Tuesday, July 02, 2013

Medical Lottery

Doctors today practice medicine on something of a lottery system, apparently; providing services to patients without ever knowing what they will be paid for those services.

Payment is determined after the fact by the insurance company, according to the billing person at my pulmonologist’s office. Her response to my question about a bill was that I should take it up with the insurance company, and when I pointed out that I was questioning an invoice on the doctor’s letterhead her response was “I don’t know, I don’t care and I’m not going to discuss it with you” and a repeat of the instruction to take it up with the insurance company.

At issue was three office visits, all identified as “office visit, long,” and each billed at $222.00. Two of them showed a discount of $96.00, while the most recent one did not, and I was being directed to pay the full amount of $222.00. I was questioning why I did not receive the discount on the third office visit that I had received on the first two and her response was that the insurance company had instructed them to collect the full $222.00 from me. I asked if she was telling me that the discount was not actually offered by and under the control of the doctor, and she said that the insurance company dictated how much would be payable.

So I asked if she saw any reason why a customer might object to paying almost twice as much for the exact same service as previously received, and she got really pissed off at me, said that she didn’t really care what I thought, and told me again to take it up with the insurance company.

So even though it’s the doctor who owns the medical practice, and I’m the guy who chooses the doctor and can choose a different one if I want to, and I’m the one paying the doctor bill, none of us has any authority when it comes to pricing. The amount payable is strictly within the purview of the insurance company and we all submit to whatever they dictate.

Is this a great country, or what?


  1. I have always belonged to the "when the insurance company pays, you have been paid" school.

  2. And the office person i question ought to be (*&^&^%#@$ for her piss poor attitude. But that's another subject entirely.