Should a doctor visit cost this much? - Mothering Forums
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#1 of 16 Old 02-14-2008, 09:24 PM - Thread Starter
 
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Yikes!

So on my first doctor visit I was kept waiting for an hour and 40 minutes before the doctor saw me, then the doctor spent all of 10 minutes with me. She did a transvaginal US to determine my due date that took about 3.5 of those minutes. I am being charged 746.00 dollars for that.

Is that a normal price for those things? The visit was 425 and the us was 321. I never ever ever go see a doctor (literally) and I just feel like that was the most expensive 10 minutes of my life!
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#2 of 16 Old 02-14-2008, 09:33 PM
 
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I am canadian so I don't know if its reasonable (sounds pretty high though) but I'd ask for a breakdown of fees...often the u/s is not analysed at the time but sent out then after, then reviewed by the doctor. The doctor may have also done things like get some health info from one of your other doctors...ordered blood work, charged for the u/s referral..wait the doctor did the u/s?
sounds high....
I had a transvag in a hospital while travelling possible m/c...it was no where near that...

8 might be enough
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#3 of 16 Old 02-14-2008, 09:48 PM
 
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If you don't have insurance, ask if they can reduce the rates for you. That helps in some cases. I would also ask if they can itemize the charges for you too. That helps you see what they are charging so much for. Sadly Docs charge so much because of the insurance thing. If we all paid out of pocket like years ago, things would be so much more affordable.
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#4 of 16 Old 02-14-2008, 09:49 PM - Thread Starter
 
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This was quite literally the appt:

Sat in waiting room for an hour. Called by nurse who took my weight, height and bp. Sat in exam room (alone) for 45 minutes. Doctor came in. Asked if I had other kids, if I was having any morning sickness, when my LMP was. She then asked me to disrobe and stepped out, came back, stuck the old prober in, wiggled it around and said "There's the baby. There's the heartbeat. You're 9 weeks." Then she handed me a packet and that was it. She couldn't have ordeded charts from another doctore because there is no other doctor.

And we do have insurance but I still feel like this is high! Basically, we don't pay for this but it comes out of our HRA. All other visits are covered 100% but not another us. So that kind of bugs me because we really wanted to find out the sex.

I mean, are they billing it by how many minutes I was in the office? :
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#5 of 16 Old 02-14-2008, 10:01 PM
 
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That seems like a lot to me. The couple times I went to my PCP without insurance it was less then $100. Right around that but not quite as much.
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#6 of 16 Old 02-15-2008, 03:57 AM - Thread Starter
 
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Okay I'm just getting really upset now and I'm looking all over the internet for some comfort . . . the office visit is billed as "Office/Outpatient visit new lvl 4". Does anyone know what that means?

Thanks!
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#7 of 16 Old 02-15-2008, 01:47 PM
 
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Offices are probably different with what their various codes and levels mean, but I found one website which indicates that a "Level 4 New Patient Office Visit" means there was a comprehensive history taken, a comprehensive exam given, and "Moderately complex medical decision-making" required. It also notes that if billing is based on time, 45 minutes of face-to-face with the patient is required. Again, this isn't to say that's what your office uses "Level 4" to mean, it's just something I found on-line.

FWIW, your bill seems really high to me.

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#8 of 16 Old 02-15-2008, 01:59 PM
 
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To be honest, I would say those fees were on target, at least for the NY/NJ metro area...I live in NW New Jersey and pay slightly more than that for a midwife visit plus u/s. Also, TV Ultrasounds cost more.
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#9 of 16 Old 02-15-2008, 02:40 PM
 
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My whole pregnancy should be $2700 for the doctor's fees including if I'm go to the hospital for birth. I don't know if U/S would be extra, but $400 seems like an excessive hourly rate (yes, I know they weren't with you an hour, but presumably they did something to prepare for your appointment and did something afterwards, so I'm giving them the benefit of the doubt.)
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#10 of 16 Old 02-15-2008, 02:45 PM
 
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I'm not sure about the ultrasound cost... My OB/CNM practice charges $250 for the initial (which is the comprehensive blah blah blah visit) and $125 for each f/u if I don't continue with them (if I deliver with them they charge a global fee for all care and delivery). My non-nurse midwife charges $275 for the initial visit. Your costs seem high especially given the fact that you no way received what they're billing you for in terms of the office visit. I would talk to your insurance company b/c they'll have a better idea of coding etc.

ETA: not in your DDC...just popped in when I saw the title!
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#11 of 16 Old 02-15-2008, 03:33 PM
 
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Wow! My dd just went to the doc and we got 30 minutes with her, it was $90.

Mom of a 7 yr old, 4 yr old, and 1 yr old. Wow. How did that happen?
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#12 of 16 Old 02-15-2008, 04:34 PM
 
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My pre and post natal care will cost me $1000 and I have to have it paid in full by March 20th.

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#13 of 16 Old 02-16-2008, 01:31 AM
 
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Yikes! That seems high! I didn't have insurance back when I was pregnant with my son. My midwife ordered an U/S for me at 18 weeks, and I had to go to a reproductive specialist place for it, it was like $175 if I recall. Of course that was back in 2002. I think all my prenatal care, birth, and postnatal care was like $2100 total.

Seeing scary prices like that for one visit make me even more happy I am doing a UP/UC this time around!
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#14 of 16 Old 02-16-2008, 12:58 PM
 
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Is that with or without insurance? An u/s at my OB/MW practice is $175.00. I did find out yesterday that with this insurance we have I will pay a $30 copay for each office visit which I've never had to do before, so that was a shock. Not to mention the deductibles. It's all just so crazy :

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#15 of 16 Old 02-16-2008, 10:14 PM
 
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I would say those fees are probably accurate. I know that is about what an ultrasound runs. If they "just" coded a level 4 exam the doc visit part seems a little high but if they did any diagnostics or other codes it is probably what they charge. Insane but true...:You could complain about the little time and the high level code they used. They may reduce the code to a lower level and a lesser fee.

Good Luck!

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#16 of 16 Old 02-16-2008, 10:56 PM - Thread Starter
 
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Okay, so I spent about two hours on the phone with different people yesterday, and I'm not going to bore all of you with the long sob story, but the last woman I talked to was actually very helpful. She explained the billing process and what the visit level four actually included: new patient (okay), office visit (okay) positive pregnancy exam (?) and level four IS the amount of time and what you're being diagnosed with. Apparently level 4 is 45 minutes so the woman I talked to was more than understanding when I said I spent ten minutes with a doctor. Also, I asked her what the positive pregnancy exam was, since I didn't have any sort of exam. She said it could be something like a pelvic exam or checking the baby's heartbeat. Okay, so THEN my question was she checked the heartbeat on the us, which I got charged 321 for. So what was the us charge for? Rolling the machine into the room? She thought that was really funny and laughed.

She was very understanding though and said it was really high. The doctor had just "followed standard procedure" though. She said I should write a letter documenting what her (the billing lady) and I just spoke about and also include the EOB from my insurance and then the medical group manager can reduce my rates. She didn't know how much so we'll see.

Oh yeah AND I called the actual ultrasound place (where I'm supposed to go for my 18 week us) and they said that their charge for a us is 275. So it seemed a little ridiculous that the 3.5 minute us done by a doctor on a small machine cost MORE than an hour long us done by a sonogram tech . . . anyway that's just me! I will let you guys know if and when the rates are reduced.
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