The Surprise Cost of a Visit to the Doctor

visit to the doctor

Luna and Midnight

As many of you know I have two awesome cats, Luna and Midnight.  They are very friendly and just love everybody.  They are sister cats and have been with me for eight years.  Kate, unfortunately, is allergic to them.

When Kate and I started dating, she was very allergic to the kitties.  Every time she came over to visit me, she would sneeze constantly, her eyes would get red, and her nose wouldn’t stop running.  She then started taking antihistamines and that seemed to help out a lot.

When we decided to move in together, she knew that she had to take an antihistamine every day and hope that she would get use to the cats slowly.

It seemed like Kate was getting used to the cats because there were days that she didn’t sneeze at all.  She was able to pick up the cats and rub them all over her face without any allergic reactions – yes, that happened.

We did, however, started noticing that her days were pretty much allergy-free, but at night she would start to sneeze.  It would make sense since we’re at work all day, but this was happening on the weekends as well.

Kate was getting really tired of sneezing and having to take allergy medication almost every night so we decided to look into an allergy doctor and perhaps get allergy shots.

The Visit to the Doctor

Kate found an allergy doctor close to our house and decided to make an appointment.  When she went to her appointment, the doctor told her she needed to get a “skin scratch test” to help determine what she was allergic to.

Well, the scratch test was inconclusive because they didn’t tell her she wasn’t supposed to take an antihistamine the night before.  When you take a blood test, they make sure to tell you to fast the night before, but oh well.  She had to go back another day for a second scratch test.

The second scratch test told her what she already knew; she was allergic to cats and highly allergic to dust and dust mites – that explains why her allergies are worse at night when we are in bed.

The doctor told her to come back in a week to get her shots because they needed time to make the allergy medication, but before she left she wanted to know how much the treatment would cost.

We have health insurance through work, but our deductible is $500 and then the insurance covers 80% of any cost over $500.  Since this was the first time Kate went to the doctor this year, she knew she would have to cough up the $500 if the treatment was more than that so she wanted to know what the total cost would be.

The lady at the front desk told Kate that the office charges $45 per shot, Kate’s insurance allows the doctor to only charge $15 per shot.  So Kate knew she would be paying 20% of $15, or $3 per shot.  Weird that what they charge and what the insurance allows are so different, but oh well, $3 is a good deal… or so she thought.

And then The Bill Came

What the doctor’s office conveniently forgot to mention was that this visit to the doctor was $250 and the skin scratch test was $600!

We realize that there is a cost associated with the visit to the doctor and with the scratch test, but the office didn’t mention this cost at all.  Even when Kate asked, “How much is this treatment going to cost?”

That was pretty crappy, but since she only had to pay the $500 deductible plus $9.92, or her 20% portion, she was okay with it… upset, but okay with it.

And then The Second Bill Came

When the second bill arrived in our mail, Kate noticed two charges – a charge for the first shot ($3) and a charge of $1,000 for something she did not know. Luckily the insurance only allowed to charge $650 so she would only have to pay 20% of $650, but she still wanted to know what that charge was for.

Kate went and asked the “lovely lady” at the front desk what the $1,000 was for and she said it was for the serum.  When Kate asked her how come she didn’t say anything about the serum when Kate asked how much the treatment would cost, the lady responded, “Well, don’t you know you need a serum?”  To which Kate responded, “No, this is my first time doing this.  I don’t know what I need or don’t need.  I wish you would have told me that this was also going to be part of the cost when I asked.”  The lovely lady went on to say, “We don’t have time to go over this with every patient.”  Are you freaking kidding me?

Cost Upfront

We don’t go to the doctor often so I don’t know if this is normal practice, but shouldn’t doctors tell you upfront what things are going to cost?

When I go to the mechanic, he tells me right away how much he’s going to charge me to fix my car.  If he finds something else while he’s fixing the car, he calls me and lets me know and asks whether I want it done or not.  Why can’t doctors do this?

If we would have known the cost upfront, we would have thought longer about whether we want to start this completely optional treatment, which is not guaranteed to work.  We’re lucky that an extra $600 is not going to make or break our emergency fund.  But what if your treatment is not optional?  What if you don’t have time to consider whether you want specific tests/treatments done?  What if $600 means that you’re not eating this month?

And why are they charging people without insurance a different price than what they charge insurance companies?

I know there’s a big debate about health insurance in this country and that’s a discussion for another time, but there’s not doubt that insurance companies and doctors are playing a weird game here.  I don’t know what it takes to fix this problem, but I know something has to change.  On a related note, check out this article about a surprise $117,000 medical bill.

Anyways, this little rant is not really about policies, but about our specific allergy doctor.  This has been, by far, the worst experience we’ve had at a doctor’s office.  Maybe it is just the group of people that work there or maybe it is a problem everywhere.  Either way, I don’t like it.

Have you had a bad experience at the doctor’s office?  Should we expect doctors to tell us how much the treatment is going to cost or is that too much to ask?

20 comments

  1. Yes, this is extremely common. I always ask for a detail breakdown of my expected costs before an elective procedure… and it’s almost always wrong/incomplete. I’ve also refused to pay for things I didn’t explicitly authorize.

    Usually the doctors, nurses, and admins are really apologetic about it though. In my experience they hate the insurance game just as much as I do. Sounds like you have a crappy doctor’s office. I wouldn’t patronize a place that wasn’t interested in being polite and helpful. If you decide to go somewhere else, be sure to nuke your original doctor’s office’s yelp page. Hurt ’em where it counts!

    There are a couple major problems with healthcare and consumer choice. One is information asymmetry, because there is very little chance you will ever know more than your doctor about whether a test/procedure is necessary or not. At the end of the day, we have to trust our healthcare providers.

    The other main problem is urgency blindness. While your experience wasn’t an emergency, it’s easy to imagine how much worse the unknown/unexplained costs could be in an emergency situation. You probably wouldn’t have the proper state of mind to research the cost of suturing a finger back on if you were sitting in an emergency room bleeding. Nor would you be in any state to argue with a doctor’s potentially costly recommendation.

    Which is why healthcare is not (nor will it ever be) a free market, and we should have universal single payer healthcare. 🙂
    Mr. Frugalwoods recently posted…Travel Cheap: Went to Paris, Skipped The LouvreMy Profile

  2. Kalen says:

    My wife and I used to go back and forth with hospitals and clinics, because we didn’t have insurance. We would go in for something and tell them to let us know before they charged us for anything. Without fail, we would end up with a bill for something we didn’t authorize.

    Every. Single. Time. Seriously! It was ridiculous.

    They are used to dealing with patients who have insurance, which makes it even worse, because they tend to be more liberal with the charges when you have insurance. It’s a messed up system.
    Kalen recently posted…Why You Should Always Read Your Insurance Policies CarefullyMy Profile

  3. Will says:

    My experience has been the same with doctors. It’s as if they say, “Welp, you need this stuff so who cares the cost.” Even though most of the time you do have options such as which doctor to go to and which course of treatment to pursue. They seem so out of touch.
    Will recently posted…My Experience Flying on a Private JetMy Profile

  4. I have a severe allergy to cats, which I didn’t know I had until I started dating my partner. He didn’t have a cat personally, but a few of his relatives do, and I found myself with uncontrollable sneezing, itchy eyes and a runny nose. I had done some research online and one site mentioned that female kittens that are lighter in colour tend to have less of the protein that causes the allergy. Siberian cats are also one breed of cat that are considered hypoallergenic.

    I can’t say I’ve ever experienced that with my family doctor or any specialist. They’re pretty upfront with costs. They have signs posted by reception and will also mention it to me verbally.
    MakintheBacon recently posted…Investing in my Education by Learning about InvestingMy Profile

    • Aldo says:

      Yes, I know about those other cats. Unfortunately I had my kitties before I met Kate and those hypoallergenic cats are costly. I got my two lovely cats for free.

      Isn’t it nice to find a decent family doctor? I like people who are just honest and tell it to you straight. I’m not against them charging for the treatment, I just want to know how much so I can decide whether or not to take it.
      Aldo recently posted…Too Smart To Fall for Scams? Think AgainMy Profile

  5. That is just awful. I agree with Mrs. FW, definitely leave bad reviews where you can. They should have taken the time to explain things. Not having the time to go over it with patients is a horrible excuse. I also don’t really like dealing with any medical procedure for this reason. It does seem like there’s always something unexpected tacked on to the bill.
    Erin @ Journey to Saving recently posted…How to Split Your Household Bills After Moving In TogetherMy Profile

  6. That sucks! Now that I have crappy insurance I ask about every single cost every time they say they are going to do something, and I ask if it’s absolutely necessary. I hate to do it and I wish I had all the money in the world to be taken care of but I don’t. They will ding you for every thing imaginable. I also, by the way, throw in that any medical conditions might be due to stress from job loss or lack of income (whether I’m doing well or not) because they seem to be more upfront with costs when you say that.

  7. At $1000 I’d say they most definitely DO have time to go through this with every patient. The cheek!
    Tania at Pinching Pennies recently posted…5 Hard and Fast Rules to Make Money Blogging (Or Not)My Profile

  8. I can definitely feel your frustration! I mean, how come she expects everyone to know that the serum would cost that much?! I also hardly ever go to a doctor, and it’s definitely her job to give a brekdown of how much things are going to cost. Agree with other commenters. Leave bad reviews if you can, so that they realize they have crappy customer service.
    Suburban Finance recently posted…3 Way to Psych Yourself Into Being More FrugalMy Profile

  9. That receptionist or Nurse Cratchet needs some training in customer service / client care.
    debs @ debt debs recently posted…Travel Cheap: Went to Paris, Skipped The LouvreMy Profile

  10. Tennille says:

    I agree that is absolutly rediculous. I deffinently agree that the office you went to seems to be very unprofessional. When asked the price of the shot she should have told you it with the cost of the serum included. I have never been to a doctors separate those costs when asked how much a shot was.

    I have never had that bad of an experience with a doctors office, but I have with a dentists office. I went in to get a tooth filled and he was running behind. He started the procedure and then left in the middle of it, because it was time for his vacation. He didn’t fill the tooth and I sound up loosing in in the end.
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  11. Good point. The healthcare system is such a clusterf*ck. They really should be transparent about everything ahead of time.
    Stefanie @ The Broke and Beautiful Life recently posted…New York City Is As Expensive As You Want It To BeMy Profile

  12. Unfortunately this is really common and we now not only have to become self-advocates for our medical treatment, but we have to be self-advocates for the costs of our medical treatment. It is crazy how doctors don’t even know what is covered or not anymore. I usually call my insurance company myself before I let them do anything to me. You just can’t trust the system.
    Shannon @ Financially Blonde recently posted…Why Working Moms RockMy Profile

  13. They don’t have time to go over the costs with their CUSTOMERS?!?! That is insane! I have noticed that in this country, medical providers have the mindset that they are doing you a favor, rather than providing a service that you are buying and can shop around for.

    Doctors should be willing to tell us about every penny associated with their service, in the same way that a restaurant better tell me if something I order costs extra!

    I won’t go on a rant about healthcare in this country (maybe I’ll blog about it lol), but something has to change fundamentally.

    I do know that they charge a different price for insured people because the insurance companies put a cap on what they will pay for each procedure/visit. Non-insured people don’t have a group who does this on their behalf. The best analogy would be an employee union.

    I’m glad you had a large enough emergency fund to cover this without disrupting your life.

  14. Wow, I’m so happy to be in Canada! Ya, I had to wait for my testing, but I knew the cost upfront: $0!

    I can’t believe you weren’t given a full quote at your first appointment. How are you supposed to make a smart decision about whether to go ahead with the procedure?
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