Originally published November 27 2012
Doctors now charging for extra visit when patients ask questions
by J. D. Heyes
(NaturalNews) Are you uncertain about your medical condition? Have a few questions for your doctor? Well, if so, you might want to bring extra money with you the next time you go in for a visit. Or better yet, ask your doctor's receptionist before you go in: "Will I be charged for asking questions?"
Like airlines that charge for extra luggage and banks that charge you to let you use your own money, now doctors and clinics are charging for something they have implored patients do to for decades - ask questions about treatment, diagnoses and anything else they don't understand.
What's next, a second opinion surcharge?
So baffling is the practice that even seasoned, experienced medical professionals don't get it. Just ask (for free) Susan Krantz, a Minnesota registered nurse with a business background who noticed a strange charge recently on a doctor's office bill.
"Even as a registered nurse, I can't figure out what this is," she told the local CBS affiliate, WCCO.
'You can be charged if you ask too many questions'
She was upset when she opened her bill and found, along with the list of procedures performed, an itemized charge of $50.06 for something she didn't get.
She called her clinic to inquire and was puzzled by the response.
"You can be charged an extra office visit if you ask too many questions," she told WCCO. "I said, I don't understand that, because isn't that what this visit is for?"
Medical coding and billing is as precise as it is complex, most often requiring specially trained personnel to enter charges, lest the physicians' practice be audited and fined by state and federal watchdog agencies. So it comes as no surprise that Krantz's clinic, Park Nicollet, told the CBS affiliate that billing has to accurately reflect medical services provided.
But answering questions?
If physicians believe their work goes beyond the scope of any visit, Park Nicollet says clinics have to code it as such on their bill. The clinic said that is to assure that coverage for a "wellness" visit doesn't fraudulently or otherwise improperly cover care given to an "acute care" matter.
If that sounds like a tortured excuse, that's because it is. But in the great scheme of healthcare over regulation, it makes sense.
State and federal healthcare regulations (which, you may remember, are about to get a hundred times worse as more Obamacare mandates begin to take effect) contain strict requirements for doctors in terms of how they bill their patients and their insurance companies. On the surface, it stretches credibility to claim that merely asking questions changes a visit from "wellness" to "acute." What happens if a patient asks questions during an acute care visit? Are they billed for a double acute care visit or something?
And yet, such charges don't occur in a vacuum. They really don't.
In Krantz's case, she must have been at her doctor's office for a wellness visit because she was charged for an "acute" visit as well after asking her physician about a sore hip.
"As always the doctor's visit started out with her asking what questions do you have? And I had a little list. This one and this one and this one. And she said, OK," Krantz said.
But because of coding requirements, that was "okay," as in, "I'm gonna have to bill you for answering those questions." As ridiculous as that is.
The patient gets hosed, as usual
When asked about the charge, Park Nicollet called it an insurance issue, saying in a written statement that "the insurance company may require that patients pay or make a co-pay for services beyond the 'preventative' part of the appointment."
The statement goes on to say that the total bill sent to the insurance provider is the same as if it were only a single appointment, though it is "broken out separately on the invoice."
In other words, a single appointment has to be billed as two different kinds of appointments, for medical coding purposes. That's ethical.
Whoever is responsible - the state, the feds, Medicare - as usual, it's the patient who is getting hosed.
As for Krantz, she's turned into Paul Revere and is now spreading the word among her friends.
"I'd have never known had I not taken the time to call," she said.
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