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    aptylerman's Avatar
    aptylerman Posts: 9, Reputation: 1
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    #1

    May 23, 2008, 11:32 AM
    Extremely High Bill for simple diagnosis
    Hello,

    I recently went to a doctor to determine if I had a hernia or a sore muscle. I expected that this was a routine visit. The doctor determined I had a hernia and sent me to the surgeon. The surgeon did not agree that I had a hernia and very casually scheduled me for at CT scan. The CT scan was in there office, not a hospital. My frame of mind was that this was not a big deal. A 15 minute procedure/test.

    The scan confirmed the surgeons opinion that I did not have a hernia.

    The bill came yesterday and I am stuck with a $4000 diagnosis. They are telling me there is no recourse. I am saying the surgeon should have given me an indication of how much the CT scan would cost before I agree to it. This test was not necessary. If I had any idea it would cost $3500 I would not have taken it. I would have gotten another opinion.

    The price is not indicated anywhere (unlike everything else I have ever paid for). Their confusion over the diagnosis turned a simple doctor visit into a extremely high sale for them. I did not agree to this price before hand and I want to know how I can reduce this bill or get the elective CT scan off the bill.

    Thank you,
    Fr_Chuck's Avatar
    Fr_Chuck Posts: 81,301, Reputation: 7692
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    #2

    May 23, 2008, 12:56 PM
    Do you have insurance? If you don't, the first question out of your month before ever doing any treatment is how much. And then you negotiate on the price, While I don't care for discount cards, if you don't have insurance you should for sure have at least a medical discount card.

    But no, this is their charges, and unless you can work out a deal on the price you are fairly well stuck
    aptylerman's Avatar
    aptylerman Posts: 9, Reputation: 1
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    #3

    May 23, 2008, 01:08 PM
    Quote Originally Posted by Fr_Chuck
    Do you have insurance ?? if you don't, the first question out of your month before ever doing any treatment is how much. And then you negotiate on the price, While I don't care for discount cards, if you don't have insurance you should for sure have at least a medical discount card.

    But no, this is their charges, and unless you can work out a deal on the price you are fairly well stuck

    So if they had charged me $50,000 I would still be stuck. The fact that they do not make their charges easily known does not matter. That is a nice scam they have going. One doctor make a mistake and then have reason to increase your billings by 2000%.

    Every where else someone who is selling something makes their prices known.
    aptylerman's Avatar
    aptylerman Posts: 9, Reputation: 1
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    #4

    May 23, 2008, 01:14 PM
    I do have insurance, but a $5k deductible.

    Is their no reasonable test regarding the reason for the appointment? I wasn't having surgery or getting checked for a terrible disease. I feel the doctor is conveniently claiming no responsibility or regard for the patients financial burdens. It should not be much for them to make their prices known before sending someone to have a $3500 test to confirm their opinion.
    aptylerman's Avatar
    aptylerman Posts: 9, Reputation: 1
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    #5

    May 23, 2008, 01:15 PM
    Is there any wonder why medical costs are sky rocketing?
    JudyKayTee's Avatar
    JudyKayTee Posts: 46,503, Reputation: 4600
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    #6

    May 23, 2008, 01:40 PM
    Quote Originally Posted by aptylerman
    Is there any wonder why medical costs are sky rocketing?


    And what if they hadn't done the scan and it was a hernia or worse - ? Then someone representing your estate would be asking about medical malpractice.

    Don't know if there's an answer - physician/hospital costs are out of sight. We have health insurance but my husband's bill for his December hospitalization was well over $200,000. I keep getting co-pay notices but have to wait for the dust to settle.

    He had surgery and I've received bills from 5 surgeons - 1 who operated and 4 who assisted!

    Of course, I don't know how this works out by the time Physicians pay their malpractice insurance, their student loans - I don't know.
    twinkiedooter's Avatar
    twinkiedooter Posts: 12,172, Reputation: 1054
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    #7

    May 23, 2008, 04:01 PM
    You saw a surgeon. You had the test in his office. He charges what the freight will bear. You got stuck with a big freight bill. I am surprised that his office girls didn't ask you about insurance as they knew the bill was going to be a whopper. You could try and negotiate with the office manager and cry foul and see if that will help. Also while you're at it, call up the local hospital (or go there) and see what they would have charged you for the CT scan. If I remember right, CT scans are not cheap. If it was a hand held scan similar to ones they give pregnant women (a sonagram) then it should have been much less than $3,500. Are you sure it wasn't a sonagram instead of a CT scan? CT scans are huge machines that they place your body into.
    excon's Avatar
    excon Posts: 21,482, Reputation: 2992
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    #8

    May 24, 2008, 07:11 AM
    Hello a:

    I had one on my neck. Cost me a grand. I think they've got a lot of room to negotiate... specially if they think you might not pay...

    excon
    bushg's Avatar
    bushg Posts: 3,433, Reputation: 596
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    #9

    May 24, 2008, 07:59 AM
    excon... has a very good point... make sure to get a copy of the diagnosis before you start to negotiate.
    Fr_Chuck's Avatar
    Fr_Chuck Posts: 81,301, Reputation: 7692
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    #10

    May 24, 2008, 08:44 AM
    Yes, on my non covered items, I almost always get them down around 1/4 to sometimes 1/2 of the bill. But then the first words out of my mount before any test is how much.
    aptylerman's Avatar
    aptylerman Posts: 9, Reputation: 1
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    #11

    May 24, 2008, 08:50 AM
    Thanks for your advice. I am continuing to research. This article is encouraging.

    http://www.nytimes.com/2007/02/27/health/27cons.html

    Sounds like a common problem.
    aptylerman's Avatar
    aptylerman Posts: 9, Reputation: 1
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    #12

    May 27, 2008, 08:15 AM
    After looking at my bill again and more closely I see that they have charged me for two CT scans, one for Abdominal and one for Pelvic. Does any one know if I have a legal leg to stand on since they did not explain to me a head of time that they were doing two scans?

    If it comes down to it, is this something I can take to small claims court?
    excon's Avatar
    excon Posts: 21,482, Reputation: 2992
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    #13

    May 27, 2008, 09:39 AM
    Hello apt:

    Small claims court?? Nahhh. You really don't have a claim. You could have asked. You didn't. They could have told you. They didn't. You DID the transaction. You just don't like how much they charged. They didn't cheat you. They didn't lead you on. They didn't trick you. They didn't do any of the things you're going to need to prove in court.

    Nahhh, your best bet is tough negotiation... However, it's a little tougher AFTER the fact...

    excon
    this8384's Avatar
    this8384 Posts: 4,564, Reputation: 485
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    #14

    May 28, 2008, 12:41 PM
    I agree with everyone else; you never asked what the cost would be and now you're upset that it's so high. That would be like ordering a meal at a restaurant without looking at a menu, receiving the bill at the end of the night and complaining that you overpaid for your dinner. It's your obligation to ask, not theirs to tell.
    aptylerman's Avatar
    aptylerman Posts: 9, Reputation: 1
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    #15

    May 29, 2008, 04:58 AM
    What about the fact that they sent me for a (singular) CT scan and charged me for two? After my doctor appointment I received an 'Appointment Schedule' that shows patient instructions for a CT Scan? Not two. I now need to ask how many pictures they are going to take and how many times they are going to bill me?

    This clinic has a 'Patients Rights' listed that mentions 'I have rights to my treatment, diagnosis and treatment in terms that I can understand'.

    Telling me you are sending me for a test and charging me for two is now very clear. Nor should I make an assumption that they may charge me for multiple.

    If I see a menu, the prices are listed. Not hidden. I am not talking about a $50 to $100 meal. This is a huge financial transaction. I understand that this service was not going to be free. I believe that this clinic and doctors benefit from their practice of hiding their costs and not considering their patients financial situations.
    froggy7's Avatar
    froggy7 Posts: 1,801, Reputation: 242
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    #16

    May 29, 2008, 08:06 AM
    Any time you hear MRI, PET, or CAT scan, you should be asking what it's going to cost. And as to the two tests... it's quite common for different body sections to be billed separately, even if the imaging is all done at once. The same way that you get billed separately by the surgeon, OR, and anesthetist for the same operation.
    this8384's Avatar
    this8384 Posts: 4,564, Reputation: 485
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    #17

    May 29, 2008, 09:07 AM
    Quote Originally Posted by aptylerman
    What about the fact that they sent me for a (singular) CT scan and charged me for two? After my doctor appointment I received an 'Appointment Schedule' that shows patient instructions for a CT Scan? Not two. I now need to ask how many pictures they are going to take and how many times they are going to bill me?

    This clinic has a 'Patients Rights' listed that mentions 'I have rights to my treatment, diagnosis and treatment in terms that I can understand'.

    Telling me you are sending me for a test and charging me for two is now very clear. Nor should I make an assumption that they may charge me for multiple.

    If I see a menu, the prices are listed. Not hidden. I am not talking about a $50 to $100 meal. This is a huge financial transaction. I understand that this service was not going to be free. I believe that this clinic and doctors benefit from their practice of hiding their costs and not considering their patients financial situations.
    You're right, you do have patients' rights to understand what procedures you're going to have. However, you seem to very much understand that you were going in for a CT scan, no? Just because you didn't ask how much it would cost doesn't mean that your doctor violated your rights.

    As for charging you twice, that I don't understand. I don't have your bill in front of me and I don't know what procedures they actually performed on you.

    I'm not sure what you're looking for on this board. You asked for advice; everyone seems to be in agreement that you're stuck with the bill but you keep arguing that you're not.
    aptylerman's Avatar
    aptylerman Posts: 9, Reputation: 1
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    #18

    May 30, 2008, 09:17 AM
    I am looking for a Legal Opinion by someone practicing law. Maybe someone has had this experience and can share a solution. Maybe someone in the medical profession that could provide some advice.

    I appreciate your opinions as well. But I was looking for someone with a professional background in this area.
    Alty's Avatar
    Alty Posts: 28,317, Reputation: 5972
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    #19

    May 30, 2008, 09:46 AM
    Aptylerman. Although not lawyers, or practicing law, excon and Fr_Chuck are well known on this site for giving accurate legal advice. You could call an actual lawyer, pay lawyers fees and try to get this bill reduced only to end up paying more in the end because of legal fees. Time to mark it up as a lesson learned the hard way, next time you'll know what to ask.

    And on a side note. I love all my American friends, you guys are great, but when I hear about the cost of health care in the US I can't help but be really glad that I live in Canada. No wonder most Americans are very health conscious, you all can't afford to get sick. I had an MRI in January, got in a week after the doctor recommended it, what did I pay, well nothing, health care covers it, and most companies pay for their employees health care, even if they don't the cost is minimal. $4000.00 for a CT scan, that's ridiculous, cremation is cheaper. ;)
    danielnoahsmommy's Avatar
    danielnoahsmommy Posts: 2,506, Reputation: 297
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    #20

    May 30, 2008, 09:57 AM
    Look you received great care and got the diagnosis you need. You do need to correct the problem, so alienating your surgeon is no the best idea.

    The problem is that you should have negotiated the cost of the proecedure before it was done. Most doctors knowwing that you don't have insurance will discount there services. Unfortunately a ct is very expensive so I don't know how much they can actually deduct.

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