ENORMOUS consulting fee from plastic surgeon -- does this sound right?

lorihmatthews · Jul 16th, 2008, 03:43 PM

I tripped and fell at the end of April. I have something stuck in my lip (probably my piece of chipped tooth) that needs to be removed. Since it's my lip we're talking about, I consulted with a plastic surgeon.

When I went for my consultation, I was told it was $100, but when I explained this was reconstructive, not elective, they said they would bill it to my insurance company as an office visit. I paid my $30 copay when I had my visit.

I'm now seeing a charge to my insurance company that hasn't cleared yet of $690. WTF? I called the billing department and I was told that's what the doctor charges for consultations. I said no way, this was reconstructive and was supposed to be billed as an office visit. They said they would wait to hear from my insurance company and "would see about working with me on the fee."

I have a call in to the doctor's office and am waiting to hear back. What does everyone think about this?

Oh, and on the doctor's website, it says his consulting fee is $150.

http://www.drmosser.com/financing.php

guccimamma · Jul 16th, 2008, 04:33 PM

i think they are trying to bill your insurance company for a gigantic amount of money, but if it doesn't go through...they will bill you the $100 or $150.

they will probably say it is a "mistake"

PinkSuadeSoho · Jul 16th, 2008, 05:23 PM

I know it is normal where I live, but some do not charge a consult fee at all.

PinkSuadeSoho · Jul 16th, 2008, 05:28 PM

Also I forgot to add, sometimes they will apply it to whatever it is that the patient is having done.

skigirl73 · Jul 17th, 2008, 12:09 AM

Quote:

Originally Posted by guccimamma

i think they are trying to bill your insurance company for a gigantic amount of money, but if it doesn't go through...they will bill you the $100 or $150.

they will probably say it is a "mistake"

ITA. I had foot surgery about a year and a half ago and the surgery was an hour and 20 minutes long. I got a bill for like $1500 from the anesthesiologist and almost freaked out. But I had gotten the bill before the insurance paid them, so I wound up owing them like $150. Then I saw how much the hospital billed the insurance and almost fell over. They billed almost $10,000 for a surgery that was less than 2 hours and was out patient. After it was all finalized there was some huge discount that got applied to the hospital charges, so it was more like $2000, which was covered by the insurance. It was so bizarre because it was the insurance company that applied the huge credit to the amount the hospital tried to bill. I don't understand why they don't just bill the amount instead of playing all of these games with numbers! Anyway, it sounds like the Dr. is just trying to get more $$ out of your insurance!

puddinhd58 · Jul 17th, 2008, 08:11 AM

Lori,
Almost all physician and hospitals have one charge for patients paying cash and another for billing Medicare and Insurance. The reason is, all insurance co. and Medicare has negoitiated rates. They could bill $1000.00 but the insurance company may have a negoitiated rate of paying $150.00 and that is what they will be paid. They must write off anything over the rate.
Wait for your insurance EOB (explaination of benefits) and see what it says... if you have any questions after that, feel free to PM me if you want...

gillianna · Jul 17th, 2008, 10:41 PM

Some doctors do try to scam insurance companies. I would call your insurance company and see what they have to say.
I had a doctor bill my insurance for a skin biopsy for my daughter which was NEVER done. She went to the dermatologist for a office visit and they put office visit and then also billed for a biopsy. Their office was beyond rude when I called and questioned the charge and said the doctor never did a biopsy and why were they charging my insurance.
My insurance company did not care about the charge and paid the bill and they told me it was not their problem so I guess the insurance rep did not care if the company was ripped off. I did write a nasty email to the doctors office saying they were doing insurance fraud by saying a biopsy was done when it wasn't and a few weeks later I got a corrected bill to the insurance that took away the charges. I wonder if they did that to 10 people a day how much money they could make???? I also wonder how many people really check their insurance letters from their health insurance carrier for every office visit?

lorihmatthews · Jul 20th, 2008, 04:14 PM

Well ... all is turning out OK. I checked my statement online and since my doctor is within the network, a lot was written off. All I'm responsible for is my $30 copay which I already paid. Yea!

Jul 16th, 2008, 03:43 PM	#1
lorihmatthews Luv my Persian Joined: Oct 2006 Location: San Francisco Posts: 6,447	ENORMOUS consulting fee from plastic surgeon -- does this sound right? I tripped and fell at the end of April. I have something stuck in my lip (probably my piece of chipped tooth) that needs to be removed. Since it's my lip we're talking about, I consulted with a plastic surgeon. When I went for my consultation, I was told it was $100, but when I explained this was reconstructive, not elective, they said they would bill it to my insurance company as an office visit. I paid my $30 copay when I had my visit. I'm now seeing a charge to my insurance company that hasn't cleared yet of $690. WTF? I called the billing department and I was told that's what the doctor charges for consultations. I said no way, this was reconstructive and was supposed to be billed as an office visit. They said they would wait to hear from my insurance company and "would see about working with me on the fee." I have a call in to the doctor's office and am waiting to hear back. What does everyone think about this? Oh, and on the doctor's website, it says his consulting fee is $150. http://www.drmosser.com/financing.php

Jul 16th, 2008, 05:23 PM	#3
PinkSuadeSoho Live the Life U Love Joined: Jul 2006 Location: British Properties,Beautiful By Nature! Spectacular by SIGHT! :) Posts: 3,735	I know it is normal where I live, but some do not charge a consult fee at all. __________________ Money can't buy me love- BUT........it can buy me PURSES! My must have WISH LIST! Thomas Wylde Leather Skull Hobo Thomas Wylde Leather Misson Cross Handbag Thomas Wylde HandBag just started the search Bottega Veneta HandBag just started the search Only then will I call it a BAN

Jul 16th, 2008, 05:28 PM	#4
PinkSuadeSoho Live the Life U Love Joined: Jul 2006 Location: British Properties,Beautiful By Nature! Spectacular by SIGHT! :) Posts: 3,735	Also I forgot to add, sometimes they will apply it to whatever it is that the patient is having done. __________________ Money can't buy me love- BUT........it can buy me PURSES! My must have WISH LIST! Thomas Wylde Leather Skull Hobo Thomas Wylde Leather Misson Cross Handbag Thomas Wylde HandBag just started the search Bottega Veneta HandBag just started the search Only then will I call it a BAN

Jul 17th, 2008, 08:11 AM	#6
puddinhd58 Heart of a Golden Joined: Dec 2005 Location: Chicago Posts: 572	Lori, Almost all physician and hospitals have one charge for patients paying cash and another for billing Medicare and Insurance. The reason is, all insurance co. and Medicare has negoitiated rates. They could bill $1000.00 but the insurance company may have a negoitiated rate of paying $150.00 and that is what they will be paid. They must write off anything over the rate. Wait for your insurance EOB (explaination of benefits) and see what it says... if you have any questions after that, feel free to PM me if you want... __________________ ~Kathy~ What is man without the beasts? If all the beasts were gone, man would die from great loneliness of spirit, for whatever happens to the beast also happens to the man. All things are connected. Whatever befalls the earth befalls the sons of the earth. (Chief Seathl, Duwamish Tribe)

Jul 16th, 2008, 04:33 PM	#2
guccimamma guccimamma Joined: Aug 2006 Posts: 2,672	i think they are trying to bill your insurance company for a gigantic amount of money, but if it doesn't go through...they will bill you the $100 or $150. they will probably say it is a "mistake"

Jul 17th, 2008, 10:41 PM	#7
gillianna Member Joined: Dec 2005 Posts: 3,499	Some doctors do try to scam insurance companies. I would call your insurance company and see what they have to say. I had a doctor bill my insurance for a skin biopsy for my daughter which was NEVER done. She went to the dermatologist for a office visit and they put office visit and then also billed for a biopsy. Their office was beyond rude when I called and questioned the charge and said the doctor never did a biopsy and why were they charging my insurance. My insurance company did not care about the charge and paid the bill and they told me it was not their problem so I guess the insurance rep did not care if the company was ripped off. I did write a nasty email to the doctors office saying they were doing insurance fraud by saying a biopsy was done when it wasn't and a few weeks later I got a corrected bill to the insurance that took away the charges. I wonder if they did that to 10 people a day how much money they could make???? I also wonder how many people really check their insurance letters from their health insurance carrier for every office visit?

Jul 20th, 2008, 04:14 PM	#8
lorihmatthews Luv my Persian Joined: Oct 2006 Location: San Francisco Posts: 6,447	Well ... all is turning out OK. I checked my statement online and since my doctor is within the network, a lot was written off. All I'm responsible for is my $30 copay which I already paid. Yea!