$650 for an orthopedic consulation? wtf?

[MrsZ]

Last December I made an appointment to see an Orthopedic surgeon for a consulation in January. I was seeking a 2nd opinion.

 

When I made the appointment, the receptionist ran my medical insurance and told me that they did accept GHI. I also verified online at the GHI site and this doctor was listed as a provider within my network.

 

I saw the doctor in January. I brought an MRI of my ankle and we had a 10 minute consultation.

 

Fast forward August. I receive a bill from the doctor’s office for $650. My insurance did not pay the visit because they applied it to my deductible.

 

I called the doctors office this morning. I was told by the billing that $650 is the standard fee for a consult and that it notes in my file “patient is aware that this doctor does not take GHIâ€.

 

Because I do not want this to go into collections, I agreed to pay them in installments. They in turn agreed to reduce the fee to $500.

 

This seems completely unfair to me.

Does anyone agree? Is there any recourse I have?

[Why Chat]

Last December I made an appointment to see an Orthopedic surgeon for a consulation in January. I was seeking a 2nd opinion.

 

When I made the appointment, the receptionist ran my medical insurance and told me that they did accept GHI. I also verified online at the GHI site and this doctor was listed as a provider within my network.

 

I saw the doctor in January. I brought an MRI of my ankle and we had a 10 minute consultation.

 

Fast forward August. I receive a bill from the doctor’s office for $650. My insurance did not pay the visit because they applied it to my deductible.

 

I called the doctors office this morning. I was told by the billing that $650 is the standard fee for a consult and that it notes in my file “patient is aware that this doctor does not take GHIâ€.

 

Because I do not want this to go into collections, I agreed to pay them in installments. They in turn agreed to reduce the fee to $500.

 

This seems completely unfair to me.

Does anyone agree? Is there any recourse I have?

 

You made an appointment for January.

You have an annual deductible of AT LEAST $650.

 

Call your insurance Co. and ask them what THEIR "discounted/approved" fee would have been for this procedure, ( it might show on your EOMB- explanation of medical benefits).

 

If it would have been less than $500.( including any co-pay you would have been obligated for) get it in writing or refer to your EOMB and pay the balance to the Dr. that WOULD have been paid if you had seen him in Dec.

 

The good news is that all the rest of your medical for the balance of the year will have had the advantage of the deductible being used up.

[MrsZ]

Thank you for your advice. After I calmed down, I came to the same conclusion.

 

My annual deductible is $200. I did talk to my insurance and I have all of the documentation and I do plan on only paying them the $185 dollars that the insurance would have paid them had them had it been December.

 

Call me paranoid, but getting a bill in late August for $650 seemed odd. The person I talked to in billing sounded like a CA. This person had all the pushiness, arrogance and ignorance of a CA or a temp hired to collect medical bills. They told me that $650 is a standard fee for a consulatation with an orthopedic doctor. I decided to call several doctors in his area of practice in his zip code and in more expensive zip codes in NYC. I learned $200-$250 is the standard. The rest of what this person said to me was a lie as well. Something tells me this doctor hired someone to clean up his billing and they sounded like a CA.

[Why Chat]

Thank you for your advice. After I calmed down, I came to the same conclusion.

 

My annual deductible is $200. I did talk to my insurance and I have all of the documentation and I do plan on only paying them the $185 dollars that the insurance would have paid them had them had it been December.

 

Call me paranoid, but getting a bill in late August for $650 seemed odd. The person I talked to in billing sounded like a CA. This person had all the pushiness, arrogance and ignorance of a CA or a temp hired to collect medical bills. They told me that $650 is a standard fee for a consulatation with an orthopedic doctor. I decided to call several doctors in his area of practice in his zip code and in more expensive zip codes in NYC. I learned $200-$250 is the standard. The rest of what this person said to me was a lie as well. Something tells me this doctor hired someone to clean up his billing and they sounded like a CA.

Have you checked your credit reports??

You need to opt out

http://whychat.5u.com/OPTOUTINST.HTML

 

It is possible that a CA has your personal data, which means that the whole World will have it soon.

[philly1030]

Last December I made an appointment to see an Orthopedic surgeon for a consulation in January. I was seeking a 2nd opinion.

 

When I made the appointment, the receptionist ran my medical insurance and told me that they did accept GHI. I also verified online at the GHI site and this doctor was listed as a provider within my network.

 

I saw the doctor in January. I brought an MRI of my ankle and we had a 10 minute consultation.

 

Fast forward August. I receive a bill from the doctor’s office for $650. My insurance did not pay the visit because they applied it to my deductible.

 

I called the doctors office this morning. I was told by the billing that $650 is the standard fee for a consult and that it notes in my file “patient is aware that this doctor does not take GHIâ€.

 

Because I do not want this to go into collections, I agreed to pay them in installments. They in turn agreed to reduce the fee to $500.

 

This seems completely unfair to me.

Does anyone agree? Is there any recourse I have?

 

You made an appointment for January.

You have an annual deductible of AT LEAST $650.

 

Call your insurance Co. and ask them what THEIR "discounted/approved" fee would have been for this procedure, ( it might show on your EOMB- explanation of medical benefits).

 

If it would have been less than $500.( including any co-pay you would have been obligated for) get it in writing or refer to your EOMB and pay the balance to the Dr. that WOULD have been paid if you had seen him in Dec.

 

The good news is that all the rest of your medical for the balance of the year will have had the advantage of the deductible being used up.

 

 

Also check your policy sometimes second opinions are covered at 100% and ded and copay's do not apply. The catch is that the Dr's office has to code it as a consult/second opinion.