Annually I make sure I make an appointment to see my gynecologist for an examination and testing for cervical cancer. If this does not apply to you, it is still important and I encourage you to pass this story on to other women.
About 2 years ago there were changes in my insurance coverage so the annual visit became free. Previously there was a co-pay as any other visit to the doctor's, which in my case the doctors in our health insurance plan expect me to pay at the time of the appointment.
My annual falls in December which I did in December, 2010. I recently received a bill from my doctor and it did not list the reason why so I called their business office. It turns out I was receiving a bill from the December visit. But I explained I had come to the office for my annual visit. Yes, they agreed. But since I had discussed other things with the doctor during the visit, it could be coded as more than just my annual visit and the business office was doing just that. Thus I owed the doctor a co-pay since they were putting the paper work through the insurance for reimbursement for the visit.
Do you see what just happened? If I had only said "hi" to the doctor, the doctor performed the pap smear, and I left, the appointment would have been free. But since I had a conversation with the doctor about other things, rightfully so the doctor's office put through paperwork to the insurance with a different medical code. When I called in to make an appointment, the receptionist wrote in the medical code for my annual visit. But when looking a the doctor's notes, the business office figured out they could put my visit through insurance as something else.
This is important for several reasons.
1. Check with your insurance. You may have a similar situation and think your pap smear visit is free but as soon as you bring up other subjects, the business office will bill you for the visit.
2. Most Americans forget that doctors/dentists, etc. are small business owners. They have seen their practices/appointments reduced by 25-50% during this recession. They have had to make decisions too just like any small business.
3. The business office was doing what it was hired to do. I called them up, we had a good conversation, and they deleted my bill, but they didn't have to. I certainly don't blame them for what they are doing. I do wonder about the 9 month lapse.
4. Health insurance is extremely complex and complicated. Obamacare is going to make matters worse. I grew up at a point in history when employers were not involved at all in health insurance. It will be interesting to see the next step in this evolution play out.
5. We need to be very aware. Check your bills, ask for a details, etc. A long time ago when my children were young, I once asked about the cost of a shot. The reply - "oh, your insurance is covering it, so it is free." No, it is not. We have an amount taken out of my husband's check each month. It is definitely not free. Those monthly charges are based on all the statistics the insurance company collects and costs incurred. That shot was a cost.
For business, everything is about their bottom line. For a household, we have to do the same.
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