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RE billing question

Forum: Trying to Conceive with Medical Assistance


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December 19th, 2009, 10:53 AM
Mega Super Mommy
Join Date: Dec 2007
Posts: 1,292
Would you protest this?

I got a statement from my RE's office the other day. My insurance covered the first office visit and u/s from this past cycle because I wasn't on any fertility meds. Once I start any kind of meds, though, it's all out of pocket. It's always been like this, so it's no surprise.

My RE's office billed my 2nd u/s (even though it was a follie check b/c I was on Follistim) just to see if my insurance would miraculously cover it. Of course, they didn't, and I was 99% sure they wouldn't, so that's fine. The balance we owe for that is $500. That's okay.

BUT my insurance also did not cover the "office visit" that day, and those are $450. So my RE's office billed us that, as well, so our grand total is $950.

But here's the kicker---I did not even SEE my RE when I had my follie check u/s! He was out with the flu! I saw a nurse who did my u/s, yet I still get charged for an office visit???

It seems kind of wrong to me. I could understand if I'd seen the RE, but he wasn't there.

I just feel like I should protest the $450 office visit, and remind them of this fact.

Married with two awesome 7 year olds, we're TTC with unexplained infertility.
Thank you sophiasmomma for my beautiful siggy!
Nov/Dec Follistim cycle = BFP, chemical pregnancy
Dec/Jan TTC naturally after m/c, BFN
Jan 2010 2nd round of Follistim

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December 19th, 2009, 11:38 AM
KMH KMH is offline
TTCMA Cheer Captain
Join Date: Sep 2008
Location: right of center
Posts: 19,318
I would most definitely protest! It seems unlikely that the nurse can charge what the RE charges to see you, so you should at least get a discounted rate on the visit.

It might just be an honest mistake...my RE's office has the forms for the appointment all printed up first thing in the morning, so if the plan changes, they have to manually go in and change things. Maybe your office works the same way, and they just forgot. It's definitely worth asking about, though!

Melissa & DH
IVF babies Claire (5), Abigail (3) and George (3)

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December 19th, 2009, 01:00 PM
momma S's Avatar Super Mommy
Join Date: Jul 2009
Posts: 837
I would protest too! Our billing dept sends us bills for things I paid on site that day for. DH always asks me if he should pay something or not. Even if they didn't make a mistake I would ask for a reduction due to the fact you never saw your RE! That is a pretty expensive visit!
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December 19th, 2009, 01:01 PM
*CAMM*'s Avatar Platinum Supermommy
Join Date: Jan 2007
Location: somewhere over the rainbow
Posts: 7,986
My RE charged for an office visit every time even if i saw the NP. granted it wasnt as high as your doc is charging..i think it was $120 for us..but yeah we got charged even when we didnt see him because he reviews the information collected from that appt.

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December 19th, 2009, 03:40 PM
Posts: n/a
I would definitely call and see what they say....and OUCH your RE is expensive
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December 19th, 2009, 06:48 PM
redbirds's Avatar Blessed Again!
Join Date: Jul 2007
Location: CO
Posts: 18,447
I am with Brandi!!! My RE charges a $95 office visit (discount for OOP pay) and that is only if we are in his office longer than 10 min or so, so I don't get charged an office visit every time I have an u/s.

All I can say is it wouldn't hurt! What could they say? No? Then you are no further behind in payment than now... but if they say no, you may then see if insurance will cover the office visit. I've done that, and they've agreed to part of the resubmission, and again: the worse they can say is "no" but the best that can come from that is you buy yourself another month or two to come up with the $$$$$$$.
Gwynne, celebrating the newest of our four precious miracles

Hat's off to Vicki for my cute siggy, thank you!
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December 19th, 2009, 09:11 PM
Platinum Supermommy
Join Date: Oct 2008
Location: Minnesota
Posts: 8,103
I still get charged cycle management fees from my RE's office and I do all my monitoring at another clinic that is much closer. But we pay him for his opinion and medical advice. It stinks, but we pay it so that we can do the super ovulation drugs and such.

Wouldn't hurt to call and ask and see what they say. Like Melissa said, it could just be an honest mistake.

Yet another wonderful siggy by HeatherW.... thank you so much!!!

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December 20th, 2009, 07:43 AM
Join Date: Feb 2009
Posts: 143
It doesn't hurt to try, the worst thing that can happen is you have to pay the total amount.

On a side note, wow that is an expensive u/s. My insurance pays for mine, even though when I called to ask the lady said they don't cover that billing code. But my RE office visits are only $45 and u/s are $150.. But i do have to pay the "office visit" charge no matter who I see, unless it is just for bloodwork.

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