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Thread: Does your doctor bill for more than one visit on same day?

  1. #1
    Super Member mommafank's Avatar
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    Second time this has been experienced in our family. You go to the doctor for a check-up and get billed for a well check visit but if you discuss anything else you get billed for a second visit. My daughter took her baby for one week checkup and asked about the cord and was charged for well baby visit and for a problem visit. Of course insurance only pays for one visit so the patient pays not only an additional co-pay but the physician charge. I went for my yearly and was charged for a physical and for a medication check because my prescriptions were renewed. Just wondering how common this is and how to avoid it in the future.

  2. #2
    Moderator QuiltnNan's Avatar
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    boy, that doesn't sound right to me. i'd discuss it with the insurance company to make sure the doctor is billing properly. the insurance company knows how to break down the different codes for different types of payments. the doctor does not have to try to manipulate that. and it would seem that the doctor should look at the cord in a well baby visit anyway.

  3. #3
    Senior Member Alex J's Avatar
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    I'm not sure if that is right, I would call my insurance company and the BBB to find out if this is the new rules.

  4. #4
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    I'd get with your insurance if your doctor has a contract with them. I do believe that that is wrong....... In our office we can only charge the insurance for one MD code, one injection code at a time (I am in allergy). Each of the codes are set up for complexity of appointment and they should just be going the next step up in complexity, not adding on another code.

    What is a well check up if not to ask question? Also, if you had a 'problem' are they then going to tack on a 'wellness' check up if there wasn't a true problem?

  5. #5
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    This just sounds plain wrong to me!

  6. #6
    Super Member Grama Lehr's Avatar
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    I would find a new doctor!!! That is not right!!
    Just a thought, maybe the billing clerk is new and didn't know any better.

  7. #7
    Senior Member LovinMySoldier's Avatar
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    Time for a new doctor!

  8. #8
    Super Member Glassquilt's Avatar
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    That's just not right. Check with the attorney general's office.

  9. #9
    Super Member NancyG's Avatar
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    That is so wrong. I work for a doctor and we would NEVER charge the patient for 2 visits in the same day. Is that even legal?

  10. #10
    Super Member donnajean's Avatar
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    I believe this happend to me with gynocologist a few yrs. back. The next time I went for my yearly pap test & he asked me how I'm doing, I told him I could not tell him without them billing me extra. Gyno doc was the one originally discovered my thyroid problem. He still checks my thyroid, but I don't get a double billing. I don't think all the dr.'s actually know what happens with the billing & you have to be challenge the bills at times.

    I actually switched GP doc as you could only talk about 1 issue per visit. I had been complaining about my neck for 4-5 yrs. & he never did any testing for thyroid.

  11. #11
    Super Member grammiepamie's Avatar
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    This is what is wrong with our healthcare system. it is called double billing. I would call the insurance company and ask them if this is a common practice and why? The doctor should have looked at the cord without being asked. This was a well baby checkup for pete sake. Please call your insurance office

  12. #12
    Super Member mommafank's Avatar
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    I am being told this is legal and when I checked on the internet it seems that billing coders are saying you can do this. Personally I do not feel it is very ethical. My insurance paid only 10 % of the second visit and indicated I am responsible for the rest of it. Yes, I will be changing physicians and certainly will be checking to see what the billing policies are before I pick a new one. I do realize that physicians are often poorly reimbursed, but do not feel this is fair to the patient. My daughter finally moved from Savannah and now has new doctors who do not bill this way. She got it removed from her bill but still had to pay a large amt for the doctor doing a procedure on the cord---which was only using a nitro stick on it. And I agree this should have been part of that visit----as a nurse I would think it would have been just a normal part of the recheck exam. I live in GA now and wonder if this is something that is specific to this states law. I could not find anything when I did a Google search.

  13. #13
    Senior Member denise d's Avatar
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    Quote Originally Posted by Glassquilt
    That's just not right. Check with the attorney general's office.
    This.

  14. #14
    Super Member ptquilts's Avatar
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    I went to the ER late one night and got billed for two visit, two days, as I was there from say 11:25PM to 12:15AM.

  15. #15
    Power Poster nativetexan's Avatar
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    complain to the insurance company. he is not billing correctly unless she actually made two visits. he can charge more of course, but on one visit only. My doctor does that if i ask questions.

  16. #16
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    I went to talk with my doctor about feelings of fatigue, inability to lose weight and various other symptoms, one of which was low labido...we talked about a lot of things. He puts down low labido for everything in my chart and the labs not mentioning anything else discussed and sends me for hormone check up-which I've had before to see if I'm hitting menopause. Insurance declined saying they don't pay for anything sexual....What?

    Turns out low labido is not a covered problem and the doctors' office wouldn't change the code for the inurance company because the doctor didn't write anything else down.

    That one visit would have cost me out of pocket over $600. I called, the lab agreed to charge me the uninsured rate-wich was way less, and the doctor tried to charge me $150 but I had a letter from the insurance company stating I did not owe the doctor anything because they gave service without pre-aproving.

    So I lucked out and got it under $200. I changed back to an HMO after that.

    You have got to really pay attention the bills and what your policy covers, down to the fine print. It's so very annoying.

  17. #17
    Super Member mommafank's Avatar
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    Here is what I have found out today. My insurance rep told me that if the doctor would code it differently they would pay. I have called the doctor and am waiting on a response. I go to a GP who does my Pap which I thought ended up saving money for all of us and that is called a Well Woman visit and that is not what my doctor coded it as. So the saga continues. I just wnated to try to let others know that this could happen and like someone said watch your bills carefully and ask a lot of questions.

  18. #18
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    I've never heard of that! I'd be complaining all over the place.

  19. #19
    Super Member buslady's Avatar
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    I've not been charged for two visits, but a few years ago, when I had a PPO, I tried to ask some questions during a visit and was told I would need to make another appt. to discuss the additional issue.

  20. #20
    Super Member hobo2000's Avatar
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    My hubby and I are on Medicare with Ins. backup. I had an MRI 2 months ago for my back and no co-pay. He went yesterday for his MRI as prelim to an upcoming operation and had to pay $175.00 co-pay. Same insurance, different DR. What's up with this? I am waiting for a call back from the Ins. company, see if they can explain this one. However, both DR's. say "you have 15 minutes ask me anything you need to know" and we just pay one co-pay.

  21. #21
    Senior Member lheartsl's Avatar
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    yea that doens't sound right to me... sounds like the dr is trying to get richer....

  22. #22
    Google Goddess craftybear's Avatar
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    I would investigate it further

  23. #23
    Junior Member nnewman's Avatar
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    No absolutely not. Your insurance won't pay for 2 in one day either.

  24. #24
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    I'm with QuiltnNan, that sounds like fraud to me. In addition to reporting them to your insurance company, I'd find another doctor, one that's honest.

  25. #25
    Super Member virtualbernie's Avatar
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    This is what they are doing now. My doctor splits up her checkups. She does half today and makes you reschedule for the 2nd half and she won't answer any other questions (unless it's an emergency)--just tells you to make another appointment! At least with the double billing you don't have to pay for extra gas or your precious time! I hate it!

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