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Question about Endos and their fees

Discussion in 'Parents of Children with Type 1' started by azdrews, Sep 24, 2014.

  1. azdrews

    azdrews Approved members

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    Hi!

    I have a question and figured this was the best place to get a broad range of answers. I have been feeling very nickel and dimed by our endo and I'm wondering what the "norm" is across the country. We see a Pediatric Endocrinologist in a fairly big city in a private practice. There aren't a ton of options, but we do love our endo.

    We pay a $50 copay for the visit (which is determined by our insurance) and a $30 fee for an in-office finger prick A1c test every 3 months. They tell us that insurance won't pay for finger prick A1c's, so if we want to spare our kids the pain of a blood draw every 3 months, this is our option - to pay the fee. Then, they have a "paperwork" fee of $20 if you need stuff filled out. And the cherry on the top is a $100 yearly "Administrative fee" - which on their paper handout basically says that it is for the "extra work that endocrinologists need to do with diabetes patients" - ie:, extra phone calls, emails, prescription refills, etc.

    Yesterday I was slapped with a $50 "no show fee" (I screwed up, missed the time) and it hit me how many fees we are paying this place, in addition to the regular costs of diabetes.

    What are your endo's policies?
     
  2. Nancy in VA

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    That sounds pretty consistent with ours, although I think our insurance covers the finger stick A1C. We get lab fees and have a hard time interpreting them to know what they are covering or not. I'm not sure we have the $100 overall admin fee. But, our practice has a good number of indigent patients (city children's non-profit hospital) so I imagine if they tried to charge that, the patients wouldn't show up, and I think they would rather they get treatment than not get treatment and have issues because they couldn't afford the "fees"
     
  3. BarbDwyer

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    Wow - that is a lot. I think it is a rip off personally.

    I pay a $25 co-pay (insurance decides) and that is it. He did a finger prick at our last check up and either my insurance covers it, or the cost is built in to the office visit because I did not see an extra fee.

    My son's gp tried to charge me twice for one visit because I had two athletic forms (one for school and one for scouts). I made a minor scene and honestly can't remember if I ended up paying or if they wrote it off. I was not concerned about losing him though like I might be a good endo.

    Also - if they charge a $20 paperwork fee as well as a $100 yearly admin fee - that is double charging. Grr.
     
  4. virgo39

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    We pay out of pocket until our deductible is reached. Our endo charges for the visit and fingerstick A1Cs--I don't know the exact cost--but $30 seems reasonable to me. The office charges a "paperwork" fee only if forms are submitted other than at an appointment. Our quarterly appointments, by chance, work out well, we do ADA camp forms at the February appointment and school forms at the August appointment.

    We are not charged an administrative fee or a fee for calls the 24x7 emergency number; I assume that those costs are factored into the office fee schedule.

    We've never missed an appointment, but the policy is that there is a no-show charge. Not sure how it is imposed or the amount.

    I can appreciate your feeling the way you do. At the same time, I am very happy with our practice and think that if they started imposing an administrative fee, I'd probably gladly pay it.
     
  5. Sarah Maddie's Mom

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    The admin fee and the A1c fee sound unusual to me. Have you called your insurance company regarding those two?
     
  6. mamattorney

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    That sounds like a doctor who signs contracts to be part of insurance groups but is dissatisfied with the contracted reimbursement price, so they charge the patients "fees" that they get paid 100 cents on the dollar to make up for their perceived loss. I wouldn't like it.

    Our insurance does cover fingerstick a1c's, and while I'm not pretending to be an expert on insurance coverage, my guess is that yours does as well. I checked the reimbursement rate and although the doctor charges $71 for the rest, they only receive $15.76 from the insurance company. To me, it looks like your endo is unhappy with the low reimbursement, so they don't run it through insurance, they just charge a "fee" and collect twice as much as insurance would pay. To me, that seems dishonest. I'd want to see (even if it mean paying that $71 towards my deductible once) them bill my insurance company for the fingerstick a1c and see what happened.

    The other fees I wouldn't be happy with either, but they don't seem dishonest. Honestly, I'd have to weigh how much I liked the practice vs. paying those fees.
     
  7. Lori_Gaines

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    We only pay a $15 copay. Her finger poke a1c test is covered in that. If there is extra blood draw/lab work that is needed, we pay 20%, but that has never amounted to much. You sure are paying a lot. :(
     
  8. dpr

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    We only have our co pay and a $30 A1C. All your other fees sound like greedy BS to me. I would complain even if it doesn't help, just to voice my opinion. They may not like their reimbursement but they also have a constantly returning captive audience.
     
  9. Charliesmom

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    We have a $30 copay. Insurance covers the fingerstick A1C. There are signs that say if blood work orders or prescriptions have to be filled out between appointments there may be a fee. We also have to sign a paper that says there may be a no-show fee. ($50 for new patients, $35 for established) We missed an appointment in the spring because he was sick and weren't charged. That was the first missed appointment in 7 years, though. =)

    I would not be happy with the administrative fee or the paperwork fee during an appointment.
     
  10. LoveMyHounds

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    That's weird.... Isn't a finger prick cheaper than a blood draw?
    BTW, my DD would rather have a blood draw, if she could keep that $30 :p
     
  11. susanlindstrom16

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    We have a $20 copay, which I assume includes the A1C since we've never been charged extra for that. I don't know about the fee for missing appointments is but I'm about to find out since I foolishly made a CDE appointment for the second day of school and then forgot to call and cancel before it was too late.

    I'd be aggravated by the paperwork and administrative fees too. In my opinion, those costs should be included as part of the visit.
     
  12. 3kidlets

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    We use a large children's hospital. We have to pay for the a1c draw in the office because insurance only pays if we do it thru the lab. I think it's $25 fee to do in office. Other than that, we just have our copay $25).
     
  13. Mish

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    we're at a large hospital, and we get two separate bills. One for the doctor's services and one for the hospital services. So that's two cost share amounts after we meet the deductible. Finger stick a1c is covered by insurance though, and is part of the bill. And extra labs are billed separately, so that's another cost. But, all in all, I think OOP (after deductible) each visit only costs us about $40 or so. We've never been charged a separate admin fee, or paperwork fee. I think that's part of the downside to using a private practice like that. They CAN charge you those thing, and justify them.

    As for the no-show fee...I work in a medical office. I wish my doctor changed a fee for no shows. Yes, I understand that mistakes happen, and individually it doesn't seem like it's a big deal, but we have about 2 or 3 no shows every day. EVERY day. Pediatric days are worse. About 5 no shows on those days. That's a lot of time and money wasted for the office (Routine exam is $195 for our doctor - a specialist). So I'm all for that charge. Sorry.
     
  14. RomeoEcho

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    Since your costs are determined mostly by your insurance, it would probably be more useful to compare your own options then compare to what people on other insurances in other locations pay. Try calling another practice that you would consider using and ask what these services would cost using your insurance. You are a consumer and have the right to shop around. Also remember that you are paying for a provided service though, and know what you are willing to pay in exchange for quality and convenience.
     
  15. mamattorney

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    For those of you who pay extra for the fingerstick a1c, does your endo still run it through insurance? If not I have a huge problem with that.

    The way I see it, if they are going to charge $30 saying insurance won't cover it, then they should charge $30 and bill your insurance. If your insurance truly won't pay for a fingerstick a1c, then they will reject it and say you have to pay 100% of that $30 fee. But - that $30 will go towards your deductible for the year. If they don't run it through insurance, you are paying $120 extra on your deductible every year.
     
  16. azdrews

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    Thanks for all of the replies! Sounds like most things are pretty standard (except for the admin fee) and at our next appt. I am going to request that they run the fingerstick through insurance first, before I pay the fee. Our insurance covers most everything, so I have a feeling I have at least been overpaying for that.
     
  17. Lakeman

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    Our insurance picks up everything except for the $50 copay. But who knows how our insurance premiums compare. If I had to pay all those fees but saved a larger amount on premiums it might be worth it. Of course the real question is how much of the real big expenses get paid.
     
  18. Megnyc

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    I have a $30 copay and that is it. But my endo doesn't do the fingerstick A1C.

    I guess I can understand the fees in a way--- they do have to pay the bills but it seems a bit excessive in your case. As a side note, I considered switching to a different endo practice and their policy was if you called with an emergency and the NP wasn't able to help and they had to page a physician there was a $40 fee (this is even during the day). Maybe their NPs are awesome and can deal with anything but that seemed like a ridiculous policy to me. Lol my endo is really into texting and at every appointment encourages me to text him any time ---I'm assuming he doesn't charge for that!
     

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