Charged by the Minute at the Pediatrician?

My pediatrician has a $40 "penalty" (increased payment) for those who come in sick without an appointment, but this charge does not apply if you call and make an appointment. However, this policy is clearly stated in the waiting room, along with the explanation that this is because walk-in patients throw off the doctor's entire schedule for the day, will cause them to be late for those who have appointments, etc. If you were not informed of this policy in advance, however, I would contest it.

This is not uncommon at all.

It really all depends up on how your insurance is set-up to reimburse your physician. It's kind of complicated, so I'll try to not be too confusing.

Insurance companies negotiate fees that they pay to doctor's offices. They're almost always considerably less than if you walked into the office and paid cash. Some insurance companies pay a "capitated" fee - basically, the doctor gets paid the same amount/month per patient regardless of how many times they see you - it is in the doctor's best interest to keep you well so they can see as many different patients as possible (instead of the same patients over and over again).

Doctor's offices use ICD-9 codes to bill for visits - that's what all the information on the sheet is when you take it up to the check-out window and has not only the conditions for which you were seen but also the level of care.

Is it right that they are doing this? It depends on who you ask. Most doctors are getting paid 80% of what they did 10 years ago. I'm posting a link for an article by a physician regarding cuts to Medicare reimbursement that Congress is trying to impose upon physicians (it could cut the reimbursement doctor's offices receive by 40%).
http://www.kevinmd.com/blog/2010/03/medicare-slashes-pay-...

Sorry I don't have better news, but this is just a little insight into how the business side of a physician's office works. Most of them are barely able to keep even remotely profitable today vs. many years ago.

You need now to send them a bill on every minute you waited in the waiting room!!!

You aren't overreacting. The very practice of limiting the "regular visit" to 10 minutes is not one I'd want - sometimes you need more time... and this indicates to me the priority of the practice is not your child's health, but the doctor's pocketbook.... I understand you need a balance, but this is no where near the "care" I'd want. I would definitely look for another Dr.

Whoa, I have never heard of that.
I mean, are they now charging for time, like attorneys?
Maybe call your medical insurance provider and inquire if Ped's are now doing that... and what the billing is?

I would be questioning it as well...and they Doc's office did not inform you/patients of that new billing "rule", right?

Pretty sneaky.

that's standard for any doctor i've ever seen... there's usually several different billing levels, such as:

brief
basic
expanded

and so on, and each one is typically identified by how long the visit took. if you are angry though, by all means, find a new dr. we should all be comfortable with the physicians that provide our care.

All physicians bill this way. Most of you just don't notice it because you only pay a co-pay. Your insurance pays the bulk of the bill (unless you have a deductible). Think about it....if you are in business, wouldn't you expect to get paid for your time? You're not going to get paid the same for 10 minutes if you actually spent an hour. Payment is based on what CPT code is billed by the physician. Hope this helps.

whattttttt? realllyyy? woooooowwww. have you ever been given any paperwork 'warning' you for charges like this?
not contemplating, but change asap, and call their billing person and ask why you weren't warned about a thing like this. what now? you need to time yourself so you don't go over the minutes? man, i'd be fuming if that were to happen to us

i'd dispute, ask where in the paperwork does it state they can do this. then find a new doc office! that wont charge based on time!

I would change doctors. You are paying them good money to begin with and your children should have as much of the doctors time as they need. Thats crazy!

I would be furious! My pediatrician does not do this, but I would take my businees elsewhere! Just two weeks ago we waited almost an hour in the waiting room and then almost another hour for the doctor in the room. We were there for the yearly check-up on my one year old. What about OUR time??!! They are not God, we are the paying customer and we are not treated as such. When you are concerned about your child's well being, they need to take the time or they need to scedule more time for each patient. These doctors have a set of brass ones I tell you! WOW! BTW, you are not overreacting.

As a couple others have said, as much as it sucks, this is what happens when you have to pay out of pocket. An average ped visit for kiddo cost $250 and that was if he didn't have labs, immunizations, meds, etc. Toss in a quick strep test, or shots, or nebulizer, etc and watch the cost skyrocket. Unless they're willing to do you partial probono... they're using TCD-9 codes. And if they're owned by an insurance company or HMO (like most hospitals these days and all the clinics attached to them), they have no choice or leeway.

Fortunately our Ped let us pay off over time, and if kiddo was sick and we were between student loan checks -aka flat broke-, they'd hold the bill for us until the beginning of the quarter, and from working in a hospital I KNOW they were eating some of the costs out of kindness. I've had appts with my son that should have run over 1,000 and they were only billing at 400-500. (Our peds were a doctor owned co-op... so they DID have some wiggle room as far as billing was concerned. They could eat some of the patient cost, and not be fired and blackballed.)

I come from a family of doctors (hey Granddad/Auntie/Mum...), and then I was in the military where EVERYONE has healthcare (as in you're sick, go see a doctor. Something's broken, go to the ER). It's been a huge shock being out in "over 40,000,000 people have no health insurance land" and being one of them, and not near family. Hmmm... do I see a Dr. or feed my child? Well, I don't have novacaine, but it's only through 2 layers... I can stitch it myself (takes forever btw...sweat gets in your eyes... and at least for me the endorphins don't kick in till AFTER) or it's just a finger, I can set it myself, or I'm just going to have to cross my fingers and hope the cancer is in remission until I can afford to fly home, because I sure as hell can't afford the $1400 checkup.

Medical costs are astronomical, and if you're sans insurance (or even worse, have crappy insurance where're you're responsible for 50-80%) you pay through the nose for every minute of care. If it makes you feel any better though, the doctors are in an equally bad position. They're seeing more patients, for less time, and being paid waaaaaay less while their costs are going nowhere but up. Very few are in private practice these days... because they plain and simple can't afford it. Nearly everyone I know in the medical field is exhausted. CNA's are doing nurse's jobs, nurses are doing doctor's jobs, and doctors are busier than a one legged man in an a** kicking contest, and trying to stay afloat at the same time.

All of that said, if the office staff is snarky... or you get a bad vibe from the clinic in general SWITCH!! Voting with your feet is a fantastic methodology. :) :) :) But as far as the billing goes... pretty standard.

I think this in absolutely outrageous. Pediaticians are supposed to be available to you when your child is both well and sick and if you just happend to have a question or concern.

In this particular case, were you aware you only had 10 minutes? Did you have an appointment, even if it was made just an hour or two earlier? I can understand a small surcharge for a walk-in or last minute appointment, but $70 is ridiculous. I'd contact your insurance company.

Since my insurance has extremely high deductibles, I pay all actual medical care out-of-pocket, so I'm acutely aware that my last three doctors DO charge different rates for a brief visit and an extended visit. I don't know what the time cutoff is, probably around 10 minutes, but I usually pay for the extended visit (currently about $80 more).

i have never heard of that......i could see more doctors starting this with the new insurance laws.......did you get in right at your appointment time, did you have to wait 10-20 minutes? if yes can you charge them for waiting, lol.........i think it's only fair that if you never had this happen before that they should have sent you a notice of change or warned you when you made the appointment, just like the credit card laws that are in place, they have to warn you of changes in your contract......maybe since they didnt warn you this time they will scale back the charges.

Who is your pediatrician? That is crazy! I want to make sure I don't go there!

can you please give us here on the site the name of the practice, in case any of us use the same one, that way we could compare notes

i have never heard of anything like this at a doctor's office, i think i would like a dollar deducted off my bill for every minute i have to wait! :)

thanks for sharing, i am sure we will all be on the lookout