palmettoprimarycare 5 minute office visit to doctor charged at 266! (cost, county)
Charleston areaCharleston - North Charleston - Mt. Pleasant - Summerville - Goose Creek
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You are correct that you should be able to get an estimated cost prior to treatment, but you are completely wrong when it comes to your statement above.
Based on what? They work in a system that they created.
Many times they dont know how much it is going to cost you as they dont know what is going to occur in the examination room and, prices are typically dependent on what that doctor's office has negotiated with your particular insurance company. If they knew those things they could tell you how much would be billed to the insurance company, but how much you end up paying would be dependent on your benefits, your past out of pocket amounts, and maximum coverage limits.
During the last twenty year or so of my life. I have not gone to the doctor's office much. But when i have, it has ALWAYS broken down the same way...
I get to the office
I spend ten minutes getting signed in
I spend about 20 minutes filling paperwork
I spend about 20 more minutes waiting to be called to the back
I spend 5 minutes getting weight and blood pressure recorded
I spend 5 minutes telling the physician assistant what I am there for
I spend the next 15 to 30 minutes waiting in the examining room for the doctor
I spend 5 minutes trying to convey what is happening to the doctor
the next ten minutes can vary depending on what is wrong
A prescription is written and plans are made
I spend 5 minutes taking care of billing issues and making the next appointment.
I can tell you that this is very standard because I write software to support the process. The same software that is used to enter the billing codes. This is why it can be and is standardized and why it can and should be made known to the patient ahead of time.
I can tell you that this is very standard because I write software to support the process. The same software that is used to enter the billing codes. This is why it can be and is standardized and why it can and should be made known to the patient ahead of time.
There is no clinical or ambulatory software that dictates your wait times or locations in a physician's office or clinic.
Your paperwork is probably due to not being seen annually.
Doctors tend to over book due to cancellations and no shows. Appointments later in the day are always the worst.
Most billing occurs days after the fact by a billing specialist or is out sourced to one of the many companies that specialize in reimbursement. In these cases doctors give a percent of their fees to the billing company in exchange for immediate payment.
If the office had a full time billing clerk on hand to punch in what occured during the visit, they probably could tell you how much your insurance company would be billed. Of course that may increase the overhead which will get passed on to the consumer.
As you see that doesn't happen and there is plenty of competition in the market.
If you feel that's a highly valued service offering, I urge you (or anyone) to open your own clinic.
There is no clinical or ambulatory software that dictates your wait times or locations in a physician's office or clinic.
Your paperwork is probably due to not being seen annually.
Doctors tend to over book due to cancellations and no shows. Appointments later in the day are always the worst.
Most billing occurs days after the fact by a billing specialist or is out sourced to one of the many companies that specialize in reimbursement. In these cases doctors give a percent of their fees to the billing company in exchange for immediate payment.
If the office had a full time billing clerk on hand to punch in what occured during the visit, they probably could tell you how much your insurance company would be billed. Of course that may increase the overhead which will get passed on to the consumer.
As you see that doesn't happen and there is plenty of competition in the market.
If you feel that's a highly valued service offering, I urge you (or anyone) to open your own clinic.
None of this changes the fact that they are working in the system that they created. Nor does it indicate that they cannot - if they wanted - post prices for common services. They CHOOSE not to... But that will change.
Yes it does. They don't post the negotiated price for every procedure for every insurance provider, especially if they have a NDA with each insurance agency.
They could pay a person to discuss your bill with you as you leave, but I don't see a rush to do this.
And you completely ignored the ones that outsource their billing.
Will it change? We'll see. I doubt there is a taste for compelling such in Congress right now.
They don't post the negotiated price for every procedure for every insurance provider, especially if they have a NDA with each insurance agency.
how do people not understand this?
And just because doctors work in a system that is flawed doesn't mean that they are somehow the ones calling the shots to keep patients in the dark and not let people find out what the guy down the street is "charging." That's illogical.
I guess what I'm saying is that it's really not the doctors that are keeping people in the dark and making the billing process into some mysterious unsolvable puzzle. It's the third party payment system that has created all of this.
It will be interesting to see how many doctors (especially primary care types) shift toward a cash pay system for some things like basic visits. That would probably be a welcome change, and I'm guessing the whole system could save some money by doing it that way.
You come in for a common cold. There are soo many outliers that can happen from that visit. The physician looks at your throat and sees you have strep. He now needs to do a rapid strep test. He listens to your heart and hears a new murmur that has never been there before. He needs to do an EKG and xray of the lungs. He needs to do a blood test/culture to rule out other things (bacterial endocarditis, Rheumatic fever...etc)..The process keeps going, and what are you going to do? Say no, stop you went over my $100 mark?
Do you expect them to say, ok for this test it'll be 60, this one is 80, this one is 20? Noway. If you walk into an urgent care clinic, the physician has no prior history. They can't guess and give you prices on the consultation if they have never seen you before. The doctor will not waste his time reciting to you prices (in fact it's very annoying). As it has been posted above, different insurances pay only so much based on your plan and co-pay/deductible.
Picking and choosing exams is not the way to go, and it makes life more difficult to make a diagnosis.
I used Doctor's Care several times and was very satisfied with their care. They were out-of-network for me but I was willing to pay for the convenience. They even remembered my name when I walked through the door.
I guess if Palmetto didn't work for you then you should take your business elsewhere.
For what it's worth, I never received an estimate on auto repairs unless I asked for it. I take my car to the dealer and tell them what is wrong. Usually I tell them that if it is over X dollars, call me before starting.
While it would be nice for doctors to post their fees (and frankly not a bad idea at all), I think it may be like other professions. you need to ask.
I had no issues with Doctor's Care. They said I needed an x-ray, I asked how much and the doctor said $100 right on the spot.
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