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Discussion Starter #1 (Edited)
I find myself in a situation I'm not sure how to handle. A couple of weeks ago I had my annual physical with my PCP. I've been going to this MD for about 3 yrs and initially chose him because he's convenient location wise, I can get an appointment with ease (at least with his Physicians assistant who is very competant), pleasant office staff and he's easy to talk to and has never given me a hard time with any prescription requests. I'm an RN so he's always appeared to have respect for my judgements/opinions on on what I need to remain healthy. We usually cut through the "BS" and commisurate on the sad states of affairs that is healthcare and insurance companies.

The last couple of years I've noticed he's been a lot more rushed-performing his physicals in (seriously) less than 2 minutes (patient fully clothed). I've chalked it up to him getting a bigger pt load or perhaps just rushing things with me since I'm a nurse and generally very healthy. I did comment to his medical assistant last time "wow-that man gives the fastest physicals ever). She reposnded..."Yeah, that's how he always is...." My husband goes to him too, loves him, but not being in the medical field maybe doesn't realize he isn't the most thorough examiner.

Anyway, after my 2 minute health assessment while he was checking off/ordering my annual lab work, I brought up a couple of health issues I had been experiencing over the past year but certainly didn't require a separate visit for. One query regarded the best treatment for a post-nasal drip, and the other was a ? about IBS. He recommended for one: Nasal spray....and two, a particular probiotic. The converstation lasted maybe another 2 minutes.

A couple of days ago I received my explanantion of benefits from my inurance company which showed a billing for my physical ($200) paid in full as my inurance covers 100% preventative care. I'm on a high deductible plan for sick visits but my employer will kick in the first 2K and I pay the final 1K before everything is paid in full again. If I DON'T use all of my company's share of deductible in 2010 that they kick in, it rolls over to 2011 account. This same explanantion of benefits also showed another $100 bill for a physican visit which a call to my insurance company revealed was for a 'sick' visit. The insurance company allowed $75 for the visit and was covered by my employer as I hadn't reached my 2k deductible mark yet.

I called my docs office to inquire why I was charged for a 'sick visit" as well as my annual physical and after browsing through my chart (MD wasn't in) they said it looked like we 'dicussed things out of the ordinary for a regular annual physical". WHAT?!?!?:angry: SInce when is it not appropriate to ask a few general questions about health issues during an annual visit? My doctor was obviously milking the system for a few extra bucks and probably not realizing he was screwing MY wallet because he didn't know about my particular high deductible policy. I know it's not alot of money we're talking about, but his billing for a 'sick visit' results in me getting $75 less put in my company's bank for the deductible they can kick in in 2011. Maybe I find it particularly irritating since my premiums for insurance are going up 30% in 2011 and my deductible portion rising from 1K to 1.5K.

The office staff I spoke to obviously isn't going to admit that he 'did wrong' in charging me for asking questions but I could tell from their voices they felt awkward in trying to justify his actions. They kept telling me I'll have to talk to him about it. He returns from vacation in a could of days.

I just don't know what to say when I speak to him. Should I be honest and level with him that I understand the frustration of the insurance industry but can't condone the 'milking' of it when it directly affects my wallet? I can't see him admitting such an act of wrong doing, yet I don't see how he can justify in words charging me extra for what should be included in an annual visit. He probably figured my inurance would pay for it in full and I would never notice. I really don't want to begin a search for another doc at this time and my husband wants to keep him also as his PCP. It's just very awkward and not sure what approach to take.

Any thoughts....suggestions....? Thanks for reading this long post!
 

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HI:

Billing is based on coding. God only knows what the coder wrote. I would let him know as these mistakes might affect him in the future.

Doctors know NOTHING about billing!
 

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I understand completely what you are saying BUT if you bring it up to him and he will never admit it, you probably will have to find another doctor because both of you will feel uncomfortable around each other. Let's face it, he is milking the system too.....and you are paying for it. The only suggestion I know otherwise is just tell him how you have to pay and it is costing you and maybe NEXT time he will remember to do what he should have done in the first place. Good luck to you if you want to keep him..........:wub:
 

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I would talk to him about your not understanding why your insurance bill came and charged you for a sick visit when you were there for a physical. See what he says. You'll know where to go from there. In case it is a coding mistake you won't have accused him of anything and if he says otherwise then bring up the issue that it came out of your pocket and just what you said "I didn't know that I couldn't ask a question or two during my annual." I think all of this leaves the door open to still seeing him or going somewhere else.
I have sort of the opposite problem. I have an internist who is a cardiologist who I love to death. Takes so much time with me on any visit and asks all about me and any health concerns. Gave me free Lipitor samples to help me save money. Problem is I am a small biz co-owner and my insurance company called to say my $750 a month pp insurance premium (with $1250 in plan; $2500 out of plan deductible) is going up to $1190 pp, per month.:w00t: A 49% INCREASE. :smpullhair:Insane - but it's the only health plan she takes. Do I shop for cheaper plan and get a guy who's "wham bam thank you ma'am" like yours above or pay that insane price that I really can't afford. And DH and I are healthy. Health care is so out of control and I think they're really trying to stick it to us before regulations come in.:smilie_tischkante: Sorry to add rant to rant but it all stinks!
 

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Janet ... I read through your post quickly and want to take time to go back and re-read it. In the meantime, I will offer my advice. Report this to your insurance company ... on the phone (speak to someone higher up) and also send a written report to the insurance company.

My daughter works for BC/BS. And, with that, I can tell you this needs to be reported. Any good insurance company will do an investigation. Believe me, the insurance companies have ways of checking issues like this out. And, there are the dishonest doctors who know exactly what they are doing ... coding more time than what was spent with the patient.
 

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I might think about finding another doctor, not so much because of the billing. He just sounds too quick. Some day you might not be so healthy (I hope not!) but then you may want someone who takes his time with you and listens to you. I am sure you know that being too quick can cause a wrong diagnoses.
 
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