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Is a tetanus shot (TDAP) considered preventative care?
Does $351 sound like the going rate for a TDAP?
Something tells me this is a bit high...
Yes, it is preventative care, as it covers 3 different diseases. And that is off the wall expensive. I am not sure, but Walgreens and CVS both list it somewhere in the 60-80 dollar range.
It's cheaper to get routine vaccines through the Health Department, CVS or Wajgreens than from your doctor. Most doctors will charge for an office visit in addition to the vaccine. The cost of the vaccine can also be marked up significantly by a doctor's office. CVS shows this vaccine is under $60.00.
So I owe ~$150, which still seems high to me. All I did was walk in get my shot, and 5 min of chit chat, done....Scheduled a week in advance as well, insurance said it was in-network.
So I owe ~$150, which still seems high to me. All I did was walk in get my shot, and 5 min of chit chat, done....Scheduled a week in advance as well, insurance said it was in-network.
Forget what you were billed, what doe the EOB say?
Forget what you were billed, what doe the EOB say?
Not quite sure what you mean by that.
My insurance covers 100% for preventative care. I haven't received anything from my insurance yet, this is the doctor's office bill I am looking at that says insurance covered $202.57 of that $351 total.
Forget what you were billed, what doe the EOB say?
What they were billed does matter because it is the office visit that I'd be questioning in the scenario.
I own a medical billing/coding company and know this coding stuff well.
If the reason OP came in was for the TDAP and they did not see the doctor they cannot be charged for an office visit. AND if the doctor was seen for an pre-determined shot visit there is no way the chart documentation could support billing a level 3, if at all. The admin charge covers the nurse doing the shot which is customary. Most insurance nowadays cover TDAP's under preventative care which for many is 100% coverage.
TDAP visits usually include 2 line items: TDAP + Immunization Admin. Nothing more.
I'd really be questioning how an office visit was justified for a shot visit which probably makes up the bulk of the patient share due.
The doc did come in and talk to me after the nurse checked my vitals. I had seen him 3 weeks before for my yearly physical in which I had a fungal rash and pneumonia at the time, which the doc treated. He asked me if everything went away and I said it seemed like a second rash came up after I took the fungal and pneumonia meds. After a min or so of me describing my symptoms he knew exactly what it was and said it was viral rash probably triggered by the pneumonia and it would go away in 6-8 weeks, not to worry about it, no additional meds or procedures needed. Gave me my shot and I went on my way. I was in the patient room for probably 5 mins tops.
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