Wow - $745 for a visit & strep test - just wow. And all of the other stories - amazing.
My S definitely understood the importance of having the scratched eye checked - that was why he chose to go to urgent care rather than wait until the next day to get into the eye doctor. The urgent care doctor was good, and he did check the eye out. I had no issue with paying for whatever he did - I just didn’t want to pay for anything other than what was done. It’s possible that my insurance company bundles one of the services into a more expensive bundle - but if that’s the case, I think that stinks. Believe me, once we moved to a high deductible plan, we became much more aware of costs. That was part of what H’s employer hoped to accomplish by moving to the HDHP, but it’s so darn hard to be a wise consumer when you can’t figure out what things will cost beforehand or what they should cost when you get the bill. It’s just frustrating.
the main thing I get from this is the boss is a jerk. he could have lost sight in his eye if just a few things were slightly different and he waited. if my employee came to me and said a cat scratched my eye I would say can you drive or do you need me to take you to the doctor?!?!?
I have worked for decades in medical billing and coding. The billing for op’s son sounds fishy to me. An injection is not eye drops put in eye. An injection should use a needle. A few drops of a lidocaine like substance is not a seperately billable charge in an outpatient setting to my knowledge.I am not an expert in opthamology, but this general principal (injection requires a needle) applies to everything. I could find no code for a “night” visit that allows an upcode for this type of visit. What cpt did they use for that? I am familiar with the idea of after regular hours, but if the Urgent care center is open, I wonder if that really applies.
Years ago I took my step D to an urgent care when she was visiting. It was$195 forjust the visit back then. Of course her insurance was out of network, and she was an adult with her own insurance at the time.
Unfortunately, there are many medical organizations that are not on the up and up. Many years ago, we took our daughter to Columbia Presbyterian outpatient. When the old doctor retired and the new doctor saw her, they wanted to charge her as a new patient. They changed billing ID to do this.(This would not cause a flag by insurance company.) This was in my opinion fraudulent, as she had been a patient of the practice without the requisite break that would have made her a new patient. When I treatened to report to blue cross, they changed it.
I have been to doctors who billed a consultation when there was no referring doctor. I know of doctors who use the old “I forgot to change the template” excuse when they are called on the carpet as well. There really should be no excuse for this.
Luckily, most doctors do not bill fraudulently or mistakenly. Everyone can make an honest mistake. It is just when there is a pattern of the same mistake over and over that one becomes suspicous.
anothermom2 I can not see (pun not intended) where any doctor other than an eye doctor would inject something into a person’s eye. certainly not in an urgent care setting, not even in an emergency room unless the eye doctor was the one doing it. it could be an error by somebody looking for the correct code.when I go to wendys they get my order wrong 1/2 the time and it is ordering straight from the menu. does fraud happen in medical billing?? yes…but I give med practices the benefit of the doubt.