I just got billed $100 for each of the 2 laryngoscopies I had related to my acid reflux disease (GERD) over the past 2 months. Simply put, the doctor got his fiber optic video out and stuck it in my throat for 5 seconds to see how my GERD is progressing and that cost me $100, on top of my $40 in-network co-pay.
I was pretty upset. I went in thinking all I had was $40 co-pay and now I’m being charged $140 for 5 minutes of this guy’s time. I called the doctor’s office first, who advised me that the insurance company is deeming this procedure as a “surgery.”
I had gone in thinking I’ll just have to pay $40 for a co-pay and now I’m essentially getting charged $140 for 5 minutes of this guy’s time when all he did was examine me while I sat on a chair. I asked the guy on the other line if this seems right to him, and what he would have done if he were me. He said, “I would have reviewed my insurance policy before I went in and figured out what my potential charges would be before I see a doctor, especially this one being a specialist.”
No you wouldn’t have. 5 minutes before I got the bill, I didn’t even know what laryngoscopy meant. And there’s no way in hell you’re going to review every single item in your insurance policy before you go in for a simple examination. But I didn’t tell him that, because he said the professionally correct answer. Personally he may have emphasized with me at one point or another, but he wouldn’t dare say that while we were being recorded.
I then called the insurance company, who after fumbling around different operators finally got to a person who simply read out loud my policy word for word. Basically, she said, anything like stitches, colonoscopies, and laryngoscopies are deemed “surgery,” so they go towards my $500 deductible. I always have the option to appeal it, though.
“Yeah and I’m sure I’ll be charged for it anyway because you can always claim that it’s part of my policy. Well it doesn’t seem right to me, and I am disappointed to hear that you don’t agree with me.”
No doctor or doctor’s office or insurance company, no matter how great, can tell you exactly what you’d be charged before or even during a visit, for various reasons. Absolutely nobody knows what the doctor will deem to be a necessary procedure before you go in. And there’s no way in hell that the doctor will be able to tell you before doing any procedure, “by the way, you’ll be charged $100 for the next 2 seconds of my time while you sit on your chair, do you still want to proceed?” There are literally thousands of insurance policies out there, and who the hell knows?
If the doctor’s office personnel are savvy enough, they will know the right codes that are similar enough in procedure that will still get them paid by the insurance policy upon claim resubmission and you won’t get charged for it. Unfortunately, asking that didn’t work for me this time. I might have to divvy up $200.
Ironically, my only chance now at overturning that is going back for an appointment and asking the doctor if there’s anyway he can take that off list of procedures I’m to be billed for. Unfortunately, if he says no, I’ll be stuck with $200 + another $100 for 2 more seconds of his time.