Yesterday, I received a medical bill that is a perfect example of what is wrong with health care costs in this country. Several weeks ago I had an ultrasound as part of prenatal testing. The ultrasound was performed in a perinatologist’s office on one of their high-tech ultrasound machines. The scan took about 20 minutes, and was performed by a sonographer. The bill for that portion was $378. That part seems reasonable to me.
Here’s the part that makes me stabby: after the initial ultrasound, the perinatologist came in. He put the wand back on my belly for about 30 seconds to take a quick look, then said everything was fine. I saw him for three minutes, at the most. The bill for that portion was $370!
I’m fortunate that insurance covered the cost, for the most part. The scan ate my entire deductible, so in that sense, I had to pay $250 for it, but I would have had to pay the deductible at some point with this pregnancy.
Why Do Doctors Get to Bill Twice?
This isn’t the first time I’ve heard of this. A woman I know had a D&C with hysteroscopy to remove uterine fibroids. Although her doctor only dilated her once, she was billed for it twice – once for the hysteroscopy portion and once for the fibroid removal. When she challenged her doctor, she was told, sorry, that’s just how it’s billed.
Um, NO! That should not be okay. You don’t get to bill twice for only doing one thing. That would be like a deli charging me twice for a sandwich that they only made once.
And that is what is wrong with this country. In order to cover their costs, providers have to create creative ways to bill knowing that the insurers will only pay 50% of that cost, at most. So, if the true cost is $370 for the machine, sonographer, and perinatologist, they find a way to bill twice for it in order to make sure their costs are covered. (And actually, the total after insurance was $259.92, so it was only covered at about 35% of the charge.)
I’m not blaming doctors, I’m blaming the system. There has got to be a better way to come up with realistic costs and realistic payments than to just ask doctors to pad the bill and hope. I can definitely understand why some doctors are opting out of the insurance/medicare system and simply taking cash-only patients at a reasonable price that adequately covers their costs.