I have seen posts and comments online before about how being uninsured can be more beneficial. I do not question this but have never encountered it myself until today.
I had septum work done years ago and went in to my doctor have it looked over and just make sure everything still looked to be in the right place. In the process my doctor used a little camera and suction device to clean out my nasal cavity – it took 2 minutes tops and the entire appointment was about 15 minutes, maybe less.
Once all was said and done I left and received a call shortly after asking if I had insurance. Of course I said yes and gave over the insurance information. Then I see the posting to my account for $1100. I have since had a very kind and understanding phone call with my doctor’s office and ultimately if I had said I was uninsured, I would have been charged $100. But because I said I had insurance, the 2 minute camera got billed as a surgical endoscope for $800 and then a $250 appointment fee.
I discussed with my parents after and was told my uncle gets his ears cleaned by an ENT for $400. I am not sure how long this takes but I can only image if he was uninsured that the bill would be significantly cheaper. Of course this is not the case for everything in the health insurance world, but if you ever have a short appointment coming up, it may be worth your time to call anonymously to check the rate of being insured vs uninsured for an upcoming appointment. Can’t hurt.
To my knowledge: my first BS insurance experience.
byu/TheoDubsWashington inInsurance
Posted by TheoDubsWashington
1 Comment
Let’s clear up some information here –
Yes, scopes will always be considered surgical in nature, even if not a “surgery” itself. This will, unfortunately, always be more expensive. You’ve also left out whether this $1100 charge is the BILLED amount vs ALLOWED amount. There’s a big difference there. Is $1100 applying to your benefits? Or does the claim still need to process?
I place doubt on the providers office having a thousand dollar markup for a nose scope and office visit between cash and insured rates. You’re telling me the process of dealing with insurance is worth $1000? Even if it was, and $1100 os the contracted rate, why aren’t you getting pissed at the doctor for negotiating and agreeing to that contracted rate? Im not saying insurance is without fault here, but providers are a part of the problem here.
Finally, paying cash is not a one size fits all solution. For example, those on Medicaid are not allowed to pay cash and providers cant accept cash from those patients because it essentially defeats the purpose of being on that program.