Doctor charged me for a routine exam-- any others experience this?

22 posts in this topic

Hi All,

 

I'm a litte surprised and trying to get some more information here.  A couple of years ago I moved and visited the nearby ob/gyn for my routine exam.  The office was a little rushed and chaotic, but overall I was okay with it.  Since I had surgery for large ovarian cysts about five years previously, my exam has always included an ultrasound with the wand.  My insurance has always covered it, and I have never been charged for one.  The new doctor also did this without any extra charges.

 

I come back this year and lo and behold, the office worker tells me I have to pay 45 euros to get an ultrasound with the routine exam.  I said this couldn't be right and I would talk to the doctor about it.  The doctor said, this applies to 20 year old girls who don't really need it, but of course, it was indicated in my case.  So we went ahead and had the exam and when I came out, the receptionist tried to charge me 45 euros.  I said it couldn't be right, and she said no, the doctor said I was to pay specifically.  I asked to speak to the doctor and was refused.  The receptionist suggested I take it up with my insurance.

 

At that point I said I was going to need to ask some questions and just left.  I feel scammed somehow.  I have seen doctors hawking various optional procedures for a range of sums that have to paid for, but an ultrasound?  Can she just do this?  Her reviews suggested that she has complained about her cash flow during appointments with other people, so maybe she simply decided to slap arbitrary surcharges on necessary procedures.  Has anyone else experienced this with any kind of doctor, and is it very typical? 

 

I guess a bill is coming, and I'm baffled about whether or not I'm required to cough up.  Any advice?

 

Sorry this was long.

 

 

 

 

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Just to be clear, I moved within Munich a couple of years ago.  I have lived 15 years in Germany total and had a child here.  Never been charged for an ultrasound or other diagnostic testing at any point, ever. 

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I am not sure why, but I get a feeling she is both charging the insurance and charging the patients a fee to top it all off, if she is having problems with her cash flow.  I am pretty sure the value of an ultrasound is more than 45 bucks.  But it would be bizarre if this were the case.

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This examination usually costs me €40.  I have always been told it is not a part of the "normal" examination paid for by the TKK and have to sign an agreement to have this examination.

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2 hours ago, tinwoman said:

 I am pretty sure the value of an ultrasound is more than 45 bucks. 

 

No, that is about how much it costs. My last one was 26.81 Euro to be exact (as I delve through my health papers today) but it depends on exactly what organ etc and what is done and of course the overall bill also had some typical other standard items (the small consultation fee etc).   Many routine procedures are not relatively expensive in the scheme of things, cetainly often cheaper than people might think.

 

Is it on some sort of cycle, perhaps?  With my insurance, the gynae and mammogram are covered every 2nd year for instance.  Or is she saying she's not doing "public system" work, possibly, an increasing phenomenon?   At least,if demands for payment continue, you need an invoice (and if they are insistent, you might well get one by post, of course).  It's not that unusual to settle smaller bills in cash right away, although we don't have to.

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honestly this sounds like a fault on the receptionist's part.

 

I have an ultrasound once a year that's covered, and I can opt to have a second one during my 6 month checkup for 40 euros. 

 

last time I got a bonus second ultrasound for the year as there was some reason to think my fibroids *might* be giving me trouble.  They are indeed covered by insurance when the doctor deems it necessary to perform them.  A purely elective sonogram (a patient request) is not covered, and those are the ones you have to sign off on.

 

The fact that your doctor told you the same herself, that you have never had to pay for it in the past (even with this same doctor) and that the receptionist is the one who refused to cooperate and refused to get the lowdown from the doctor (with you present!) makes me think it's just that simple:  the receptionist screwed up.

 

Beyond this, I have a sneaking suspicion you won't see a bill for this as they usually demand payment at the time of service for elective procedures.  It's not clear in your original post, but if you didn't sign off that the sonogram would be elective and that you agreed to pay for it, I don't even think they CAN charge you for it.

 

 

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2 hours ago, tinwoman said:

I am pretty sure the value of an ultrasound is more than 45 bucks.

 

pricing of every procedure imaginable is set in stone according to the medical fee tables. A sonogram is silly cheap here *for real*, especially when compared to the US.

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Thanks for these comments.  Since my last ultrasound was over two years ago, and I have had medical issues which mean an ultrasound should be included in the exam , I am certain that my insurance covers it but that the doctor and the understaffed office simply didn't want to be arsed with recovering the cost that way.  I guess we'll see if they send me a bill.  Either way I'm done there, which is a shame-- the location is certainly very convenient for me.  But if such a simple issue cannot be cleared up by the doctor and her team without rudeness and stress, then I need to go elsewhere next year.  :(

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My two cents: before you´re jumping to conclusions about the doctors ethics you should clarify if she even knew that the receptionist tried to charge you. As was said above it might be that it was merely a case of misunderstanding. If the charge turnes out to have been authorised by the doctor I´d call the insurance. I very much dount that you´ll have to pay if you didn´t sign for it.

 

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19 hours ago, tinwoman said:

I am not sure why, but I get a feeling she is both charging the insurance and charging the patients a fee to top it all off, if she is having problems with her cash flow.  I am pretty sure the value of an ultrasound is more than 45 bucks.  But it would be bizarre if this were the case.

 

16 hours ago, lisa13 said:

 

pricing of every procedure imaginable is set in stone according to the medical fee tables. A sonogram is silly cheap here *for real*, especially when compared to the US.

 

You can find the list of costs here (and in many other places, but I find this easy to search in if you know what you're looking for). An internal ultrasound (assuming 403+410 applies) costs €42,54 on average and up to €62,66 if there is a good reason (has to be written down on the bill)

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14 hours ago, tinwoman said:

the doctor and the understaffed office simply didn't want to be arsed with recovering the cost that way

 

oh come now, that's not what you described in your original post.  You said the doctor confirmed you should not have to pay so  the sweeping cynicism about the whole office, let alone the doctor, is a bit much, isn't it?

 

what is that saying?  oh yeah:  don't attribute to malice that which is adequately explained by stupidity (or incompetence, or in this case - a simple mistake?)  https://en.wikipedia.org/wiki/Hanlon%27s_razor

 

 

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In response to my question about the ultrasound being optional, the doctor said that I needed the ultrasound, and that the policy was for 20 year olds with no medical history of needing it.  She said it was clear I should have one, given my age and prior surgery.  After the examination, the receptionist tried to charge me for it.  I said, the doctor told me that I was not the target demographic of the policy and could I speak to the doctor?  She said wait, I waited, she walked into the doctor's office between appointments and walked out, and said, the doctor would not see me and there was nothing to discuss with the doctor.  I do believe she asked-- she was very clearly not in charge of anything there.  I don't think the receptionist is the problem-- I think the lack of clarity and good communication are the problem (and there is not really a language issue; her English is fine) and I think the ambiguity was intentional as per the impression I got. 

 

Anyway it is good to know that other ob/gyns consider this an elective procedure although like I said, the question has never come up before in my case. 

 

Thank you for your responses.  They have been very helpful. 

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The thing is that, to me, most of that sounds quite normal.   My doctors simply would not discuss billing or insurance policies etc routinely.   I just know they never will.   They are medics, and they also cannot burn up time discussing that.   That discussion always goes to the admin side - no exception.

 

I'm currently having to repeat process and had to incur some additional costs (about 30 Euros) because the office staff made a mistake. I moaned about it here a while ago.  A lot of doctors' receptionists are really not trained individuals (especially in high employment settings).   Someone prepared to sit in an office and do the best they can is what we get.  They simply won't know the rules inside out.  Mine can't always retain a copy of a form until my next visit, or do the checks listed on it, by the looks of it :rolleyes:.   It does not greatly surprise me they don't know everything. 

 

As a post above says, it happens sometimes.  If you have an OK practice round the corner, it's probably not worth sweating.

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1 hour ago, tinwoman said:

it is good to know that other ob/gyns consider this an elective procedure

 

agh

 

it's only "elective" when the doctor sees no need/justification to perform one.  if you didn't sign off on the cost for this "elective" procedure (before they did it), they should not charge you for it.

 

I have not seen a doctor yet who didn't clearly identify treatments or tests that I'd have to pay for myself, in the course of any exam - the receptionist is not privy to these discussions so yes, it makes sense that the doc would do that as needed.  One office even offered a menu of extras I could book before my appointment ;)  If the doctor just does whatever it is without asking, I've never been billed.  On the occasions I took an extra test electively, the doc just mentioned it to the receptionist as he walked me out and I was charged and required to pay on the spot.  It's not rocket science.

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" I have not seen a doctor yet who didn't clearly identify treatments or tests that I'd have to pay for myself, in the course of any exam "--- this is exactly what was missing here....she was very pushy and did not really listen but just kept talking, very fast, throughout; that is just her manner, which in my previous visit I had put down to her being kind of a "character" and didn't want to give demerit points for that with her so close by and otherwise quite knowledgeable. 

 

And yes, receptionists are undertrained and probably underpaid considering what they have to deal with. 

 

I am familiar with having to sign off for treatments with my dentist, since almost everything he does is "optional"-- the insurance pays for very little. 

 

If they send me a bill I'll cut my losses and pay it, anyways.  It isn't enough money to go to the mat over. 

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Hi Lisa,

 

In my earlier comment I wrote " In response to my question about the ultrasound being optional, the doctor said that I needed the ultrasound, and that the policy was for 20 year olds with no medical history of needing it.  She said it was clear I should have one, given my age and prior surgery."  That was exactly what she said, neither more nor less.  She did not say in a simple declarative sentence, "you will have to pay/not have to pay for it" but this was strongly implied by the conversation, strongly enough that I went ahead with the examination feeling relieved. 

 

If this all sounds terribly sketchy and confusing and you have no idea what went down, welcome to the club.  That is exactly the problem.  I was there and I don't understand what the h*ll was going on. 

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