My turn to vent about a 1st world problem. I absolutely hate how the medical/insurance billing works in this country. I have decent insurance (a high deductible HSA), but trying to find out what a procedure will cost is impossible.
Example 1: My wife got major knee surgery a few years back. Before the list, I asked what it was going to cost me out of pocket. Nobody could give me an answer. I then asked for an itemized list of all the costs and what was covered and what wasn't. Again, nobody could answer. The Dr. had his fee, the hospital had multiple fees (OR, recovery, nurses), the anesthesiologist had their fee, etc.. etc.. In the end, she's going into surgery and he really didn't know what it would cost us in the end. We got a number of bills and paid them. then 3 months later, we get a partial refund as we paid too much.
Example 2: My adult kid needed to renew a prescription for an inhaler. Dr. said that he couldn't do it over the phone as he hadn't seen the kid in 2 years so the adult kid needed to set up an annual exam. Kid does so and annual exams are covered for free. We get a bill as the Dr. incorrectly coded it as an "office visit". I argued with the billing person and tried to escalate..but to no avail, they weren't changing the code.
My insurance provider changed to a different provider, but same plan (high deductible HSA).
Today: I schedule an annual exam with a dermatologist back in Nov. They said the earliest appointment was May. I asked if there were any sooner appointments as there was a spot on my arm I had concerns about. The found an earlier slot. I specifically asked: "Will this cover both looking at the spot and my annual preventative exam?" They said yes.
Today, I show up, Dr. comes in, looks at the spot, takes a sample for a biopsy and says "When you check-out, make sure you set up the appointment for your annual exam." I explained this was supposed to be an annual exam and she says it wasn't scheduled that way. From the time I entered the exam room until I left, 5 min. When checking out, I have a bill for $360 for this visit (plus there will be a lab fee for the biopsy as well). The woman looks the computer and says "Oh, I see the mistake the person made in schedule it, I'm so sorry. Best we can do is September for an annual exam."
Frustrated but understanding mistakes happen, I ask what the cost will be for the annual exam. She says she can't tell me as it will be between $77 and $193 depending how they "code" it. For instance, if they have to do a biopsy, it will be at the higher end of that range. I ask how come my 5 min. biopsy cost $360 today then? "Because it was coded as an office visit". I asked if she could give me a description of each code for the annual exam. Nope.
I would switch but when I looked at other providers in the network, they either weren't accepting new patients or the wait time was even longer. I'm not sure any other place is any better although I'll keep looking.
Ugh....I hate how the medical / insurance / billing works in this country.
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