When Is enough...enough (Doctors' Billing Vent)

Updated on November 23, 2011
K.G. asks from Fort Wayne, IN
19 answers

I had posted a week or so ago about my Dr 2x billing. And I have been told this is common practice now for any ?'s outside of why you are there you will be billed for another office visit. This is just disgusting to be nickel and dimeing patients to death. We are paying $180 for a physical which by definition is talking about your heath concerns. Well I guess not, we were also billed bc hubby brought up to her that he has had trouble sleeping, she never said to him "I am done with your physical if there are any other concerns I will have to bill for a 2nd visit to cover your concerns" He would then have the choice to either talk to her or skip his concerns and leave. I have already spoken to billing, ins and the nurse who will talk to the dr about the 2nd charge, and if the dr will not drop the 2nd charge we will have a new dr next year. I know some of you think that, thats how it is and not rock the boat. Let me equate it to you in a differant way, say you take your car in to have the engine wotrked on and the mechanic does your breaks also without asking, then bills you for it, do you pay for it or stand up for yourself. Why are we allowing this to happen? I think we as a society have allowed others to dictate how we will be treated for way too long. What happened to "bedside manners" treating patients with respect and dignity and not a $ sign. Sorry just venting,

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So What Happened?

To those that said maybe it was a mistake in the transcript it was not. This is how she does her billing. The the thing that makes me mad is she "baited" hubby into to ? of is there anythig elae. Yes we do have insurance, but we are on the hook for office visits and yearly phys. I think I will be looking for another doc I have yet to hear from the office if the charges will be removed or not.

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answers from Cincinnati on

I don't think you should be billed 2x if its in the same visit. That is the one of dumbest things I"ve ever heard. Had he gone a day or 2 later, then yes I see another bill happening. At my doctors they address all my concerns in one visit and don't charge double. I would be rocking the boat. My FIL rocks the boat a lot. I think you should find another doctor

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answers from St. Louis on

Actually a better analogy would be you bring your brakes in to have the break pads replaced and they find out your rotors are bad as well.

Anyway it is not a matter of dignity or respect, the doctor treats the patient. He treated your husband in the best way he could. I work in a billing office, I assure you there is little about billing that is in the control of the doctor. We have one coder per health insurance carrier. Some of the major carriers we have two coders. All of this is because every insurance company requires something different and they have to know or we don't get paid. If we have a staff of 30 people, each one knowing a different set of rules and usable codes, how on earth can you expect one doctor to know all that information and still treat patients?

3 moms found this helpful


answers from Denver on

Umm - I'm a little unclear - did he ask the question while you were still in the office? If so - then they shouldn't be double billing you - I think a question about sleep trouble during a physical is completely within the boundaries. Now if it had been - I have this big ugly old wart on my foot - can you take it off - that might warrant another bill as it's an actual procedure. I would think about finding another doctor

2 moms found this helpful


answers from Dallas on

I had to take my daughter to her pedi (we love this pedi) last week and I was presented with forms to sign stating charges for any paperwork requested (signature for athletic forms, vaccines forms, etc), if you page the Dr you are charged $5, and any extra questions will be extra money. It was stated that if you are there for a physical and ask something not related to the physical, you will be charged for a separate office visit.

SO, while in the office, daughter is talking to the Dr. and the Dr kept saying "Is there anything else I can help you with today", just baiting her to ask something $$$$... and I was afraid to open my mouth because I knew there would be more charges coming. Daughter said no.

SO, I go to pay... I don't have co-pay... we have a $15,000 deductible that we'll never hit and I am told my 15 minute visit is $205.

Daughter blurts out, thanks obama and everyone in the office hears it. That's ok, her right to speak her mind... Surprisingly I did not get charged for that.

The Dr files it to my insurance but unlike yrs ago, when the insurance pays what is reasonable and customary, the office wrote off the balance (EX: Insurance pays $40 for strep test, Dr. charged $45) and now the Dr. will bill you for anything the insurance does not pay... no more write offs. Thanks obama

Then to top it off, they wanted me to leave a credit card number and photo of the card on file for instances when I might call in to ask the nurse a question or for any charges that might go toward me account. I declined this and said if they need to charge me, I will gladly pay but no one has free reign with my credit cards.

Thanks BO

ETA: I understand that the Dr. herself may not be the one to incorporate these new "rules" and I have great respect for Dr.'s but thanks to bo we are all going to be nickel and dimed to death now.

1 mom found this helpful


answers from Washington DC on

Fight, fight, fight. And find a new doctor.

1 mom found this helpful


answers from Chicago on

A physical is a wellness check, meaning that it is not the time to bring up problems. Problems should indeed be addressed in separate appointments. They are billed differently, and the doctors' time for a physical appointment does not allow for addressing problems.

Very often we moms complain about long waits at the doctor's office, and problems being addressed during wellness visits is a huge culprit of what makes a doctor run late. Very often, especially men, will go through their physical, and just as the doctor is about to leave & go on to the next patient, the patient says, "Oh, by the way....I've got this...." The doctor ends up late for the next patient, has to code another visit & write the notes, perhaps order scrips, maybe issue a referral, etc.

It would be nice to think that we could just talk about everything with our doctor at a physical, but the fact is that doctors (especially good ones) are so crunched for time that problems really should be handled in totally separate office visits. JMO, as the wife of a doctor who works his butt off for his patients. But, yes, the doctor SHOULD tell the patient to make a separate appointment to address the problem (this does anger quite a few patients, though, as they don't want to have to come back).

1 mom found this helpful


answers from Indianapolis on

I have to say, the healthcare company I work for has never, ever done that as far as I know. For one thing, because of Obama's healthcare reform, all physicals will be paid in full by insurance companies soon. I think that has to start officially Jan. 1st, but our company started doing it back at the beginning of the year as soon as the bill passed. Also though, our doctors know that it's wrong to treat patients like that and that they'll leave the practice if they ever were treated like that. I wish you the best of luck in finding a doctor who's more ethical! I would definitely be reporting that office to the AAMA board in your area because of unethical practices.

1 mom found this helpful


answers from New York on

I would find a new doctor. A physical should cover all of your health questions and issues. Yes, you should rock the boat and stick up for what's right.

1 mom found this helpful


answers from Kokomo on

this would be a big problem for me because we have to pay for half of the dr. visit. So I pay 67.75 each time we go to the dr. If a dr. is going to charge for two office visits then there is no way I would be staying with them. This is just not right. I do understand that she might have had to write down a different code for his concern of not sleeping however there should not have been a charge for a second office visit. If you have not contacted your insurance I would do that as well just to make sure they are aware of the charges and to see if there is something they can do to help you out.
I know that in 2003 I switched drs. well the new dr. did a blood test for allergies. Well my insurance does not cover allergy testing. I was not asked about having it done or anything. When I got the bill for it I called the dr office and a nurse or someone in the billing department told me he should not have ordered that because no my insurance does not cover that kind of blood work. Well it was $700. My husband and I refused to pay the bill and wrote a letter to the place that did the blood test as well as to the dr. I do not know what happened between the dr office and the lab but I never saw a bill again for it.


answers from Chicago on

I know medical billing is outrageous, but I've never heard of a doctor billing you by the number of issues you bring up during an appointment! You don't mention insurance, so I'm not sure if you're covered. But under my plan, anything that can be considered preventative (rather than waiting for a massive, expensive blowup) is covered 100%.

I'd find a new doctor.


answers from Seattle on

Fight it.

If you do not say anything and roll over and take it, it will keep happening.

That is how we have gotten into the messes all over the country. We have been taking it for too long, from people who care nothing about us.

It is a robbery they are trying to commit. The only difference's is, they can commit it, and not get into any sort of trouble....Because it is what they do.

I had to start paying for my Doctor's visits the day of....For this very reason. I would get a bill a month later and not know why I was being charge 300 extra bucks. So, now I put the deposit(I do not have insurance so I pay $150 regardless, just to get into a room) and then at the end of the visit they tell me what the coding was and how much it will cost....plus for paying the day of I get a whopping 25% discount(not complaining, it has made the difference of about 80 bucks at some visits).

Fight it. That is major BS if she is going to bill you like that.



answers from Dallas on

Fight it. Be a thorn in their side. Recently my daughter was in the ER for ingesting medicine. She got terrific care in the ER. I was told she needed to observed for three to five hours and checked every half hour because her breathing or heart could be compromised. Of course, you don't question that when a doctor tells you this about a loved one.We went upstairs to the observation floor. Originally she got a thorough exam. As the doc was talking with me I confirmed again that she needed to be checked every thirty minutes and this wasn't something that could be handled with a follow up appointment. I was told we absolutely needed to stay. FOUR hours later not one person checked on her. No one looked in. No one touched her, even after I talked to nurses...more than once. I finally asked to leave and no one even checked her before we left. I was told it was policy to check on patients every four hours...which I understand, but we were a "special" circumstance. She could have fallen asleep and something horrible happened and no one would have known. I was pretty ticked. Then I got a bill for almost $2000 (Just for the observation time, this did not include the ER time). It took a few months and lots of hours on the phone. I was not every able to make it go away....we didn't expect that, obviously we owed something. But I was able to reduce it by $850. No one was willing to help us either, which is why it took so long. We talked to insurance, patient reps at the hospital, the billing department, requested copies of records (to check billing codes and looking for fraud).. It finally came down to me calling the billing department and asking to speak to a manager. I told them we were absolutely NOT satisfied with out care and we needed to negotiate the billing. I told her that we were willing to let it go to collections if need be. I was polite, but firm. Never yelled and never attacked the manager. She put me hold. Had to call me back. I called the patient care rep and told her the same thing. Then they called back and offered me the discount. I am still not pleased with how much I had to shell out to let my kids watch tv all day, but it's better than what they expected me to pay. Good luck!


answers from Minneapolis on

Its defiantly a rude practice to do so. I dont think the doctor himself did it, what might have happened is that he noted it on the charts that he talked about sleep problems, then the transcriptionist wrote it as a separate code. Then the insurance received it and figured it was a separate charge as an office visit. I really think that its one pitting the other... I have recently fought, appealed, fought, and appealed my daughters charge to the insurance. I lost, because there rules are so "strong". They are stating that while I am in the office talking to the surgeon and the surgeon says that she strongly needs the surgery and THEN she needs a helmet to fix a deformity, I take it he knows what he is talking about, and that he is the formost expert in this area, I figure the man knows the ropes about insurance and what is required first. When I get the helmet fitted and ordered that day cause according to the surgeon, "we have an opening now so rather than go home and come back you should just get it done". OK I am at the hospital, no where near a computer or phone. SO how am I to know that my insurance requires 2 weeks of physical therapy on a bone deformity. RIIIIIIIIIGHT. Anyway I do it all, and they bill me the 4 thousand bucks and wont turn the bill around. They say we broke their "guidelines" granted they say this and NOT rules. That we have to pay for it since we did not go through them and approve it first, and this is a doctor related issue and we should see if they will cover some. WHAT??? my head is spinning and my daughter is still having treatments and racking up more bills. Great



answers from Pittsburgh on

Check out this article. It has a link to help you file a complaint. Texas is O. of the states that even has a hotline to call.


It might be his "policy" but that doesn't mean it's ethical. So SPEAK UP and let someone know! Good for you. I've said for many years that doctors are like plumbers, electricians and lawn care people--if you don't like them, their work or their ethics--FIRE them!


answers from St. Louis on

I totally agree with you. If you were there for your daughter and the 2nd question was about your daughter then no extra charge. With that being said, if the 2nd question was about you or your husband then I would totally understand the 2nd billing.

I agree with you that we are getting nickled and dimed out of everyone now. We keep paying more and more, but our paychecks keep showing less and less.



answers from Phoenix on

I agree with you 100%. I'd be upset about the $180 physical also. I complain because my doctor charges $90. Once when I had my thyroid tested they raised my medicine from 60 mg. to 90 mg. It made me sick as if it were too much medicine. I called and asked if I could go to 75 mg. since that's what they usually do. It was a mistake for them to skip a level and I've been on thyroid medicine for over 16 years. They said I needed to come in for that. I made an appointment, the doctor asked why I was there, I told them the same thing I said on the phone, he said no problem, gave me a RX and charged me $90. They've been my doctor for 12 years. I've been on the same thyroid meds for 16. Why skip a dose and why have me come in? I guess I don't go in often enough so they needed to make it worth their wild to call in the new RX. They didn't check me out or even check my blood pressure. I should have had that for $90. So I feel your pain, totally! Fight this and change doctors unless they bend over backwards for you. Good luck!



answers from Dallas on

I would still fight it, but I would also find another doctor anyway. You are just going to have this problem again in the future. I don't know where this is the norm and how a sleep question isn't in the realm of a physical. If I got 2x billed everytime I asked the doctor a question outside the realm of what I was there for, I'd be bankrupt. I've asked my doctor questions about other members of my family and still didn't get double billed.


answers from Milwaukee on

I agree with the PPer that's ridiculous and I would fight it.

I do everything I can to not go to any docs through our Children's Hospital as they bill you for the visit, the facility, and then another for the doctor.


answers from Providence on

I guess I should stick with my doctor, then. She takes at least 15 minutes discussing with me any issues I have at the moment, then performs the physical, and then lets me know how to proceed with the said issues I brought up. I thought all doctors book at least 45 min for a physical to assess, exam, and diagnose. It's called Quality Care for a reason..I would find a new doctor in your network...

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