Do doctor's visit really cost this much?
Posted: Sep 8, 2016
So, I'm one of those people generally don't go to the doctor unless they are spurting blood across the room, but...
A couple months ago, I found a lump in my breast, so I made an appointment with a GYN. I went there, they had me leave a urine sample, he felt the lump, wrote me a referral to a breast surgeon and for a mammogram/ultrasound and told me it would definitely need to be biopsied (freaking me out some more) and that was it. I had the mammogram/ultrasound. His office calls and says he wants me to come in to discuss the results which of course put me in a total panic. A couple days after that, I got the patient letter from the radiology clinic stating that they found an area believed to be benign and recommended 6-month follow up.
I go back for the 2nd appointment with the GYN. They try to have me leave a urine sample, which I questioned, and nurse tells me they do it every visit to check for UTIs. I told her I was just there 2 weeks ago and it was ridiculous to do another UA and refused to do it. The doctor comes in, reads the report, gives me a copy which says it is a small cyst just under the skin probably sebaceous, and he recommends I still go to the breast surgeon to see about having it aspirated and he wants me to come back in 6 months. That was the extent of the visit.
Today, I get the EOB from the insurance. I haven't met the deductible so this all has to come out of pocket. The GYN is charging $293.33 for the 1st office visit plus $1.67 for the UA and then $152.21 for the 2nd visit plus another $1.67 for a UA that I refused to leave them a sample for. The mammogram and the ultrasound combined are only $233.05, so less than he wants for a visit where he felt my breast, scared the crap out of me with the whole definitely needing to be biopsied thing, and wrote two referral slips. Am I just out of touch with how much things cost or is almost $300 for that an insane amount? Not to mention another $150 to read an imaging report. He was only in the room maybe 10 minutes the first time and about 5 minutes the second time.
Sorry this is so long. I am just so upset. I am barely paying my bills as it is and now this. I expected the imaging to be several hundred dollars and they are actually less than I thought, but I really wasn't expecting a doctor visit to be that much. ;
I don't have much to go on, but it does - seem high to me.
[ In Reply To ..]
I went to a dermatologist to have a skin lesion checked for cancer a while back and that was $95. My husband goes to a family doctor for his blood pressure regularly and that is $120. If I were you, I think I would call the office and tell them you will have to pay this out-of-pocket and ask if the fee can possibly be reduced somehow. I was in a serious accident once with no medical insurance when I was young and a lot of the fees were reduced when I explained the situation.
Thanks for the idea about trying to get it reduced. - Me
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Around $100 was what I was expecting to be. I just can't believe this guy is charging me almost $450 for basically writing a couple referrals.
$1.67 for a UA is a bargain! - Val
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I got stuck with almost $1000 of bills ($500 mammogram and $400+ lab work) because clever clever Blue Cross in CA cannot figure out that when one wants bills sent to a PO box because one does not get mail at the house, that one actually wants the address changed. Of course Blue Cross failed to change the address, I didn't get my bills and the bills for the mammogram and lab work went to collections.
Months later I got in touch with the California department of managed care to complain about Blue Cross's incompetence and the clever clever lawyer from CA suggested that I rejoin Blue Cross and resubmit my bills (I guess by asking nicely). By then I was already on Medi-Cal and did not see the point in losing more money.
Almost $300 is ridiculous and I would be upset too. This may be a stupid suggestion, but maybe you could trade transcription services? or negotiate for a lower amount based on your reduced income?
That's horrible! - Me
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I hate insurance companies. I was pretty happy with the $1.67 for the UA, well except for the one that I'm being billed for and didn't even have, but his office visit is just crazy. I am going to call them and see what they say.
I can tell you this much--sm - anon
[ In Reply To ..]
I have the EOB from my daughter's quarterly appointment with the endocrine doctor.
Office visit, outpatient 40 minutes, billed $293 and amount allowed $189.59 (most likely the negotiated price). These appointments often do truly run in the 20-40 minute range.
I will say, your UA sounds really cheap, so that is a positive. My guess though is that it is not a UA, but just a quick dip. The capillary blood specimen collection that is billed is $15 and negotiated to $6.49. That one burns my hide because the collection is my daughter poking her own finger with her own poker and they just dab it and put it in the machine for the A1C and the A1C is billed separately.
Planned parenthood and community health services - sm
[ In Reply To ..]
They used to provide a lot of free services such as mammograms if their funding has not been cut by congress.
My very affordable insurance pays for a mammogram every year.
Check your community resources and see about getting on Medicaid.
You're out of touch. - sm
[ In Reply To ..]
You're actually lucky it wasn't more than that for 2 office visits. Which is why the high deductibles on so many insurance policies mean people still can't afford to see a doctor even with "insurance."
If your budget is tight, you should have just started with a mammogram, preferably a low-cost or free one though the department of health, Planned Parenthood, or similar. And if you have health insurance and haven't had a mammogram this year, that should have been free if you're over 40.
Then look around for a local hospital with a gyn clinic. You'll pay much less than for a private office visit, and you may get more time and attention from a fellow than you get from a private-practice physician (which the fellows will all be in another year or two).
As one of my nice docs told an uninsured and unemployed patient just last week, "You can't afford to pay for private office visits. Call the GI clinic at XYZ hospital and make an appointment there instead."
Screening mammograms are the only ones that are free - Me
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When you have a symptom, such as a lump, they do a diagnostic mammogram and it is not free.
Yeah, but if she hadn't had her screening mammo this year, - sm
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she could have just gone for that, let them find the lump when they read it, and acted surprised.
It's ridiculous - LMT
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that just because these doctors are "specialists" they can bill that much, especially for a 15 minute total visit and I definitely would not pay for the second UA if you did not do it. If doctors want to charge that much, then they need to spend the time allotted with the patient...not walk in the room and 5-10 minutes later walk out. They aren't doing an adequate job and should not get that kind of pay, specialist or not. I would raise heck with the doctor's office. They don't have to charge that much. I did billing before and believe me..Doctors get away with too much over billing.
Specialists - oldmare
[ In Reply To ..]
My son was under the care of a pediatric pulmonologist for many years and the office visits were always around $250 and that was about 12 years ago.
He recently saw a neurologist and the visits were close to $300 each time he went.
Specialists will rob you blind.
Doctor visits - Been there
[ In Reply To ..]
I work at a multispecialty clinic and those charges actually seem reasonable to me. The initial consult is always going to cost more. $1.67 for a UA is incredibly cheap. You should not be billed at all for the mammogram as one a year is included in everyone's basic coverage. I hate having to meet deductibles and I think dentists are worse. I'm kind of used to big bills because I've had 2 orthopedic surgeries (knee and ankle) and an overnight stay is at least 20K. Just throwing this out there, but physical therapy is horrible too, $150 to $160 a session, I had to pay 30% and finally had to stop with my knee because I couldn't afford it any more, it was actually as much as my out of pocket hospital bill. I've been through 2 breast cancer scares and false positive mammograms and it is extremely scary, the doctor's office has you in a panic before you even get there. I hope everything turns out okay for you, and you might be able to get some financial assistance on your expenses from your doctors office, at least maybe a payment plan. Good luck.
Crazy, isn't it? Even if a specialist charges only $150 a visit, - sm
[ In Reply To ..]
they'd schedule at least 4 people per hour for followups, so that's over $20,000 per week and over a million a year allowing he takes a month's vacation. Yeah, he's got rent and overhead--maybe he pays each of 4 people in the office $50,000 a year plus bennies (not likely, but he could be one of the generous bosses) and rent is 10,000 a month and other expenses run $5,000 a month. Still leaves over $600,000 a year for him. Assuming his tax bracket is 50%, the poor guy has to get along on a measly $300,000 of course, but with even a halfway decent investment adviser, he'll do better than that.
And this is why doctors from all over the rest of the world always wanted to come practice in the US--it's where doctors in specialties could end up rich instead of just middle class. Now, of course, the hospital groups and insurance companies are raking off their giant share of it all, and docs themselves are sliding back into the middle class if they don't run their own practice/group. However, whoever profits from the huge fees, it's still the poor patients who pay through the nose.
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