This summer my husband and I went in for some routine medical check-ups. We paid up front for most of them and then sent the bill into our insurance. Ever since, we have been getting more bills mailed to The House from outside labs saying we still owe money. If we had known about all these bills, I'm not sure we would have went in for the check-up. We didn't even have anything wrong with us! Does anyone have any advice for figuring about exactly how much your doctor is going to charge you. It feels like when we went into the doctors they were connected with several different offices and yet had limited communication with these offices. It felt very disconnected to the point that I wonder how you can trust that you're actually being charged for services rendered?
Any time I have ever gone in for routine checkups, all the lab work and other stuff was covered by my insurance. It could be an issue with the insurance coverage you have, you may want to go through that more closely and contact your insurance agent (or an insurance agent in general) to clarify all this with you. They may have offered you a low price initially but with a lot of catches that you are just now finding out about. In general, hospitals and doctors offices will nickle and dime the hell out of you and line item everything (I've seen them charging like $35 for a *paper cup* to hold patients pills in when they are in Emergency), but the insurance companies generally push back on all these exorbitant costs and negotiate lower amounts with the hospitals so you don't have to be bothered with all this. My main point is, even if the doctors office gave you some sort of line item bill, that may not be what your insurance company would actually pay them, and it wouldn't be what you actually owed. The bill that they would show you would typically be for someone who had no insurance at all and was paying everything out of their own pocket. Also check and make sure if what you are getting are actually bills. Often times I would get these letters sent to my house for all the different services I was billed for, but the insurance company already took care of them, they are just sending you these for your own records. I think it's also a way to help bust doctors offices who are falsely charging for extra stuff they didn't do. One of my dentists used to charge my insurance company twice for everything. If I went in to have one cavity filled, he would charge my insurance company for two cavities, and I caught him doing it because the copies of the bills were also sent to my house even though my insurance company took care of them.
Even though your doctor's office drew blood for the blood tests, then do not perform the tests. The blood is sent to an outside lab. They want to be reimbursed for their services regardless of the results of the tests. It's great news that all your tests were negative. Do you know if the lab has been paid by the insurance company? Perhaps they don't have your insurance information. If not, they just need to know where to bill your insurance company. Whenever your insurance company pays any claims for you, then send out something called an Explanation of Benefits (or something similar). It will let you know if you own any additional money like co-pay, deductible, co-insurance etc. If you haven't received a statement about the lab, then it's a good chance they haven't been paid. Second, if you have PPO or some type of managed care plan, then the outside lab might not have been a contracting lab with the insurance company. If that's the case, then you owe the balance of what the insurance didn't pay. Most contracting doctors use a contracting lab so hopefully that's not the problem. Also, you can ask the doctor what his/her fees are upfront. Most people just don't ask.
It's a huge hassle but you have to be diligent and ask everybody before a service is performed that your insurance actually covers it. For example, you go to a facility to get a procedure done, and you are told the facility is covered so you think everything is OK, but then the doctor who did the procedure is "out of network" so you have to pay a bill for his services. Just remember that everything is probably separate -- from the facility, to the doctor, to the x-rays, to the lab company, etc. You can keep yourself safe from surprise bills by asking everybody "does my insurance cover this" and they will check for you. If a certain facility or doctor doesn't take your insurance you can work with your insurance company to find another local facility/doctor that does.
The best way to find out how much your doctor is going to charge you is to go to a doctor that is really popular among your circle of friends and is known to many people. In this way you can always discuss about your doctor and talk about them to get more reviews on them.
I would definitely speak to the doctor's office in advance before seeing anyone. Tell them that you do not want any tests done by outside labs without your consent and in the event you need them you want to know the cost to you prior to agreeing. Also let them know that you want to know how much the office visit is up front and that you want to be consulted about any procedures or actions while in office that will cost you before they are performed. They are obligated to give you this information so do not be afraid to ask.
