Billing Practices of Healthcare providers & Insurance

I recently had yet another experience with a healthcare provider billing me for a trivial item and it turning into a $100 copay with the insurance company. What? I thought. All the doc did was examine me with a scope and I got charged for a surgery from my insurance company. This happened twice because after the first visit, there was no bill. When I called to dispute this because of lack of knowledge, the doc’s office manager insisted that is how they bill. I am writing this blog to make people aware that they need to talk with their insurance provider and the medical doctor before they get anything done. Forget about life and death, this country is all about the insurance companies (HMOs and PPOs) and the pockets of the medical doctors.

Don’t get me wrong- there are medical doctors out there who would not bill like this and would work with a patient. I have had this happen in the past. But, this was not one those doctors. I will not be returning to this doctor or recommending her to others – in fact, I already filled out several surveys cautioning people on the billing practices of this particular office but I would recommend that before you see specialists or have ANYTHING done by any medical provider, you ask the right questions – is this covered by insurance? Is this considered a surgical procedure? If that means you stop the appointment short and leave to call your insurance, I would do it. It is sad that you have to worry about this in addition to the medical problems you are seeking help for, but that is the state of health care in our country and frankly, it stinks.

I hope that one day we can worry about our health and seek prevention instead of having to see doctors after the fact. I hope we can have a good health care system in our country that cares about the patient instead of the bottom line and more importantly, health care providers that truly want to work with you and provide great “customer” care or patient care instead of sticking it to you and talking with you like you are just another number. I remember a time when doctors would make house calls and they were like family. That is no longer the case – HMOs, PPOs and insurance companies have replaced what was once family doctors. It is all about the bottom line now – the copays, the codes, the treatment codes, and the patient is generally not even a factor anymore.

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