An adventure in United States healthcare
I know this is minor compared to what others have dealt with, but it’s the worst I’ve experienced … so far.
- During a recent checkup, my doctor suggested that I get a mole on my back looked at by a dermatologist.
- I made an appointment with the dermatologist that my doctor recommended.
- At the appointment, I’m told the mole should be removed and biopsied.
Would you like to do it right now,they asked.
- I replied,
No, I’d like to determine how much this will cost; I’ll be in touch.
- I called my insurance company and asked,
Based on my plan, how much will having a mole removed cost me?
- They replied,
We can provide you with an estimate if you provide us with the procedure codes, which you can get from the dermatologist.
- I called the dermatologist and said,
I was there the other day and was told I should have a mole removed; I want to get an estimate from my insurance company first, and they need procedure codes from you.
- They gave me two codes.
- I called my insurance company back, explained everything again, gave them the two codes, and was told I’ll get an estimate in a few days.
- I received the estimate: $91.92.
- I decided that’s an amount I’m willing to pay, so I made the appointment.
- I have the procedure done; 40 minutes of waiting on a table, 5 minutes of numbing the area, and 15 seconds of slicing.
- A couple of weeks later I received a bill for $604.00. Am I even surprised? Nope.
- I called the insurance company and was told,
the initial estimate wasn’t wrong, your share of the cost is $91.92 for the two codes provided, however there were other fees such as the biopsy and a facility charge.
- I called the dermatologist, transferred to the billing department, and was told the same thing,
this procedure incurred a cost from the dermatologist, the biopsy process, and the facility that the dermatologist uses.
I don’t know when, in this process, being an average person with average questions bit me in the ass, but I think it was around step #8 or #9. When I called the dermatologist to ask for codes, they interpreted my request as only the codes that apply to the process of removing a mole – the numbing and the cutting.
Maybe I’m naive, but I’d like to think the dermatologist would’ve been, you know, human and said something along the lines of,
just in case you weren’t aware, there are going to be other codes associated with this procedure, but nah, they didn’t.
So, I’ll chalk this up to a lesson learned: next time I’ll either ask more questions about the various layers and their codes, or I’ll just go to a local clinic instead.
Oh, and the biopsy results came back clear/negative/whatever.