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Discussion Starter · #1 ·
Hi,
I hope I'm posting in the right forum.
I am 2 months pregnant and was referred to a very good and reputable OBGYN by my internal medicine Doctor. When I called to make an appointment, the receptionist explained to me that they charge their patients the fees of her total prenatal care plus delivery upon the first visit! So she said if my insurance pays 80% of costs, then I would have to write them a check for the 20% which would amount to about 1K. Well, the thing is we have a 5K deductible for prenatal visits and now they have billed me for $5,000 with the explanation of (anticipated care).
I have seen the doctor twice now. but now that they realize that I have a 5000 copay, they have sent me a bill for that amount. Is that ridiculous? Can a Doctor charge in advance of his/her services? My insurance company told me that I shouldn't pay them in advance and that the Doctor needs to bill the insurance company at each visit so that they have a record of how much I'm paying out of pocket so that once the 5K is reached, their part kicks in.
I have an appointment next week and I am going to tell them that. but what if they say that they won't accept it and they won't provide services to me?

I guess I'm asking if this is normal and if it's not, how can I argue back that they are obligated to provide services to me as long as I pay at each office visit?
Thanks for any thoughts you guys can share with me. I'm very nervous right now.
 

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That sounds crazy. I've never heard of that for a doc's office. If they refuse services, take it as a sign that you were meant to find a different care provider. What if you decide to move, or switch docs, or the care you require changes? That sounds like they're trying to rope you in somehow. I'd follow your insurance co's advice.
 

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Discussion Starter · #3 ·
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Originally Posted by St. Margaret View Post
That sounds crazy. I've never heard of that for a doc's office. If they refuse services, take it as a sign that you were meant to find a different care provider. What if you decide to move, or switch docs, or the care you require changes? That sounds like they're trying to rope you in somehow. I'd follow your insurance co's advice.
Thanks for your response. That's exactly what my husband said. I would be so diappointed if I have to switch Doctors though. I get really nervous about this kind of stuff. Finding a new Doctor and everything. I'll let you know what happens next week.
 

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I definitely agree with the PP.. I've never experienced anything like that with an OB. I usually pay my $20 co-pay the first visit and then I am billed at the end after I've had the baby. While your insurance is probably very different from mine they can't expect their patients to just hand out $5000 at one visit.. that's ridiculous and I don't know very many people with that amount of money just sitting around at any given moment.
 

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Discussion Starter · #5 ·
well, I was about to put up a real fight with the Doctor's office, until I came across this thread. http://parents.berkeley.edu/recommen...nancy.html#fee
I am in the same shoes at the last poster and looks like i have to pay up. However, I hope my insurance will know how to count all my payments towards the deductible..... as if I needed more stress in my life.
by the way, I live in LA and maybe this is just something Souther California Docs do.
:
 

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That is how my OB does it. I anticipated that though and switched my insurance before TTC to no fee OB coverage. You can shop around and find one that doesn't but from my experience that is the standard.
 

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Discussion Starter · #7 ·
wish we'd been smart enough to think ahead. I believe it's too late to switch now that I'm pregnant. Just have to accept the fact that I screwed up!

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Originally Posted by lyttlewon View Post
That is how my OB does it. I anticipated that though and switched my insurance before TTC to no fee OB coverage. You can shop around and find one that doesn't but from my experience that is the standard.
 

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Yeah, 7 months into my second pregnancy, I decided I'd really rather have a midwife-attended homebirth, but since I had paid for everything upfront (I didn't have insurance), I was stuck.
 

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Quote:

Originally Posted by happynose View Post
Hi,
I hope I'm posting in the right forum.
I am 2 months pregnant and was referred to a very good and reputable OBGYN by my internal medicine Doctor. When I called to make an appointment, the receptionist explained to me that they charge their patients the fees of her total prenatal care plus delivery upon the first visit! So she said if my insurance pays 80% of costs, then I would have to write them a check for the 20% which would amount to about 1K. Well, the thing is we have a 5K deductible for prenatal visits and now they have billed me for $5,000 with the explanation of (anticipated care).
I have seen the doctor twice now. but now that they realize that I have a 5000 copay, they have sent me a bill for that amount. Is that ridiculous? Can a Doctor charge in advance of his/her services? My insurance company told me that I shouldn't pay them in advance and that the Doctor needs to bill the insurance company at each visit so that they have a record of how much I'm paying out of pocket so that once the 5K is reached, their part kicks in.
I have an appointment next week and I am going to tell them that. but what if they say that they won't accept it and they won't provide services to me?

I guess I'm asking if this is normal and if it's not, how can I argue back that they are obligated to provide services to me as long as I pay at each office visit?
Thanks for any thoughts you guys can share with me. I'm very nervous right now.
Wow, $5,000 seems a bit steep for prenatal care and delivery. Where I live, standard prenatal care and delivery run around $2,500 from an OB. I would definately complain, because you don't know how much they are going to actually charge you for the L&D and prenatal care. They could just be gouging you for $5,000 when they normaly only charge $3,000.
 

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Quote:

Originally Posted by happynose View Post
. I believe it's too late to switch now that I'm pregnant. Just have to accept the fact that I screwed up!
It is NEVER to late to switch! You always have the freedom to switch care providers. Mamas switch OBs and Midwives all the time. It's really not a big deal. And truthfully, practices that have a ton of patients often don't even know the difference! I hope your situation works out with this OB (if that is indeed what you want), but remember YOU are the consumer here.
 

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Discussion Starter · #11 ·
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Originally Posted by elriomidwife View Post
It is NEVER to late to switch! You always have the freedom to switch care providers. Mamas switch OBs and Midwives all the time. It's really not a big deal. And truthfully, practices that have a ton of patients often don't even know the difference! I hope your situation works out with this OB (if that is indeed what you want), but remember YOU are the consumer here.
oh yes
I meant too late to switch insurance companies.
 

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That sounds silly to me too. I knew when I got pregnant that we would be moving around 25 weeks, so I would not have accepted anything like that. Besides, you might change your mind and choose another doc or hospital and like the pp, be out of luck because you already paid all that $. It sounds really unethical to me, like they want to make SURE they get their $ regardless of quality of care or other variables, (what if you had to transfer to a specialist at another facility?)

Sounds like a bad practice that ought not be in my medical care. The doc must be wonderful for you to upfront $5K! Good Luck!
 

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That is way more than what our total costs have been for prenatal care and delivery (2K or 3K?) but all our billing is done after delivery so it is the total opposite here. Though when I had some spots removed at the dermatologist he did bill it this way - wouldn't even take me to the exam room until I paid. Always felt a bit underhanded to me.

Good luck deciding what to do.
 

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I've seen agreements that you had to have everything paid in full by month 7 or so but upfront? What if you miscarry or something like that? (god forbid!) My contract was for a flat fee of $2350 or some odd number around that amount. The midwife I spoke with charges $1950 for a standard home birth withing the city and then up to $2350 for up to 100 miles out of town. First visit free, $400 due upon the second visit. Tests and supplies are extra.

It sounds like your doctor has either been taken for a bath a lot or is just outrageous. Insurance companies can be really tricky though. I had full coverage with my last delivery in a free standing birth center. Their care was something like 5K complete. Maybe less. I didn't really pay attention because it wasn't coming from my pocket directly. They used to have to wait around for a long time to get re-embursed from the insurance company. Sometimes doctors have to fight to get paid. There is one blood test I can take to check for down's syndrome late in my pregnancy. My OB doesn't put a lot of stock in the test but he says with it, he can go to the insurance company and say "OK, this test came up with this result, we need to prescribe more advanced care and you need to pay for it." Insurance companies really only pay as little as they have to. It can be such a crock too. I mean. I have a $35 co-pay and the insurance company may only pay $2 more dollars because they agreed to pay $37 per visit. It almost seems absurd when you have to pay cash!
 

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I've switched care providers twice now...I'm very happy now. From an OB who I met once, to midwives at a birth center, now with a HB midwife.

Granted this is hearsay, but I trust the women from whom I heard this--they're very experienced midwives here in Phoenix. I was informed that some obs/practices are beginning to charge women per visit if they do switch later in the pregnancy b/c docs only get $$ from insurance companies if they ultimately deliver with them. So that could be what they're looking out for. Anticipating a switch and trying to get money before you leave?? But...like I said, this is just something I heard. And I'm not too knowledgeable on the total cost of things either.

Best of luck...I hope you find someone that makes you feel really good about this miraculous event, not stressed over money...
 

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My experience was with a birth center, but they had a flat fee for "normal" births at the center and you arrange a payment plan at the first visit. If you change providers before the birth, they adjust the payment on a "per visit" basis, but my insurance still covered that. I can't imagine why insurance wouldn't cover necessary prenatal visits, even if you switch providers????

Is there any option to pay in installments?
 

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I had to pay my entire OB bill by 7 months. I decided to not let it wait, and paid it off a month or two early, and they FIRED me right before the birth for not agreeing to their course of treatment (they said I had to have a cesarean and I wanted to try a VBAC), leaving me out a LOT of cash, and without an OB to boot.

I would not prepay ever again, especially if it is someone that I am not already familiar, comfortable and trusting of.
 

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Discussion Starter · #18 ·
Thanks to all of you for your thoughts. I am going to talk to the Doctor's billing office this morning and see what can be done. It's true I could always drop this doctor if they're going to be inflexible with me. I'm going to tell them to split the amount into monthly payments. If they refuse, I am going to call around for another doctor.
 

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Quote:

Originally Posted by happynose View Post
wish we'd been smart enough to think ahead. I believe it's too late to switch now that I'm pregnant. Just have to accept the fact that I screwed up!
Ah too bad! Hopefully they will be worth the money! I had referred a friend to my OB and had to switch because she couldn't pay up front. She ended up with a pretty good MW.
 

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Quote:

Originally Posted by khaoskat View Post
Wow, $5,000 seems a bit steep for prenatal care and delivery. Where I live, standard prenatal care and delivery run around $2,500 from an OB. I would definately complain, because you don't know how much they are going to actually charge you for the L&D and prenatal care. They could just be gouging you for $5,000 when they normaly only charge $3,000.
My OB charged $2500 for the 45 minutes she spent at the actual birth. Everything else was on top of that.
 
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