The U.S. medical system is skewed toward profit. I should know that by now. And yet, I was still surprised when I got an invoice for $299.96 for a twenty minute appointment for steroid injections in my head. (For more on that fun, go here.) The recent bill was made all the more surprising by the fact that the first appointment cost just over $100.
“Ah,” I thought, “I’ve heard about this before. They’ve made a billing error and are charging me for a treatment room, when my appointment took place in a normal examining room. I’ll simply call them and sort it out.”
According to Denita, the customer service representative, “treatment room” is just another expression for “facility charge.”
Because my doctor’s network is at a public hospital, this cost is set by the government.
If you don’t live in the U.S., you’re probably scratching your head, wondering why on earth the American government wants hospitals to charge $391 for me to spend 2o minutes in an examining room. You’re also probably wondering why I just wrote $391, when I previously said I was billed for $266.
After the insurance adjustment, the bill was $266.
This means if you don’t have insurance you’re on the hook for the whole $391.
By now, non-Americans in other industrialized nations are likely feeling a little smug.
Because I’m American. I asked if I could talk to someone to get the fees waived because they were so clearly ridiculous.
Danita offered to put me in a payment plan.
But the issue wasn’t about ability to pay, it was the expectation that I should pay $255 for passing twenty minutes in a bare bones examination room
If you’re wondering, that’s $12.75 a minute, just over $.21 a second, to pay for something that should be considered the cost of doing business.
It’s like going to buy a pair of shoes and being told, “That’s $65.97 for the shoes and $20 to help pay our electric bill.”
To be fair, I should admit, it doesn’t just happen in the medical field. These days — and yes, I do realize I sound like an old-timer using that phrase — when you buy tickets to any event, you go online, jump through a few hoops (or many, as when The Engineer recently purchased tickets to see Jeff Dunham), pay your money, and print the ticket. For this, you are charged a service fee, which seems to get higher every time we go anywhere.
Exactly what service are we getting?
The program that “allows” us the dubious convenience of buying tickets online?
The non-existent customer service if — God forbid! — you make a mistake in the labyrinth of the procedure?
The doubtless minimum-wage-receiving contract workers who take the tickets at the venue?
These are all part of the cost of doing business and should be covered by the exorbitant cost of tickets.
My “facilities fee” is the same. Why am I paying for my medical provider’s building every time I visit? At that rate, I could pay to share an apartment for a few weeks.
Danita did say I could speak to a supervisor, but the supervisor would offer the same choices — a payment plan or 10% off.
So I asked Danita for 10% off. The bill for two visits (including the doctor) went from $597.92 to $538.12.
That means I paid $13.45 a minute for the doctor and the facility, instead of $14.95.
Wow. I feel so much better.
Addendum: It bears saying, though it should be obvious, that the most ludicrous part of this kind of medical bill is the assumptions that everyone can pay them, and that those least able to pay, the uninsured, are expected to pay a higher rate.