Don't know if this is OT or not.
I recently had to go to Urgent Care for a wound on my hand which had difficulty clotting and then reopened on Day 2. Also needed a tetanus shot.
I called my PCP first. She said I should go to Urgent Care because her (group) practice doesn't stock tetanus shots any more, nor do they do stitches.
I hate Urgent Care. The waits are long (no appointments), and I feel the care is substandard.
I was seen by a physician's assistant, who is the only practitioner there. He looked at the wound, which had stopped bleeding finally, and then left, wrote some notes, and sent in a medical assistant to put ointment on it, three steri-strips and a bandage. She then gave me a tetanus shot.
They billed my insurance $200. for an outpatient visit, $100. for debride of skin/tissue, and $95. for the tetanus shot ($50. for the medicine and $45. for administering the shot, two separate items).
Office visit had a $106. write off, and after Medicare and secondary ins paid I owe $2.85. The shot write off was $35.66 total, and my share was $2.96.
BUT HERE IS WHERE IT GETS INTERESTING...Medicare paid nothing for the debriding of skin/tissue. My secondary stated that since it wasn't an item Medicare paid for, they wouldn't either, and that I had no liability. The Urgent Care billed me $59.18 after a write of anyway.
There was no debriding done, it was a false charge to begin with!!! I called their billing people, and they tossed it around for awhile, even after I told them that A--such a treatment had not been done, and B--my insurance said I wasn't liable for payment anyway.
I told the biller I wasn't going to pay, they needed to investigate. I called back yesterday (since she hadn't called back) and she said she "just found out" the bill was in error and I owed nothing.
I know it wasn't a lot of money, but it was fraud plain and simple, and I wasn't going to pay it. You have to keep after your medical bills.
Isn't it amazing how much they inflate the bills compared to what they'll accept to settle them?
Fern
Needless to say, I am shopping for a new doctor. However, I am thinking that people who accept to pay this much are going to be very demanding patients and will expect the doctor to be at their beck and call 24/7. It remains to be seen whether doctors will rethink this arrangement a few years down the road.
