FUDiabetes

Medical bills

Not really sure where this fits in, but just wanted to vent about medical bills for a minute. I have a high-deductible plan.

I live in an area with LOTS of endos, so I’ve been fortunate to be able to switch as needed over the past few years. My favorite endo was at a huge medical institution (rhymes with Believeland Cynic), but it was too hard to drive to her and the bills were outrageous. Facility fees, fees to look at my CGM data, fee for endo. I switched to a local endo I found online - he was just ok but his nurses were awful (didn’t know the different pump manufacturers). Ended up back at Believeland Cynic, even though their billing practice is outrageous.

Just got a bill for a recent visit with a different endo within the Cynic (because mine moved and I really didn’t want to drive too far)… same facility, but they added a $180 “Treatment and Observation room” fee. I’m chatting with an online representative about it and they aren’t really helpful. I hate that I have to pay over $300 for this appointment - and the endo wasn’t even remotely helpful! (I think she is a recent grad.) It’s just infuriating.

I will say, all of my supplies and insulin are covered as long as I’m enrolled in my insurance’s Diabetes Management Program (learned the hard way that if I’m not, I’ll have to pay for that stuff). I know I am very fortunate. But I hate that this one big institution can charge whatever they want and people have to pay it.

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Hey @allison! That sounds like a bummer. Have you discussed a discount or asked them if they offer one? I had good luck with this over the phone with a couple of large institutions in California. I just waited until a few bills gathered (related to same procedure) and telephoned and asked if they offered a discount if I paid in full. They did!

Aside from the pricing, your experience with a good endo sounds positive - but it’s a bummer they moved on and you got stuck with someone unhelpful. :frowning: Can you get through your deductible and then it’ll be free - maybe it’s so high that never happens though. What about seeing a CDE (certified diabetes educator) instead of an endo? We’ve had good luck with a couple of those in the past.

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Thanks for the feedback!

I wish I could get a discount but have a feeling I can’t because it went through my insurance first. (That’s how it works at the hospital where I work.) My deductible is around $3000, and after that I have a $1500 coinsurance. Almost halfway to my deductible, but not sure if I’ll get there. I do have an HSA that my employer contributes to, which is really nice. It just sucks to have to pay these bills, especially when they seem extravagant.

My favorite endo is just too far away and too difficult to get to now. I miss her! (edit: I don’t think I’ve ever seen a CDE. Is that in place of an endo/in addition to? How often vs endo? Endo wants every 3 months, which is ridiculous…)

Is that after it is processed by your insurance?
I would ask for clarification on the $180 charge. Could be a billing error.

I typically see outrageous charges, then knocked down by contracted price by insurance contract. I don’t pay bills until I see the EOB.

Last year, I got notice from collections, for medical bills I never received. They were billing me over $300. Called billing office, and they said my bill was on hold, but no one knew why.
Fortunately they retracted the collections, I paid them once re-filed claim, they e-mailed corrected bill. Thankfully, no more notices from collections.

With my investigation, determined they originally had faxed info to my insurance, which was not actually received correctly. Took over 7 months to get corrected. Was originally told by insurance too much time had passed, but somehow they found error on their side that caused the fax submission problem.

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@allison I empathize with your situation. One way I get around many of the bills (my endo charges $472/30 min) is using online messaging. I ask my question, occasionally offer to make an appt, and usually can get what I need without going in. Does your clinic offer anything like this?

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What a pain for you! Glad they figured your stuff out.

I did sent the endo office a message directly to ask. I checked my insurance - it did get processed through them but they didn’t pay and there was no insurance discount, as there often is. I am confused and frustrated about this. Thanks for your feedback.

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Thanks! I can do online messaging, but I really don’t need them for answering questions - just writing prescriptions! I don’t know how long I can really go before they’ll refuse to write them… maybe once per year? I’ve never gone that long without seeing someone in over 20 years, though.

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Its possible since you were a new patient to them, they billed you as if you had more extensive “Observation and Treatment”.

But if you just consulted with endo, I would expect just an office visit charge. Billing coders have to guess from drs notes what to bill for.

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I can only speak for the medical group I see, but their rule is that you have to be seen at a minimum of 1x yearly or you are not an active patient that they can prescribe for.

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It was just like a regular appointment. I don’t think they even looked at my old records because they asked how I was diagnosed… which was almost 25 years ago… and it’s all in my chart!

I guess billing coders could have been involved, but with our electronic medical records I think physicians usually do their own billing. I’m an audiologist and everyone in my department (rehab) does his/her own billing.

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That’s been my experience with other physicians (at least for the hospital I work at, not from my own personal experience). I may just cancel my next appointment and reschedule when I feel like it!

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Can you ask your insurance if that charge should be allowed, and then go back to the prestigious clinic and ask them to remove the charge which seems quite ridiculous.

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I will ask! I am currently waiting to hear back from my doctor’s office to see if they can answer why I was billed that in the first place. If they don’t take care of it, I’ll ask my insurance. It is ridiculous! Thank you!

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i hope you can afford your insulin. does your insurance cover the bulk of it? sadly and horrifically so many Diabetics are dying now b/c the pharm companies have jacked up the prices for insulin that those in need cannot afford it, and then they are rationing their dosing in an effort to have some sort of insulin maintanence; this efffort is unfortunately inadequate and so many are unnecessarily dying just b/c the insulin pricing is too high.

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Absolutely - it is so horrible to hear about people not being able to get their insulin. Fortunately, my employer pays for all of my insulin, and even Victoza (off-label, but they still pay). They also cover the cost of all of my diabetes-related supplies. I am SO fortunate in that aspect, so I’m not really griping that “ugh, I have to pay a bill” - but more that this is a ridiculous charge, IMHO.

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i am so fortunate b/c i am on Medicare/AARP and they cover EVERYTHING diabetic (except for a very reasonable co-pay for my insulin). i do have to pay AARP a rediculous some of money each month, but what i get out of it is well worth the expense; and, the expense doesnt come close to the amount of the bills that you are paying.

(my endo is at Mt SInai Hospital department of endocrinology, and he is not only fabulous, but i dont even have a co-pay) (thanks to Medicare)

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This drives me crazy. News flash hospitals and doctors there is currently NO CURE for diabetes…so how about ONE prescription that covers a year, or better yet how about ONE prescription that has NO end date since the disease isn’t going anywhere! When you want/need to amend something on it, you’ll reach out to them. :frowning: I hate that diabetics have to go through this mess to just get a script written. Sorry, @allison. :frowning:

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@ClaudnDaye from your mouth to “For-Profit” medical care administrators. Give 'em heck! :grimacing:

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Yes! I cancelled my appointment in June. I’ll go in when I feel like it, darn it!

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Here’s the reply I got from my doctor’s office, which I sent to my insurance company to ask WTF?!:

Our office is now considered an outpatient department of the hospital which means that when you are seen in our department you will see charges from the hospital and from the provider that you see. The fee that is billed out to the insurance is $183 and is charged every time that you are seen in our location. If you have any questions on how your insurance processed the charge please contact your insurance directly or call the 1-800 number that is on your statement.

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