DEAR DR. GOTT: I brought my eight year old to her pediatrician for a well visit. During the visit the doctor asked if she had been complaining of a sore throat. When I said no the doctor told me that my daughter’s throat was a little red and she had a faint viral rash on her back. She told me to keep an eye on her because she may be coming down with something. My daughter never developed any other symptoms.
When I received my insurance statement and bill, it showed that I had been billed for a well visit and a sick visit. When I called to point this out, I was told that they were charging me for an appointment that I hadn’t made. I said it took all of 30 seconds for the doctor to say what she said to me. The doctor then told me that because my daughter had presented with these symptoms, she had to record it and bill a sick visit in addition to the well visit.
My insurance wouldn’t cover a second visit on the same day, so I ended up having to pay for an appointment that I didn’t make or need. I wouldn’t bring my child in for a run of the mill sore throat anyway unless she was really complaining.
I want to know if this is a normal practice or am I right to be upset about it? I like the pediatrician but am looking into others because I don’t want to be double charged again.
DEAR READER: I believe you are right to be upset about it. While the pediatrician was correct to make note of the symptoms in your daughter’s medical record, there was no need to bill for a sick visit that didn’t occur. These were incidental symptoms that weren’t causing distress found during a routine medical exam. Your pediatrician’s office was wrong to bill for two appointments.
Because you have already paid for the fictitious appointment, it is likely too late to contest the bill; however, it is within your rights to either call or write the doctor’s office and express your dismay of the situation. If you know of other families who use the same pediatrician and have experienced similar situations, perhaps a call to the local county medical association is in order.
Some physicians are getting more creative in their schemes to bilk insurance companies and patients out of money. This is unethical, immoral and just plain greedy. Many people, especially families, can’t afford health insurance as it is, and these physicians are only making matters worse by billing for testing or appointments that weren’t ordered or made. This drives payouts up and causes consumer costs to rise.
And, before, I receive mail from physicians complaining about my stance, let me just say I managed to keep a thriving practice for 40 years and I never once scammed my patients. In fact, I worked with my patients — above and beyond the norm — so far as bartering and even refusing payment from those without insurance. Through kindness and generosity physicians can maintain a healthy practice. These traits keep patients coming back faithfully, whereas greed and indifference will drive them away.
Because many of my readers such as you don’t want to visit the doctor if they don’t have to, they might enjoy my Health Reports “Dr. Gott’s Compelling Home Remedies” and “More Compelling Home Remedies” for simple, easy and inexpensive remedies to common health complaints. Send a self-addressed, stamped number 10 envelope and a $2 (for each report) US check or money order to Dr. Peter Gott, PO Box 433, Lakeville, CT 06039. Be sure to mention the title(s) or print an order form from my website, www.AskDrGottMD.com.
