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Old 01-09-2016, 07:07 AM
 
58 posts, read 96,710 times
Reputation: 20

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Hi Folks, Happy new year!
I wanted to post this thread for a while now but my 18 month old son kept me on my feet .
After my kid started going to the daycare 3 months ago, I have had to take him to his pediatrician every now and then because of ear infections and wheezing. Each time the pediatrician will use his stethoscope and otoscope , advise us to use the nebulizer and prescribe a least effective antibiotics. The total visit would last ~10 mins. This happened for around 9-10 visits and eventually we thought of consulting a ENT in blakeney on our own to figure out why the same symptoms were re-occuring.
ENT spent just 5 mins with us, used his otoscope to peep into my son's ears and told us to try over the counter allergy relief spray . That also did not help and my son's symptoms re-appeared.
Finally we switched our pediatrician and she gave a stronger antibiotics and oral steroids, which seems to be working better than the totally ineffective antibiotics prescribed before.(knock on wood)

Now I got the bill from the 1st pede's office and his original fees for those 10 mins were $200 and after my insurance adjustment, I have to pay $156. ( total $156 X 10 ) . The ENT billed us $250 for his 5 min totally useless session and after insurance adjustment, comes ~ $170.

1) Can someone please tell me if these doctor fees are normal and standard in charlotte area for just 5-10 minute visits? ($200 for 10 mins approx equals atleast $500 an hour/$1mill a year)
2)I feel that the 1st pede could have prescribed us a stronger antibiotic in our 3rd or 4th visit and thus saved my son from all those misery and pain, but he chose not to, so that he could make more money. I smell a ripoff here . Is this common practice among most of the other doctors too?
3) Can I talk to the billing office to negotiate the rates and is it possible at all , to get the rates lowered.
4) I understand each physician has its own rates. How do I know which doctors have lower rates compared to the others, say in the same facilities like Novant?

Thanks in advance for looking at my post. Looking at all these bills is making me mad .. Happy weekend!
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Old 01-09-2016, 09:20 AM
 
4,039 posts, read 4,911,551 times
Reputation: 4772
Doctors don't bill by the hour. You should have received a yellow sheet when you were done with the visit and they would have marked the reason for the visit. Is your 1st Ped out of network on your plan? Do you have to meet a certain amount before your plan kicks in?

When my son was a baby I had him at his peds office a lot because of ear infections. Outside of the $20 copay, I never had to pay any other money to the office. When he had the evaluation with the ENT (I got a referral and he was in network), I also didn't have to pay anything outside of the $30 specialist visit.
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Old 01-09-2016, 11:33 AM
 
58 posts, read 96,710 times
Reputation: 20
Everyone is in network. I have a HSA plan with a certain amount of deductible ( $3500 ) which has to be paid from my pocket after which Insurance pays 80% . Wow!! You had one heck of a plan. I don't even have an option to choose copay plan under my insurance. Coming back to my questions, if the doctor does not charge by the hour, Do they charge per visit? Also are these fees standard or Can I call up the office and negotiate the rates?
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Old 01-09-2016, 02:14 PM
 
1,585 posts, read 1,915,516 times
Reputation: 4958
You were charged pretty standard rates. They charge per visit, type of visit, plus anything additional that was specific to your visit. You can of course call and try to negotiate but most likely will not get you far. You can also request that the visits be audited. They will have another Dr. confirm that the course of action the first Dr. took was correct, seeing that Doctors are within the same practice, you can guess which way it will turn out.

We tried negotiating with ours, it took over 8 months, and finally paid the bill and found a new Dr.'s office.
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Old 01-09-2016, 06:57 PM
 
99 posts, read 92,519 times
Reputation: 306
Charlotte has very expensive medical care costs, and it can vary widely from one place to another. I remember when I had a CT scan a number of years ago, one place quoted me $2000, another quoted me $450. It really pays to call around.

In my experience, what you paid is pretty typical for a specialist visit.
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Old 01-09-2016, 09:39 PM
 
Location: Indian Trail, NC
930 posts, read 2,149,582 times
Reputation: 381
But, if you are going to Dr's in network, they are contractually obligated to a certain fee with the insurance company. So, they can only charge you whatever fee the insurance company allows according to how the visit was coded. Example: New patient office visit is usually more than an existing patient office visit. Or specialist are more than a GP. I would check with the insurance company and look at the EOB's and make sure that what you are being charged it correct.
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