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Getting what you paid for..
Old 12-05-2015, 12:57 PM   #1
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Getting what you paid for..

The knee surgeon's office called well before the surgery and asked for a deposit (remaining deductible plus 20% cost). I paid it and I thought wow now you pay up front.

Surgeries over alls well and I see doctor on day 14 and he gives me a return date of 2/1 I'm thinking great. I ask him to complete my paperwork and he says call my secretary every day.

Seems to me they had no issue taking my money ($800) up front and I have to chase them to fill out a few lines on some docs? It will be fine but I see more of the never ending degradation in how we patients/ consumers are treated.




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Old 12-05-2015, 01:12 PM   #2
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If they don't respond timely then I would relay the sentiments in your last sentence to them.... with a wry smile.

As I recall for DW's surgeries, the process is they do the work, the bill the insurer, the insurer processes their bill and sends us an EOB telling us what was billed, the negotiated amount, what the insurer paid and what we owe, the doc sends us a bill that (hopefully) shows the same amount as the EOB and then we pay the bill. Easy.
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Old 12-05-2015, 03:16 PM   #3
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Yeah seems they want the money up front... They have quite a bit of leverage...


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Old 12-05-2015, 03:29 PM   #4
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Yeah seems they want the money up front... They have quite a bit of leverage...


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There are other surgeons out there that replace knees.
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Old 12-05-2015, 04:05 PM   #5
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If you pay up front, cuts way down on office staff time and effort attempting to collect from the slow payers.
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Old 12-05-2015, 04:20 PM   #6
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I often have to pay up front if I haven't met my deductible, but it's never been more than what my insurance agrees to for an in-network provider. In the case of a procedure, the provider is usually good about calling me ahead of time to let me know how much I'll be asked to pay when I arrive. They've already called my insurance to get the billing amount.

Don't know about that plus 20% business, unless it's your coinsurance - that must be it.
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Old 12-05-2015, 05:11 PM   #7
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Ive had 4 surgeries in my lifetime and Ive never paid up front.
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Old 12-05-2015, 05:38 PM   #8
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Seems to me they had no issue taking my money ($800) up front and I have to chase them to fill out a few lines on some docs? It will be fine but I see more of the never ending degradation in how we patients/ consumers are treated.
I agree completely. Just wait until you get another bill for that same $800 next month and they won't accept their own receipt as proof that you already paid it. BTDT, a few years ago although it finally did get straightened out. Maybe it is due to the staff working in these places. But whatever the reason, you shouldn't have to deal with this situation.
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Old 12-05-2015, 05:57 PM   #9
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For the past 8-9 years I have had a High Deductible HSA health plan and never had to pay deductibles or any portion of my bill until the ACA was implemented. Even doctors that I had seen for years now ask for money before seeing the doctor.


The ACA has changed the way many doctors and hospitals do business now.
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Old 12-05-2015, 06:33 PM   #10
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For the past 8-9 years I have had a High Deductible HSA health plan and never had to pay deductibles or any portion of my bill until the ACA was implemented. Even doctors that I had seen for years now ask for money before seeing the doctor.


The ACA has changed the way many doctors and hospitals do business now.
Perhaps - but not all. We were asked to pay the co-insurance amount at each visit during check in - but were billed for the rest after... sometimes several months after.
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Old 12-05-2015, 06:34 PM   #11
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Physicians offices are not the big profit makers that many people think. Most have a 50% expense ratio, and meeting the payroll weekly is not something doctors need to worry about. Their patients' well being comes first in their minds. And doctors are no longer Dr. Marcus Welby--making house calls. Practices are very much businesses and they require good office help and good management.

Very few doctors are really making the big money. When they have the big house, two kids in private school and a couple of luxury automobiles, there's not much $ left. And building a $5 million retirement portfolio is very difficult for those that are notorious for making poor investment decisions. They don't have an employer matching their 401K.

I'll pay the doctor for his services promptly, however we're now having to pay the hospital on front end for an estimated deductible. I'll be danged if I pay the doctor before our insurance company tells me how much to pay them. There are other fine surgeons out there that also need the business.
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Old 12-05-2015, 07:06 PM   #12
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Perhaps - but not all. We were asked to pay the co-insurance amount at each visit during check in - but were billed for the rest after... sometimes several months after.
I should have stated the dr. or hospital requests that we pay a portion of the bill, not the entire amount. They bill us for the balance after the insurance company processes the claim.
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Old 12-05-2015, 07:10 PM   #13
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Perhaps - but not all. We were asked to pay the co-insurance amount at each visit during check in - but were billed for the rest after... sometimes several months after.
Wow, this thread just floors me. First heard of docs refusing to prescribe/administer due to cost of an item in another thread the other day. And now seeing the references to that going on with more common procedures. I've had the question asked abut making co-pays often enough before, but since it was being presented as a question I would just simply say "no" and wait for the insurance EOB and bills to come out before making any payments myself. If they felt strongly enough about it to refuse service unless prior payment is made, they can just scratch me off their appointment calendar.
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Old 12-05-2015, 07:33 PM   #14
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Wow, this thread just floors me. First heard of docs refusing to prescribe/administer due to cost of an item in another thread the other day. And now seeing the references to that going on with more common procedures. I've had the question asked abut making co-pays often enough before, but since it was being presented as a question I would just simply say "no" and wait for the insurance EOB and bills to come out before making any payments myself. If they felt strongly enough about it to refuse service unless prior payment is made, they can just scratch me off their appointment calendar.
If it makes a difference - I have Kaiser Permanente HMO - even with their best insurance they ask for a copay/coinsurance at time of insurance. (I think the best plan is a $10 copay... my sister has that as part of her teacher's union benefits.) The difference is mine is $55 each visit - which is applied towards the cost/deductible - then the balance is billed. I have a bronze plan (so far from the top of the line)
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Old 12-05-2015, 07:57 PM   #15
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In March this year I was referred to a cardiologist and on my first appointment I had to pay over $700 before I even saw the Doc. While filling in the forms I also noted a disclosure listing all the doctors in the practice that had a financial interest in the facilities where I would be taking any tests. (48hr heart monitor, echo cardiogram, and nuclear stress test).

When the EOB's started coming through it was only $30 a visit and on the first visit to the doc after the EOB's came through they wanted to charge me another $30 until I pointed out that by my reckoning I was $710 in credit. A couple of phone calls later and they cut me a check for $680.
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Old 12-05-2015, 08:45 PM   #16
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If it makes a difference - I have Kaiser Permanente HMO - even with their best insurance they ask for a copay/coinsurance at time of insurance. (I think the best plan is a $10 copay... my sister has that as part of her teacher's union benefits.) The difference is mine is $55 each visit - which is applied towards the cost/deductible - then the balance is billed. I have a bronze plan (so far from the top of the line)
Maybe I got by without being stung by this in 2015 because I had selected a silver plan where deductible=max OOP so technically I had no co-pays, although until reaching the deductible it was still six of one and a half-dozen of the other.
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Old 12-05-2015, 08:58 PM   #17
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In March this year I was referred to a cardiologist and on my first appointment I had to pay over $700 before I even saw the Doc. While filling in the forms I also noted a disclosure listing all the doctors in the practice that had a financial interest in the facilities where I would be taking any tests. (48hr heart monitor, echo cardiogram, and nuclear stress test).

When the EOB's started coming through it was only $30 a visit and on the first visit to the doc after the EOB's came through they wanted to charge me another $30 until I pointed out that by my reckoning I was $710 in credit. A couple of phone calls later and they cut me a check for $680.
I went through this also, echo cardiogram and nuclear stress test, and didn't get asked to pony up any money up front. I knew the cost of that appointment was likely to meet my max OOP, and did it ever! Apparently we must be living an area where demanding co-pays or deposits on expensive medical devices upfront hasn't caught on just yet. Not that they don't ask for co-pays, I just get curmudgeonly and say no thanks, I'll settle up after the insurance gets it sorted out and I've got an EOB.
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Old 12-05-2015, 08:58 PM   #18
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Maybe I got by without being stung by this in 2015 because I had selected a silver plan where deductible=max OOP so technically I had no co-pays, although until reaching the deductible it was still six of one and a half-dozen of the other.
I have no coinsurance, no copays, and most of my providers contact the insurance company or have some table they use and I pay up front until I meet my deductible.

They are very close - when I finally get the EOB it's almost exact.

I've had a few that just charge me some initial amount, like $45, and then bill me the balance after the claim has been processed.
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Old 12-05-2015, 09:04 PM   #19
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Besides, if you pay upfront you don't get to call them later when you get the bill and ask if they offer an additional discount for immediate payment with a (rewards) credit card.

The local hospital we use typically offers 10-20% depending on how big the bill is and then I get an additional 2% from my credit card company.
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