<p>is like getting an exam back. You have some idea of what it should be but you are aware there could be surprises!</p>
<p>I got an ear wax removal by a specialist (ENT). He was with me for about 5 mins. I am young and healthy so I rarely go to see a doctor. This is my first time to his office. Here’s the description of my bill:</p>
<p>NEWPT, OFFICE OR OTHER OUTPT VIS $225.00
IMPACTED CERUMEN REMOVAL $105.39</p>
<p>Can someone explain to me what the first item is about? </p>
<p>I am very puzzled how a simple thing taking no more than 5 mins can cost so much here. Actually, now that I think about it, the procedure itself isn’t that bad, considering I am using a specialist. But that mysterious additional kinda annoys me. It smells like some bogus surcharge.</p>
<p>In Hong Kong, people go to clinlics (usually walk-in with no appointments needed) for this sort of things and this would cost probably about $30. HK probably has more IPO than NYC this year and has the most expensive commercial real estate in the world; so it’s not a cheap place. But medical cost just seems much more straight forward and reasonable over there. The total here is $330 and the doctor spent 5 mins. How is that $330 distributed?</p>
<p>Welcome to the US style of healthcare. Every patient is helping pay for the malpractice premiums required. It costs a lot for training, malpractice insurance and maintianing an office.</p>
<p>The physician first had to examine you and determine the problem- the consultation fee. Then do the procedure. It is too bad you chose a specialist instead of just a walk in clinic or family practice office. In the future you can find out how to avoid seeing a physician just for ear wax- something you could have asked the ENT doctor about. btw- physician here.</p>
<p>wait till you see emergency care bills. My kid got a $400+ bill for visiting emergency since the regular doctor was nt open on Saturday. Insurance deductable $125, hospital facilities 250, and some additional charges on top.</p>
<p>Total time spent with the doctor - less than 5 minutes. You would think $125 deductible ought to cover it but the 250 went under the overall hospital visit deductible. I still can’t figure out why there is a hospital bill when the kid was never admitted.</p>
<p>I heard that cerumen could be removed using cod liver oil or something like that.</p>
<p>Anyway, medical bills are always kind of weird. You get the feeling that the person who is typing them up is afraid that you’ll dispute them unless they sound really arcane and technical.</p>
<p>The other thing that’s weird is seeing the bill and what the hospital/doctors charge, then getting your EOB and seeing what is really paid out to them if your insurance company has any kind of contract with the hospital or physician.</p>
<p>You do have to look at hospital bills carefully. My son was admitted to the hospital with RSV when he was nine weeks old. He was kept for five days. He mainly required oxygen and breathing treatments. The bill showed a $500 charge for “Operating Room Preparation.” When I contested it, they asked, “Well, were they THINKING about operating on him?” NO! Unbelievable. That money wouldn’t have come out of my pocket, anyway, but I didn’t want the insurance company paying it.</p>
<p>MaineLonghorn… you’ll love this one (and my rebellion against it).</p>
<p>About 15 years ago, I had a partial thyroidectomy at the UC Hospital. I’m just guessing this, but I think because they were working on my thyroid, they likely had to slightly hyperextend my neck, so that the tube used for anesthesia rubbed my throat more raw that I’ve ever felt it (and I’ve had strep throat lots of times). So they sent up some sort of humidifier to keep by my bedside while I was in the hospital (I think three nights), then when I was released, it was given to me to take home. I used it at home for a few days before the thing broke and wouldn’t work at all.</p>
<p>When the hospital bill came a few weeks later, I saw that I’d been billed about $200 for this humidifier (yes, everything is marked up!), which now no longer worked. Of course, our insurance paid for 80% of it, but I paid 20% and the way I saw it, we were both out of some money. So I called the insurance company and told them; they told me to call the hospital, which I did, and after several phone calls, got the amount of the humidifier credited to my account (as well… the insurance company was credited their part back, too). </p>
<p>So yea, paying attention to itemized bills is important!</p>
<p>It appears OP got charged beyond just a standard office visit fee–he got hit especially hard as a new patient (“NWPT”). The office had to create a file for him, input his medical history, the doc had to look over the info before seeing the patient–and they charged extra for that. Pretty standard practice, I think.</p>
<p>When D was born, the hospital billed my insurer for two C-sections on the same day. You’d think someone in the hospital billing department would have thought something was amiss–or at least sent me a sympathy card!</p>
<p>We live in Canada now. Having used the med system a lot for self and offspring, I’m accustomed to it. But H rarely has any need for doctors or hospitals. It always cracks me up on the few times he’s gone in and CAN NOT BELIEVE there is not a bill. He’s been here more than a decade but it still hasn’t sunk in. No bill for any walk-in clinic, no bill for specialist, no bill for the vast majority of our medications, and no bill for ER (which sadly we’ve had to use quite 3 times in a big way in the past 1.5 years). You just walk out and say good bye. </p>
<p>Sure we pay via taxes (our current total income tax is about 36% and our employer provides benefits that cover most of our medications), but it is VERY nice to never again see a medical bill of any kind. Sorry to gloat but I really think Americans ought to get away from the fearmongering and get with the program.</p>
<p>When D (my younger kid) was a year or two old, I was sent a bill from the hospital for her birth. I asked for documentation, as when S was born, there was NO bill, except for the kit that H was supposed to wear to keep “sterile” and be able to participate in the birth. For some reason, he never opened the kit, so we used it for D’s birth.</p>
<p>The hospital said they couldn’t provide any documentation, since it was too long ago. I told them I wouldn’t pay anything unless they could explain to me why I owed anything, so they told me to disregard the bill. I probably should have gotten that in writing, but I never got another bill for her birth.</p>
<p>I did double check the bill for when she was hospitalized at less than 2 years of age. The charged her $5 PER ASPIRIN for St. Joseph’s baby aspirin. She was given a LOT of aspirins during that hospitalizations, so I fought it and they finally backed down and agreed that it should have been $5 for the whole bottle instead of per aspirin.</p>
<p>They also wanted me to rent a nebulizer (which is what they vaporize medication that you inhale. The total cost of the device is roughly comparable to an electric toothbrush. I could have purchased it from Kaiser (which I am NOT a member) for $100, but they made me buy it from the participating & preferred provider. They wanted me to rent it monthly @ $30/month but I fought for 6 months until they finally agreed I could buy it instead (since it took them a week to get the model I had wanted & I needed it to be available whenever any of the 4 asthmatics in our household needed it for their breathing problems). It was insane! I told them just ONE ER visit would be FAR more expensive than the entire device.</p>
<p>Yes, it is standard for most US docs to charge a new patient exam fee that is considerably higher than “established patient” fee. This is one of the reasons that “urgent clinics” and “doc in the box” places are popping up. Their fees are lower and they can be useful for fairly standard & simple matters. I agree that it is quite amazing to see the difference between the amount billed and the amount that the insurer (and insured) pay.</p>
<p>In the future, for uninsured folks or those with high deductibles, it is a good idea to ask BEFORE you receive services if you can have some discount for paying at the time of the visit & explain that you have no insurance or a high deductible. SOME providers may make adjustments.</p>
<p>I used a non-specialist for the same procedure few years ago and I got a really bad experience. I was in pain and had to stop and left without having anything removed. I was in pain the whole night. I had to see a specialist the next morning and difference was day and night. At that time, it cost about $220. New patient at that time too. So what’s why I chose a specialist this time.</p>
<p>What’s the term for generalist? “Family practice”?</p>
<p>When I called the office to make an appointment, I told the assistant it would be my first time and I was told the cost would be about $200 or so. Therefore, what’s on the statment is considerably more. </p>
<p>I actually got insurance through work. I was prepared to pay $250 deductible but I got the following weird breakdown and this time, it goes in my favor: ;)</p>
<p>Patien Payment-Cred Card -30
United Health Care Payment -145
Adjustment -69
Amount Due 86</p>
<p>I don’t understand this one either; my plan says I need to pay $250 deductible. This is the first time I use a medical care since I enrolled. But this time I don’t care if I understand it. LOL!</p>
<ol>
<li>You paid your $30 co-pay with your credit card at the time of your visit</li>
<li>United Healthcare paid $145</li>
<li>They “adjusted” the bill because they have a negotiated fee in place with the doctor, so this “adjustment” really means “Don’t worry about this amount; no one has to pay it.”</li>
<li>You still owe the doc $86</li>
</ol>
<p>So the doc will have gotten $30 + $145 + $86 (= $251)for the visit. You will have paid $86 toward your $250 deductible.</p>
<p>Every patient is also paying to offset the low fees that Medicare and Medicaid pays as well as to cover the cost of the uninsured who have no way of paying their bills. It’s called ‘cost-shifting’. It’s a well-known phenomenon in the healthcare industry…we talk about it all the time when we are setting our rates. Now there are economists who claim that it doesn’t occur but I literally sit in meeting all the time where we discuss this. As a healthcare provider, your options to do so have diminished with the advent of managed care plans (which is why hospital operating margins are much smaller these days and hospitals are closing) but the private insurers still pay almost 50% more than Medicare or Medicaid. Of course, if you have private insurance, these costs are passed on to your employer, who in all likelihood pass them on to you, the employee. Pity the poor bloke who has no insurance and actually has to pay that $330 bill.</p>
<p>My mother got billed for an emergency ambulance to move her dead husband 200 yards from an assisted living facility to an ER, and then for an attempt to revive him two hours after he died. $4,600. The hospital owns the assisted living facility, and has set it up so that no doctor is allowed to pronounce death at it. So the bill is totally legal.</p>
<p>All to be paid by Medicare. When she complained to Medicare, they did the phone-shrug thing.</p>
<p>Contact your insurance- United Health Care. If this is a contracted doctor, and you are in a specific type of plan, he may not be able to charge you the $86 either. They may try, but your insurance can verify for you whether or not his contract with them allows him to or not. </p>
<p>I would clarify what the $250 deductible is for too. It may not be towards standard MD visits, but other things like ER/hospital stays. The back of your card MIGHT tell you that, but not all do.</p>
<p>I don’t know the details of your plan so I can’t say for sure, but probably the $30 co-pay applies to the office visit and so does the $145. Your deductible only applies to the ear-wax-removal portion of the visit. (THE PROCEDURE, in insurance-speak.) And you’ve now paid $86 of your $250 deductible. (The co-pays don’t count toward your deductible.)</p>