Lack of communication, no lack of remuneration

While opening my mail recently I had the most unpleasant experience. I’m sure it’s happened to you all as well: you get your EOB in the mail, you know, your “Explanation of Benefits” from your insurance company, and you begin scanning down the lists of charges the doctor’s office has made. Usually after about three seconds your eyes glaze over and you just cut down to the “patient may owe” section and as long as it’s $0.00 it goes in the trash. It is quite unfortunate when you actually do have a “possible” balance and you really look at the charges that have been made to your insurance company because then you see the ridiculous claims being made by our healthcare providers.

Now don’t get me wrong, the majority of the time everything is as it should be on my paperwork from the insurance company – vacations, lab work, checkups, etc; however, this one time there was something amiss. Of course strep throat made an appearance around the same time as my concern over this charge, so while at the doctor’s office it was brought up. The EOB was for a well-baby check up for the little darling’s 15-month visit. Our insurance company covers the visit 100 percent, so I should owe $0.00 – the magic number at the bottom of the page. But then I noticed that I had a “you may owe” of $48.00. So as stated above I brought up the possible charge. Well when I was told what the charge was for, I was flabbergasted.

It was explained to me that during our well check-up that my insurance company was charged $48.00 for a discussion about my daughter’s eczema and for the doctor writing a prescription for her. What … are you serious? While we were already at the doctor for a check up we were charged for a discussion about an existing problem and for the doctor to write a prescription. So yes, I was very angry. When at a check up for your child, are you not asked if you have any concerns or questions?  Yes you are; and apparently at my doctor’s office they now will charge you if you decide to have any discussions over any concerns about your child. Isn’t this the point of checkups: to ensure the ongoing health and wellness of your child? And shouldn’t that be covered by the well-baby visit fee?  

When you see how much they charge for the 15-20 minutes of time that is given to you, it’s crazy.  And to add insult to injury, they charge $48.00 on top of that for a “talk” about my child’s skin condition, a charge that  according to the billing department “the doctor rendered” and also one that the doctor did not inform me about before proceeding with said discussion. I just can’t get over the whole thing, especially because my doctor’s office has submitted this claim twice to my insurance company and they are not going to pay it; and I don’t blame them because it’s stupid.

I did ask if this was a new office policy because in the five years we have been seeing this doctor we have never gotten a charge like this, and he has written countless prescriptions over the years and had plenty of conversations with me regarding both children. Apparently this is not a new policy in the office, and as stated above, I was told that the doctor is the one who renders this charge. I just really can’t wrap my mind around this. How can you charge someone for a conversation when they are already there for a visit, especially when they don’t even know they are being charged? Why has the healthcare system become so greedy? Why does it cost $300.00 to look in my child’s ear, nose and throat and give her a sticker?  I just am done with it and saddened by my doctor and his office. It is all extremely disappointing.  

You never really know how to handle these situations, but I know that I always want to get to the bottom of the problem and do so with as much grace and dignity and money in my pocket as possible.  I figure I just will have to go to the next doctor’s appointment and nicely bring it up with the man himself, but I guess need to ask if I’ll be charged first, just in case.


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