The certain codes = certain dollar amount is what they told me when my dentist removed a salivary stone from inside my cheek a few months ago. It took less than 5 minutes and that included a small amt of novacaine numbing it. Charge was $415.00. When I called to tell them I thought that was excessive, they gave me that reason. I was shocked when my health insurance paid it.

Shirley

It's free in Alberta......

Make sure they double-check the code - they may have coded the injection incorrectly - the coding dept. is notorious for making errors.

I just received the statement from my insurance for seeing my ENT doctor - except that I only saw his Nurse Practioner and the only thing she did was look inside my ears. I was told I "had" to see a doctor after having my hearing tested. Now, that exam I would expect to receive a large bill for but not for the followup and especially when the doctor was not even there. And to top it off I had to stay with this particular ENT since I have seen him before and am considered his patient. If I had wanted to see someone else, he has to "approve" or agree to dismiss me from his care. Of course, all I had to pay out of pocket was my $35 but what it means is that my insurance costs will probably go up for specialist again next year.

BTW, I had an appointment with my Internal Med doctor a couple weeks before and her complete exam with her which took about 20 minutes was a charge of $112.00!

I would absolutely think you should follow up on this, with whoever you feel you should.

BUT

I would NEVER assume that a nurse would necessarily know the exact price of a particular procedure/shot, etc. That's not really their job. I would take that kind of info from a nurse as being what it obviously was in your case--just a guess as to how much you'd end up paying, and I wouldn't be surprised at all, if the bill was different. And there is the possibility that she was roughly correct ($35 isn't much off from $40)--for the procedure, but didn't know how much the medication was going to add to that?

I'd strongly recommend, if you want to get the exact price next time, ask someone in the office who actually works with the billing.

Linda, before paying the $65 & $40 bills, I would tell them you want the "discounted rate". There is probably no insurance company, nor Medicare that pays "full price". You may not get the full discount, but you should get some.

And imo, a nurse who doesn't know *exactly* what the charges are, should NEVER be price quoting. S/he should be referring you to the person who does know, or find out herself. And further s/he can't rely on what it was last week or even yesterday, because it isn't her responsibility to keep up with changes in charges.

Immunizations ARE pricey. You might want to check with the health dept, etc to see what the going rate is for comparative purposes.

that's great debby ab -helpful and sympathetic.

I wonder if it would have been covered if you'd have just gotten a tetnus booster? The Tdap booster now has the whooping cough vaccine in it...two in one, and they recommend Tetnus boosters every so often anyway.

Vickey-MN

I called yesterday and didn't get far with the billing person so I asked to speak to her supervisor. The supervisor phoned his morning and I asked for the discounted rate. She said that was not possible since Medicare doesn't cover the shot. She did offer to set up a payment plan for me and I accepted that. I then called my doctor's nurse and told her about the cost and asked her to pass the info on to my doc.
I did give the billing supervisor a piece of my mind about the monopoly they have here. All but a handful of doctors in town belong to this clinic and they don't have competition.

I think most people have no idea of the onerous, time consuming, expensive administrative tasks healthcare providers and facilities have to complete to comply with government mandates including Medicare billing requirements (which change every quarter), HIPAA requirements (which continue to change and become more onerous) and new ARRA stimulus requirements related to meaningful use of electronic medical records.

Most patients/consumers don't find value in the govt carrot/stick approach to Medicare reimbursement. Not sure how much people care about all the work that goes into protecting patient privacy especially as it relates to electronic data. I personally like the use of EMRs but not sure how much people in general value that.

Whether you like and/or value any of this or not you do pay for all of it when you make a visit to your friendly, local primary care provider. Not to mention malpractice insurance, workers compensation, etc.

Greetings, folks,

While the claim was that it's "free" in Alberta, that's not quite correct, for there are costs, there, as well.

In Ontario ... it used to be free, but before a recent election the Premier had promised "no tax increases".

After they were elected, it appeared that there were more homes for their dollars than there were dollars coming in ...

... so they instituted what they called a "Healthcare Levy" ...

... that's not a tax, you understand.

We calculate the level of our responsibility, i.e. annual fee, on our income tax return (federal and, for most of us, provincial) ... and it appears down near the end of our provincial calculation, so is somewhat ineligible for certain credits that we may have accumulated.

So - while I may not pay directly for my medical services, they are somewhat costly, one way or another.

Which I suspect that we old farts appreciate more than most of the younger ones may.

ole joyful

OJ, of course our tax $$ pay for our healthcare. But considering what our tax $$ cover in our healthcare, I'm all for it. I know if I have a heart attack, or cancer, whatever, my tax dollars that I've paid for the last 35 years since I left home and joined the work force, will pay for all the costs it will take to keep me alive. In the long run, I've saved money. Heck, having had 2 very premature children, one of which spent the better part of his first 3 years in the hospital, would have meant I couldn't afford more kids if I didn't have the healthcare we have. I'm ahead of the ball game. And considering what a lot of Americans pay for health care insurance and what little it covers, we're still very lucky up here.