no matter how simple it is.

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"...but our wellness exams (annual physical, pap, mammo) are free..."

@mortar235: If I'm not mistaken, this is federal law. Most, if not all, insurance plans participate with this.

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@ndcouch: I would like to say a couple things in response to your comment, as a patient (and insurance policy holder).

First, a new patient processing fee is not BS. It is a significant amount of work for an office to take in a new patient, get their existing records, figure out how to bill their insurance, etc. They have a right to bill for that work if they want to, just as you have a right to select an office that does not.

Second, the allergy skin test you describe ("60 needles") is very common and is expensive because it uses a lot of material and time. You probably didn't know this at the time but there are actually specific people and medications that must be in the building while that test is being performed in case you have a severe reaction. You could alternately find an allergist or ENT who does the test via blood which is much cheaper and less invasive, though it takes longer to get the results back.

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@ndcouch: (continued)

The allergy skin test is also rarely covered by insurance. The fact that you got $200 of it covered is rather impressive, a lot of plans won't cover any of it. Even if it seemed entirely qualitative and abstract, there is reason and rationale to it; the test isn't expensive just because they can charge a high price for it, it is expensive because it is expensive to administer.

And for that matter, they should have told you specifically which grass you are allergic to (for example, Timothy vs Bermuda) as well as which tree pollen. That is why there are so many different samples run.

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@justagigilo85: Not sure why you tagged me in that... But yeah my plan also covers yearly exams.

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@lparsons42: sorry, but the new patient registration is indeed BS. office workers are paid to do office work. if they are paid to run the office and do paper work, then why do i have to pay them to do paper work? I get paid to do the AV work at my site. A new install takes alot of time and preparation and research, yet its part of my job, so i cant charge extra every time i have to do one.

As for having to have trained personal and medications in the building as its happening..... seriously? isn't that what a doctors office is by definition? a place with highly trained medical personal and special medications.

Im not a fan of universal health care, but if you are going to try to convince me that medical treatment/cost make sense in this country and are fair to consumers, you're barking up the wrong tree.

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@justagigilo85: That was actually me you were responding to. I am glad it has to be free, because I think a lot of people on the high deductible plan would just skip their annuals if they had to pay for them. One advantage of working for a large employer is that they funded the health clinic as a test for six months and then examined sick leave records and found a dramatic improvement, so they extended the hours and made it a benefit to the health plan. I am afraid now that they have cast us to the winds and made it so much harder for us to use the clinic they will see that improvement erode and use it as an excuse to get rid of the clinic. That will make it much harder to get by on the high deductible plan.

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@ndcouch: You are missing the point. Yes, the office workers are paid to do your paperwork. The new client fee is how you pay them to do it. Do you think the doctor is paying that out of his own pocket? Whether you are charged a specific fee for administrative tasks or it is wrapped into the medical costs, you are paying for your own paperwork one way or another. In regards to your argument about your own work life, are you a contractor or an employee? If you are a contractor, you should charge extra to do a task that takes extra time such as a new install. If you are an employee, you are paid for the time you work, whether it is one major task or a herd of smaller ones. However, if you work for the type of business that does work for other businesses or private pay clients, they may charge those clients extra for your major install. If an IT contractor spends a few minutes installing a program on a computer, the fee will be much lower than if they have to reinstall everything.

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Yeah, that sounds about right for the bill. Medical expenses have gotten much higher in recent years, for a variety of reasons. I flinch every time I get a lab bill, and specialists are covered at different rates than primary care physicians, usually.

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@mortar235: I'm not sure how I ended up tagging you instead of moondrake either XD

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@hot72chev: "$2K deductible I've never met. My company has met their goal of getting me NOT to use my insurance."

For self-insured corporations (which many are), health insurance has transitioned from a provided benefit for employees to a profit center for the company. Most employees, like you, pay their premiums, which go directly to the corporate coffers, and receive no benefit, since their annual medical expenses fall below a high deductible; it's just like being uninsured, except you get to pay premiums too! (Theoretically, you do get the benefit of a lower negotiated rate for the services you use.) At least the ACA means that some preventive services - as mentioned previously - will be covered without a deductible or co-insurance. Beware of loopholes, though; for example, a "preventive" colonoscopy that actually finds something may be charged full freight as a "diagnostic" procedure, same thing if you mention any problem during a "preventive" annual physical.

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Bottom line, medical care is expensive, for many reasons.

For perspective, my dog's 20-minute ultrasound cost $375, and $175 for a special blood test that is apparently only done at a particular lab in Colorado. (That was after the usual fees for an exam and CBC.) If the suspected diagnosis is correct, I expect the needed surgery to excise his enlarged parathyroid will be well into four figures. Besides being grateful to afford it, I'll be relieved that it isn't lymphoma after all (which all symptoms and tests initially pointed to), and to have happy hopes that my mutt's health will be restored for many more rambunctious years. (As an aside to the concerned animal lovers, he recently started on prednisone, which has perked him up considerably.)

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I especially like this --
" If you are an employee, you are paid for the time you work, whether it is one major task or a herd of smaller ones." My herd has gotten way out of control.

cf cf
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@ginawoot: I disagree that the HDHP is like having no insurance. I pay less than $20/month for my HDHP which is through Cigna. Yes for the first $2000 I have to pay all the expense but that just doesn't happen for me. I never go to the doctor but if something big were to happen (car accident) I would only pay $2k deductable then Cigna pays 80% and after $5k I'm off the hook completely. In the mean time I put what I would have spent on full coverage insurance ($2200/yr) into an HSA, while the company contributes $500/yr. I currently have more than enough to pay my entire out of pocket expense plus some to invest or save (laser eye surgery here I come!)

When I'm old and going to the doctor a lot more then I'll either switch plans or start emptying my HSA. If you are responsible with that HSA while you're young it can end up being very helpful when you're not :-)

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I am not paid for the time I work. They pay me to live, eat and breath my job. I'm sure they charge more for what I do though.

I would never pay a new patient fee. It's like saying "we don't like new patients, they cause us to have to work more." If they accept my insurance, they know how to run it. I've never had an office seek out my old records, I have to have them sent. If you don't have the time or resources to take on new patients then you should say so.

My firm would never charge a client a fee to begin providing them service, they'd go out of business in 6 months.