Our daughter has been having a chronic urinary track infection since the age of 3. Now at the age of 10 and dealing with the constant bed-wetting as well as the horrible smell that gets everyone (and not to mention her fragile tween self-esteem), I put my foot down at our normal pediatrician’s office. He agreed that it was time to go to the experts. He referred us to a specialist and she is with a local children’s hospital. We were instructed that the next time she has said infection, we are to go the urgent care affiliated with the hospital. We have excellent insurance so imagine our shock when we opened a bill from urgent care for $988.00 – and that is after insurance paying their “portion,” We think this is outrageous. What steps do you recommend that we do to check this out rather than simply blindly paying it??
Thank you!! Diane.
What steps do you recommend that we do to check this out rather than simply blindly paying it??
I can only imagine how outraged and upset you are by the surprise bill.
The cost of modern U.S. medical care is out of control for the average person. Visits to the doctor can turn into giving medical practices an unaffordable blank check that leads to bankruptcy.
The first issue is to help dispel this myth that health insurance picks up everything or is responsible for the bill. Medical insurance is not for the benefit of the health care provider, but for the insured.
Meaning, the ultimate responsibility for the bill always rests with the patient or party responsible and insurance pays some on behalf of the patient. When it covers the bill or most of it, it’s a blessing. And then there are times like these.
When you visit a medical practice these days one of the initial forms they ask you to sign is a financial responsibility form. That form says you will be responsible for paying the entire cost of the visit and generally the provider will bill your insurance company as a convenience for you.
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Unless the provider accepts assignment, where they accept the amount the insurance company approves for the visit as their full payment due, you will be responsible for the rest no matter how much the bill is.
If you did sign the financial responsibility form and accepted the payment for services then it seems your options to investigate are to carefully examine the itemized bill and confirm the services you are being billed for were actually performed.
Second, you can contact the billing office of the medical provider and confirm those are the legitimate charges for the services provided, to make sure they did not bill you an incorrect amount.
Third, you can ask the financial office if they have some policy for reducing the bill based on financial need.
Fourth, you can contact your insurance company and ask them if the amounts you were charged for the services provided are the usual and customary charges for such services in your area. Generally, insurance companies have fairly good coverage for urgent care appointments so I suspect the bulk of your bill was not for the visit itself.
Please post your responses and follow-up messages to me on this in the comments section below.
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