interviewing a pediatrician-question

[nanf]

I meet with a Pediatrician a few weeks ago to see if I felt comfortable with him and his office setting.
His office charged my insurance $300 for a consulting fee. I only took up about 10 minute. Is it standard to charge for such discussion these days.
My mother is a retired pediatrician and I grew up in her office and handled general office stuff for her during high school and in summers during college. I know she never would want to charge for someone deciding on a Dr.
I've asked my other friends who did the same thing with interviewing their pediatrian and none of them got charged.
Otherwise, I liked the Dr. and that the office is only 1 1/2 blocks from me.

Should I take this charge as a sign and find another Dr?

[amp]

We did get charged for our interview visit w/ our doc, but it was a much smaller fee ($100 or a bit more? I can't really remember). I don't remember if they just charged an office visit fee or what. Anyway, I don't think it's unusual to get a charge, but yours seems steep, unless office visits are pretty steep there where you live. I might call to inquire and see if they can bill it as an office visit rather than a consult, as consults between professionals probably do cost more. Just a thought. Seeing how they handle it might help you decide what to do about the doc himself too.

[Sillygirl]

I think that's pretty outrageous. I'd call the office and question it.

[ribbit1019]

Our ped's office didn't charge us anything. That is a very high amount in my book. They want to solicite you as a patient, not deter you.
That is handy that they are so close though. It was nice not having to drive DD too far when she was so small. I would call too...ask if it a regular practice, or maybe a mistake?

Christy
DD- Maddy 06/09/04

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[kristine_elen]

We interviewed three peds and to my knowledge none of them billed our insurance (and certainly not us personally). $300 seems very high to me. I'd call your insurance and see if that is the going rate in your area, and depending on what you find out, I might talk to the doc's office. I'd try to get some other ped recommendations and then ask what they charge, or just cold call some out of the phone book.

[lilycat88]

We didn't get charged anything and our ped spend a good 40-45 minutes with us at the beginning of her day. We didn't feel pressured to leave or to hurry or anything. I felt bad that we had taken so much of her time and actually tried to pay something as we left. If we had been charged a fee for 10 minutes, I would have been so furious that I would have probably found someone else. That's just my personality, though.

[MarisaSF]

that sounds very odd to me. It's one thing to charge you for the "consult." It's another whole thing to charge your insurance company. I don't do medical billing, but it reeks of fraud from an outsider's perspective. I once heard that docs can't charge for a visit unless they actually touch/examine the patient. The visit you are describing doesn't seem like a "consult" either; I understand a "consult" to be if you are coming in for a second opinion and/or advice on a medical problem. So, unless you were going to see this doc to see if s/he could better treat your child's illness than another doc, I wouldn't think it would be a consult.
I'd call the billing service at the doc's office and see what they have to say. Perhaps someone in the office completed the bill errroneously. I work in healthcare and we fill out bills wrong occasionally; billers often catch it, but not always.

[kelly ann]

Absolutely ridiculous! We switched peds a couple of months ago and they had a free "get to know session" during the evening.

Did they warn of this fee ahead of time? Did they tell you when getting your insurance info? Either way I would call up the doctor and complain...maybe they can waive the charge. Will your insurance even cover it?

JMO, but I would probably keep interviewing other peds - good luck.

[Rachels]

WHAAAAAAAAT?!! That's crazy. I interviewed four docs, and nobody ever did anything like that. There's no way in hell I'd stay with a practice that started out by bilking its potential patients. Good grief.

-Rachel
Mom to Abigail Rose
5/18/02
New baby coming in October!


"When you know better, you do better."
Maya Angelou
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Nursed for three years!

[nd93]

How did they get your insurance info? They asked for it before a meet-the-ped meeting? That right away would have set off bells in my head.

I've never been charged. This is definitely suspect. And $300 is outrageous.

[tbriese]

i wasn't charged for my interview appointments. i can understand if they want to charge a fee but $300 is quite high in my opinion; i'd call the billing office and question it. if they don't handle it well, i'd consider looking for another ped otherwise you might be spending more time talking to the staff in the billing office than with your ped or his/her nurses.

[deenass]

Okay, I'll be in the minority here. Did you like the doc? Do you think you would be comfortable taking your child to see him? If so, I'd say use him. By interviewing him you did take up his time, therefore he had the right to charge you. And the fact that he charged your insurance company $300 doesn't mean they paid him $300, they likely paid whatever "reasonable and customary" fee they deem appopriate.


There are several practices in my town that won't even do interviews, they are busy enough and they know that word of mouth will bring people in. The ped we chose holds a monthly "new patient orientation" with a different doc each month.

[kensjen]

Find out how much your insurance actually paid. The Dr can bill any amount they like, but there is usually a standard fee for something like that, and your insurance wouldn't usually pay more than that number.

I think it is waaaayyyy too much to bill for only 10 minutes, and not even seeing a patient. I would be very leery of an office like that. Definitely give them a call, and question the bill.

[dr mom]

I don't think it is unreasonable to charge a nominal fee for that type of visit, but $300 seems excessive. It wasn't a typical office visit - he didn't examine your child, or (I assume) take a complete medical/family/social history, and there was no medical decision-making involved on his part. So in essence, he is billing for his time not his medical expertise - and while that is certainly allowed by most insurance companies and he deserves to be reasonably compensated, I don't think 10 minutes of time justifies a $300 charge.

If you liked him otherwise (well, even if you didn't) I would call the office and tell them that you are concerned this was a billing error and ask for clarification. It's entirely possible he just jotted "consult" on the encounter sheet and someone else did the coding and submitted it for reimbursement, so maybe the billing person made a mistake. I can easily see that happening. Medical coding can be complicated, and we doctors are known after all for our incomprehensible handwriting. ;)

If the office is unresponsive or unwilling to explain why they billed so much, I would call the insurance company to report the possible billing error (fraud?), and personally I would have to reconsider taking my child to a practice that doesn't take your concerns seriously - if they won't answer billing questions, are they going to be equally unhelpful when you have questions about a sick child? Hopefully it is all just a misunderstanding and you have found a wonderful new ped near your house!

[nanf]

I did talk to the Ped. office. They are just charging the insurance and see what they get. They told me sometimes they pay $50 sometimes $200, sometimes nothing.
They are not going to bill me anything-just trying to get some money from the insurance which I totally understand.
So I am quite happy to be with a ped that is only 1 1/2 blocks from me.
Thanks for all your input.

[HannaAddict]

I don't think I would feel comfortable using a pediatrician after he billed out $300 for a brief interview. I think it says something about his practice philosophy. If you have a quick question or something the nurse can answer, are they going to bill it out full freight? I do think a some sort of fee is fine, it does take time to meet with prospective parents and some meetings could probably take longer than 10 minutes. But the fee should have been disclosed up front and $300 is way too much, even if the insurance company doesn't really pay the entire amount. If he spent an hour with you maybe, but even then it should be disclosed. We interviewed a few pediatricians, all board certified, all with busy practices and no one charged us or insurance anything. A couple of the practices had specific days designated for just these types of meetings in the late afternoon. We actually asked for CVs of the pediatricians before we interviewed them and found it helpful. The ped we ended up with said no one had ever asked for that before, but he actually thought it was a good idea. (No, we are not total PIA clients!) OT, but I didn't actually go to the interview of our eventual ped. I was stuck in court and husband did the interview alone. Our ped said it was the only time in his 25+ years of practice he met with the dad only. Just thought that was interesting (and I was surprised a little bit).


ETA: Didn't see orignal poster's response. I would still be concerned about a doctor just seeing what they could get from an insurance company. Especially when insurance is so expensive these days and the amount they are trying for bears no relation to what they earned/did.


Kimberly
DS 3/18/04

[kensjen]

Not sure that I would like that answer....they are just trying to see what they can get? I know they want to be paid for their time, but to try to get more than what I would consider acceptable...?? Just a bit sketchy. I would keep a close eye on how they bill things.

But I have worked on the other side of this, so I may see things differently.

[slecompte]

I wouldn't feel comfortable either. I mean they charge an inflated rate to "see what they can get". It is Drs like this that overcharge and cause all of the insurance issues as it is. They should know what their contracted rate normally is for most insurance companies unless they don't deal with yours on a regular basis.

I don't think they should have charged at all, but...I think it is wrong what they are doing to the ins co!

Sheila

[nd93]

"just trying to get some money from the insurance which I totally understand"


I'm sorry but that is insurance fraud! That is partly why rates are going up so much in the last several years! To charge "just to see what they can get" - I am speechless.

[kensjen]

Yeh, exactly what I was thinking! I am just surprised they actually said that...I mean, I think we all assumed that is what they were doing, but I can't believe they actually said it!! Too bad you didn't have that tape recorded!! ;)

[kelly ann]

I don't understand this and I think it is awful that they are trying to milk the insurance company! They probably charge $300 because they have found a couple insurance companies that have paid that much in the past. Just on principle I would not use this ped...even if they were located right next door to me!

[lisams]

I think that's crazy, you weren't given medical advice, you were interviewing him, KWIM! Sure you used up 10 minutes of his precious time, but he was using that time to try and earn a new patient. I'm guessing they have a standard code for appointments and "interview" wasn't on there, so they just marked "consultation" which would be when you go for medical advice.

I guess I would find it odd if they even asked for my insurance info when I wasn't even a patient yet.

I would see this as a negative in choosing a pediatrician, and would for sure call them and ask about it. Maybe even contact your insurance company too. No wonder insurance is so high, drs. like this are totally taking advantage of the system.

Good luck!
Lisa

[DebbieJ]

Sounds pretty outrageous to me.

Our consult was no charge.

~ deb
DS 12/03
And a niece or nephew arriving in early August!

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[nanf]

I thought it was pretty high-thats why I asked on the board.
Like I said my mother is a retired ped and I know she never did that.
But he did come highly recommended and the office is only 1 1/2 blocks from my house. Plus from past experience from my parents, I know how difficult it is with insurance and being a DR. There are Drs. out there that practice to help people not for the money.
I can always switch Peds if I need to. Anyway the pediatrician seemed very responsive to my needs.
I know when my parents were practicing, they didn't oversee the insurance claims-they only got involved when necessary.
I did end up calling another ped office in my area and they said they would bill the insurance too-same thing-to just see if the insurance would pay. Maybe its just standard practice in my area.

[kristine_elen]

"They are just charging the insurance and see what they get. They told me sometimes they pay $50 sometimes $200, sometimes nothing."

Yeah, this kind of bugs me. No wonder health-care costs are skyrocketing if docs are "seeing what they can get" for a 10-minute confab. Jeez. If you call him b/c your child has a fever and he says "Tylenol." is he going to charge you a $15 copay and bill the insurance company for $300? I don't think it's outrageous of him to want some money (though I'd feel better if he didn't) I think it sounds like they're crossing a line.