| This entry is a follow-up to the entry of August 7th. I’m frankly stunned at the moment and I think there’s a lesson to be learnt from my experience.
My health insurance provider (HIP) never did mail me the revised Explanation of Benefits (EOB) as I was expecting and during a call to Customer Service this morning, I asked why I had not received this document.
To cut a long story short, after the HIP reviewed the charges again and determined that I am to pay the deductible because of how the doctor’s office filed the claim. Despite my visiting a doctor’s office of a major local hospital, it appears that the “office consultation” (this is how it is worded on the medical provider’s bill) has been filed as an outpatient visit. For my HIP, there’s no deductible for an office visit but there is for an outpatient visit.
I made the next call to the billing department of the hospital. The Customer Service rep, Amy, must be accustomed to calls like mine because she quickly explained that the doctor’s office I visited is considered an outpatient facility by the hospital. I explained that I had seen other specialists (unrelated to this hospital) in their offices and had never encountered the claim filed as an “outpatient visit”. However, this is how the location I visited is treated.
So, the lesson learnt from this experience is when calling to make an appointment with any doctor, ask prior to finalizing the appointment if the location is considered an office or an outpatient facility. If it’s the former, it’s likely that your health insurance provider will not charge you, the patient, a copay/deductible. If the location is the latter, it’s likely patients will end up paying a deductible.
Aside from having to pay over $230 odd as this deductible, the price is made more painful because the specialist only spent about five minutes with me. Maybe seven minutes at most.
I can start to see why some people could have money problems paying medical bills in the US. One assumes that one is visiting a doctor’s office but unless the patient specifically asks about the definition of the facility and is familiar with his/her health insurance plan (if he or she even has health insurance), the end result could be a very steep bill.
… and the paper trail for this 5-7 minutes with this doctor? Three bills from the provider’s side and two Explanation of Benefits from my Health Insurance Provider. I guess it keeps people employed, eh?
All this is enough to make me sick… | 