Author Topic: Health Care - Cost of Doctor Visit?  (Read 4078 times)

tooqk4u22

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Health Care - Cost of Doctor Visit?
« on: July 18, 2016, 01:34:47 PM »
For those of you who are on a High Deductible insurance plan or some other plan that requires you pay out of pocket for a period of time/amount - what are you being billed for a primary care visit?

I ask, because my DW had some pains that persisted for a while so she went to the Dr, got lab work, and she had an infection so they wrote her a prescription. 

Pain didn't go away, Dr wanted to see her again and wrote her a different prescription.

Each visit was billed to us at $183 - that's after the insurance companies contractual discount and does not include the labs or prescriptions.  I get it, they should get paid and they have overhead but that seems like a lot for a quick visit, labwork that really had nothing to do with doc, and the fact that it wasn't resolved. 

Just curious what the range is and if geography comes into play....also if you have suggestions for alternatives:

Cost of primary visit:  $183
Location:  NJ
Alternatives:  ?

SKL-HOU

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Re: Health Care - Cost of Doctor Visit?
« Reply #1 on: July 18, 2016, 01:42:35 PM »
My son's specialty doctor (GI, Pulmonology) visits are about $115 (my share before meeting the deductible) every time. This is just an office visit.
His pediatrician is $87 (my share before meeting the deductible) for sick visits, non-preventive visits. We are in Texas.
I recently went to my primary after an accident. I paid $29 but the yearly deductible was already met so I was responsible for 20%. So that makes the bill $145.
Yearly preventive visits are at no cost.
This BCBS high deductible plan.

I'm a red panda

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Re: Health Care - Cost of Doctor Visit?
« Reply #2 on: July 18, 2016, 01:54:43 PM »
Just went and looked at a bunch of EOBs. Depending on the doctor, an office visit cost between $150 and $180.  That was the allowable charge, the amount charged ranged from $155 to $400. 

naners

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Re: Health Care - Cost of Doctor Visit?
« Reply #3 on: July 18, 2016, 01:57:55 PM »
Be sure to try to negotiate. I've had great luck negotiating with labs. Not sure if it will work for doctor's offices, but they are probably interested in having you pay right away, so you could start with something along the lines of "this bill is very high and I'm paying out of pocket. It would be easier for me to pay right away if the bill was lower. Is there any way to reduce the bill?"

geekette

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Re: Health Care - Cost of Doctor Visit?
« Reply #4 on: July 18, 2016, 02:00:47 PM »
PA at my GP's office = $103 (after insurance discounts)
Specialists - $153 and $137, not including x-rays or procedures
Colonoscopy was $1160 after discounts (over $2700 before discounts)

NC

BTDretire

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Re: Health Care - Cost of Doctor Visit?
« Reply #5 on: July 18, 2016, 02:11:48 PM »
My doc charges $77 for a office visit.
I recently had the yearly physical* and it was $200 but
the insurance covers that, once a year.


I'm a red panda

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Re: Health Care - Cost of Doctor Visit?
« Reply #6 on: July 18, 2016, 02:12:41 PM »
Be sure to try to negotiate. I've had great luck negotiating with labs. Not sure if it will work for doctor's offices, but they are probably interested in having you pay right away, so you could start with something along the lines of "this bill is very high and I'm paying out of pocket. It would be easier for me to pay right away if the bill was lower. Is there any way to reduce the bill?"

How does "I'm paying out of pocket" work if you have insurance?

All the doctors in my network do not consider a high deductible to be "out of pocket"- the deductible is part of the insurance coverage, and you already get the insurance negotiated rate.

(My RE for instance quotes an out of pocket price at the first appt and tells us that if we never tell him we have insurance he can't bill it; but once we tell him we have insurance, we have to pay the price they have negotiated; and typically with fertility treatments that means next to no coverage.)

thingamabobs

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Re: Health Care - Cost of Doctor Visit?
« Reply #7 on: July 18, 2016, 02:28:35 PM »
That seems rather high for a primary care visit. We have high deductible as well and have not met the deductible yet. For my last PCP visit, my portion was ~$45, for a specialist it was $85.

lbmustache

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Re: Health Care - Cost of Doctor Visit?
« Reply #8 on: July 18, 2016, 03:33:15 PM »
That does seem very high. I have a bare bones plan from Kaiser Permanente.

First 3 visits (doesn't include physical or pap) are $70 each.
After that it's the regular cost up to your deductible.


forummm

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Re: Health Care - Cost of Doctor Visit?
« Reply #9 on: July 18, 2016, 06:54:04 PM »
My negotiated rate was something like $150 IIRC.

Be sure to try to negotiate. I've had great luck negotiating with labs. Not sure if it will work for doctor's offices, but they are probably interested in having you pay right away, so you could start with something along the lines of "this bill is very high and I'm paying out of pocket. It would be easier for me to pay right away if the bill was lower. Is there any way to reduce the bill?"

How does "I'm paying out of pocket" work if you have insurance?

If they knew you had insurance, I'm not sure why the doctor would accept a lower payment from you for "paying out of pocket" since you would be paying out of pocket before the visit using your HDHP negotiated rate anyway.

I guess you could pretend you didn't have insurance. I'm not sure if it's a violation of your agreement with your insurer. But if you should have larger bills during the year, the amount you paid outside of insurance won't count towards your deductible.

Sibley

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Re: Health Care - Cost of Doctor Visit?
« Reply #10 on: July 18, 2016, 07:26:54 PM »
If you try to compare health costs from different regions, it quickly becomes apples to oranges. Some areas have higher costs in general.

If you have insurance, and you use it, then you can't "negotiate" your bill. That's already done by the insurance company. If you have it and don't use it, then why do you have it?

If you don't want to pay the higher costs to see the doctor with a HDHP, then you shouldn't have a HDHP. That's how they work - lower premiums, higher out-of-pocket.

tooqk4u22

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Re: Health Care - Cost of Doctor Visit?
« Reply #11 on: July 19, 2016, 08:20:22 AM »
If you try to compare health costs from different regions, it quickly becomes apples to oranges. Some areas have higher costs in general.

If you have insurance, and you use it, then you can't "negotiate" your bill. That's already done by the insurance company. If you have it and don't use it, then why do you have it?

If you don't want to pay the higher costs to see the doctor with a HDHP, then you shouldn't have a HDHP. That's how they work - lower premiums, higher out-of-pocket.

I am well aware of how it works and was not questioning the plan, I am questioning or more accurately surveying for what the cost of a doctors visit is for those that have to pay out of pocket.  Unfortunately it is not like buying a pair of sneakers that you can go on any number of websites and see what a pair costs at various retailers....I wish there was more transparency.

Sibley

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Re: Health Care - Cost of Doctor Visit?
« Reply #12 on: July 19, 2016, 05:10:22 PM »
If you try to compare health costs from different regions, it quickly becomes apples to oranges. Some areas have higher costs in general.

If you have insurance, and you use it, then you can't "negotiate" your bill. That's already done by the insurance company. If you have it and don't use it, then why do you have it?

If you don't want to pay the higher costs to see the doctor with a HDHP, then you shouldn't have a HDHP. That's how they work - lower premiums, higher out-of-pocket.

I am well aware of how it works and was not questioning the plan, I am questioning or more accurately surveying for what the cost of a doctors visit is for those that have to pay out of pocket.  Unfortunately it is not like buying a pair of sneakers that you can go on any number of websites and see what a pair costs at various retailers....I wish there was more transparency.

As long as you understand that you're not getting good data. Between regional differences, and differences in plans/out of pocket, etc, you'd need way bigger samples to get accurate data.

I agree though, more transparency is good. I think we're starting to move in the right direction, but not quite there yet. you might try your insurance, or provider website - some of them do allow you do to some searches. Might help.

GrOW

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Re: Health Care - Cost of Doctor Visit?
« Reply #13 on: July 19, 2016, 05:52:35 PM »
This is highly dependent on location. Not just state but region and even down to neighborhood.

For us, $65 for recent CVS Minute Clinic visit to diagnose a sinus infection and $85 for an orthopedic follow up visit to get son cleared for football practice after shoulder surgery in 2015. Those are insurance negotiated rates.

Looks for price transparency tools online. Your insurance company may provide one on their website. They offer call them cost estimators. Castlight is one company that is leading the change on price transparency tool so check them out as well. They have lots of great price data and are now pushing into gathering ratings data to help determine value - i.e. $85 vs $125 doesn't tell you value until you know more about the service.

luminajd

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Re: Health Care - Cost of Doctor Visit?
« Reply #14 on: July 19, 2016, 06:31:57 PM »
I am  clinic manager at a family practice doctor's office. Price varies on level of visit, but $120-180 is the norm.
What may seem very quick to you is not necessarily quick for the medical side of things. We still needed to staff a registration staff to take your phone calls, check you in, a nurse to get you roomed, the doctor has to review your chart prior to examining you, examine, you, pay the lab person to draw your blood, etc, etc.
I hear you and agree the cost of what we would think is a simply doctor's visit is not so.
I believe most clinics bill on something called a CPT code, if you are really wanting to compare clinics, ask for the charge for a 99213, which is what most clinic visits are billed at.

GetItRight

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Re: Health Care - Cost of Doctor Visit?
« Reply #15 on: July 19, 2016, 08:47:23 PM »
Thanks to commie healthcare, I don't pay anything for doctors visits. I only go when I wake up there. I'll probably die of something easily treatable and preventable that I'll never know until it's too late. Thanks liberals.

MrsCoolCat

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Re: Health Care - Cost of Doctor Visit?
« Reply #16 on: July 19, 2016, 08:51:19 PM »
I'm not an expert but that seems high. I was literally just looking at and commenting on, "It would cost us $180-$225 each visit to the OB gyn & that's a specialist. Just my two cents. GL with everyth.

Dollar Slice

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Re: Health Care - Cost of Doctor Visit?
« Reply #17 on: July 19, 2016, 09:00:31 PM »
I inquired recently about it because we're looking at changing insurance policies and I wanted to know what I'd pay on a plan that didn't cover it... they told me it was $135 for a standard office visit. (Although I think it was more if you were a new patient - $150 maybe?)

That's in midtown Manhattan, FWIW.

JLR

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Re: Health Care - Cost of Doctor Visit?
« Reply #18 on: July 19, 2016, 09:01:20 PM »
As a comparison, a visit to a regular doctor here in Australia is about $75. Private Health Insurance doesn't cover visits to the doctor, but the government pays nearly half this amount and I pay the other half. When you go back for a follow up visit for the same condition the doctor usually just charges the government, so no cost to the patient.

bacchi

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Re: Health Care - Cost of Doctor Visit?
« Reply #19 on: July 19, 2016, 11:03:05 PM »
If you try to compare health costs from different regions, it quickly becomes apples to oranges. Some areas have higher costs in general.

If you have insurance, and you use it, then you can't "negotiate" your bill. That's already done by the insurance company. If you have it and don't use it, then why do you have it?

Catastrophic or chronic care.

I've found that not having insurance (rather, telling them that I don't have insurance) gets me a substantial discount and is often cheaper than the negotiated rates. Thanks, BC/BS!

One provider became almost angry about it; they insisted I call them back with insurance info as I walked out of the door -- and I had paid the entire bill.


gooki

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Re: Health Care - Cost of Doctor Visit?
« Reply #20 on: July 20, 2016, 05:22:45 AM »
$50 for a doctors visit.
$75 for after hours doctor.

iris lily

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Re: Health Care - Cost of Doctor Visit?
« Reply #21 on: July 20, 2016, 06:23:49 AM »
My dog's specialist charges $125 for an exam.

Kitsune

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Re: Health Care - Cost of Doctor Visit?
« Reply #22 on: July 20, 2016, 06:52:51 AM »
I am  clinic manager at a family practice doctor's office. Price varies on level of visit, but $120-180 is the norm.
What may seem very quick to you is not necessarily quick for the medical side of things. We still needed to staff a registration staff to take your phone calls, check you in, a nurse to get you roomed, the doctor has to review your chart prior to examining you, examine, you, pay the lab person to draw your blood, etc, etc.
I hear you and agree the cost of what we would think is a simply doctor's visit is not so.
I believe most clinics bill on something called a CPT code, if you are really wanting to compare clinics, ask for the charge for a 99213, which is what most clinic visits are billed at.

This. I work in Quebec (yay tax-subsidized healthcare) so my dr visits are always free... but I manage a medical research clinic where a few doctors also run a private clinic.

Baseline: in order to cover costs (rent, bills, receptionnist, nurse, paperwork, archiving, etc) + their salary, the Dr has to bring in MINIMUM 300$/hour. The Drs who do private clinics here charge 80$/15-minute time slot.