"Free" annual physical not free (1 Viewer)

[mrip541]

I had my "free" annual physical a few weeks back. Before my visit I had gotten routine bloodwork, which was covered as part of the physical. While reviewing that bloodwork my doc noticed I had low vitamin D, so kinda mentioned off-hand that she'd write me an Rx for a super strong Vitamin D supplement. I get the bill and I was billed $280 for a separate "office visit" because I received a "new diagnosis" during the covered physical. My insurance applied a "discount" so I'm on the hook for $90, because my doc gave me a vitamin I could have purchased at Rite-Aid. The whole appointment lasted about 20min and my doc billed my insurance $500, plus bloodwork. Is that really how this works? The physical is covered but if anything whatsoever is wrong with you, you get billed for a full extra office visit, and no one even warns you?!?

 

[E-Z Glider]

I had my "free" annual physical a few weeks back. Before my visit I had gotten routine bloodwork, which was covered as part of the physical. While reviewing that bloodwork my doc noticed I had low vitamin D, so kinda mentioned off-hand that she'd write me an Rx for a super strong Vitamin D supplement. I get the bill and I was billed $280 for a separate "office visit" because I received a "new diagnosis" during the covered physical. My insurance applied a "discount" so I'm on the hook for $90, because my doc gave me a vitamin I could have purchased at Rite-Aid. The whole appointment lasted about 20min and my doc billed my insurance $500, plus bloodwork. Is that really how this works? The physical is covered but if anything whatsoever is wrong with you, you get billed for a full extra office visit, and no one even warns you?!?

Must be an insurance loophole. Everyone I know that goes to my doctor tests low for Vitamin D.

 

[Sinn Fein]

I had my "free" annual physical a few weeks back. Before my visit I had gotten routine bloodwork, which was covered as part of the physical. While reviewing that bloodwork my doc noticed I had low vitamin D, so kinda mentioned off-hand that she'd write me an Rx for a super strong Vitamin D supplement. I get the bill and I was billed $280 for a separate "office visit" because I received a "new diagnosis" during the covered physical. My insurance applied a "discount" so I'm on the hook for $90, because my doc gave me a vitamin I could have purchased at Rite-Aid. The whole appointment lasted about 20min and my doc billed my insurance $500, plus bloodwork. Is that really how this works? The physical is covered but if anything whatsoever is wrong with you, you get billed for a full extra office visit, and no one even warns you?!?

You, and your doctor, are why everyone is paying higher premiums.  

Thanks!

 

[mrip541]

You, and your doctor, are why everyone is paying higher premiums.  

Thanks!

I'm not entirely sure what you're implying.

 

[Cjw_55106]

I cant speak for the "no one even warns you", but I know when I make my appointments online, it clearly says something about additional fees if they address other issues or some such thing. 

 

[RedmondLonghorn]

Almost nothing is really free. Usually:

1. Somebody else is paying for it; and/or

2. You are paying for it indirectly; and/or

3. There are strings attached.  

In this case it would seem to be a combination of 2 & 3.

 

[Joe Summer]

You know what else grinds my gears? When the waitress asks if you want a refill of your drink, and then you find out when the bill comes that refills aren't free.

 

[Parrothead]

if you like your money, you can keep your money

 

[mrip541]

You know what else grinds my gears? When the waitress asks if you want a refill of your drink, and then you find out when the bill comes that refills aren't free.

But what if the waitress just spontaneously gave you a refill without saying anything at all, then added it to the bill.

 

[shadyridr]

Same thing happened to me and my wife. Tested low for vitamin d. Both charged for our physicals. 

 

[ffjunk]

I had my "free" annual physical a few weeks back. Before my visit I had gotten routine bloodwork, which was covered as part of the physical. While reviewing that bloodwork my doc noticed I had low vitamin D, so kinda mentioned off-hand that she'd write me an Rx for a super strong Vitamin D supplement. I get the bill and I was billed $280 for a separate "office visit" because I received a "new diagnosis" during the covered physical. My insurance applied a "discount" so I'm on the hook for $90, because my doc gave me a vitamin I could have purchased at Rite-Aid. The whole appointment lasted about 20min and my doc billed my insurance $500, plus bloodwork. Is that really how this works? The physical is covered but if anything whatsoever is wrong with you, you get billed for a full extra office visit, and no one even warns you?!?

Call and ask your Doctor to waive that, Some do some don't, all depends on how you get along with them. I've heard the same thing with others I work with. At their physical, if they mention anything that is bothering them, it gets re-coded as a sick call and then the office visit copayment applies.

Also mention at your physical about how the blood work is costing more and more and sometimes they can code that so you get charged the least amount possible.

I always try to develop a friendly relationship with my Dr or my kids Doctor so when something goes wrong and its something you've dealt with in the past, you don't need to come in, they will just call in a prescription. Some things you do need to go in for though.

 

[Peyton Marino]

you guys need to get out in the sun more often

 

[B Maverick]

I had my "free" annual physical a few weeks back. Before my visit I had gotten routine bloodwork, which was covered as part of the physical. While reviewing that bloodwork my doc noticed I had low vitamin D, so kinda mentioned off-hand that she'd write me an Rx for a super strong Vitamin D supplement. I get the bill and I was billed $280 for a separate "office visit" because I received a "new diagnosis" during the covered physical. My insurance applied a "discount" so I'm on the hook for $90, because my doc gave me a vitamin I could have purchased at Rite-Aid. The whole appointment lasted about 20min and my doc billed my insurance $500, plus bloodwork. Is that really how this works? The physical is covered but if anything whatsoever is wrong with you, you get billed for a full extra office visit, and no one even warns you?!?

How is this a "new diagnosis"? Isnt this the point of having a physical? To make sure everything is good and you dont need something?

 

[shadyridr]

you guys need to get out in the sun more often

My doctor said most people that get blood work in the winter in NYC have low vitamin D.

 

[Peyton Marino]

My doctor said most people that get blood work in the winter in NYC have low vitamin D.

makes sense.  less sunlight hours and probably less parks in a big city.

I take a vitamin D supp daily unless I have extended time outside in the sun.  try to take it with a fat to help with absorption.

 

[Ministry of Pain]

Doctors are the worst. They think they are entitled to obscene amounts of money because they acted like bookworm nerds until they were 35 years old. 

 

[matttyl]

I had my "free" annual physical a few weeks back. Before my visit I had gotten routine bloodwork, which was covered as part of the physical. While reviewing that bloodwork my doc noticed I had low vitamin D, so kinda mentioned off-hand that she'd write me an Rx for a super strong Vitamin D supplement. I get the bill and I was billed $280 for a separate "office visit" because I received a "new diagnosis" during the covered physical. My insurance applied a "discount" so I'm on the hook for $90, because my doc gave me a vitamin I could have purchased at Rite-Aid. The whole appointment lasted about 20min and my doc billed my insurance $500, plus bloodwork. Is that really how this works? The physical is covered but if anything whatsoever is wrong with you, you get billed for a full extra office visit, and no one even warns you?!?

Yes, that's how it works.  You get "preventive care" covered at 100%*.  The physical (actually the bloodwork) found that you had low vitamin D, so obviously it wasn't "prevented."  So any "treatment" (if you want to call what you received as "treatment") won't be covered at 100% as "preventive". 

The question I get asked (unfortunately) is about colonoscopies.  Generally, they can be covered at 100% as a "preventive measure", but if during the procedure they find a polyp, well then they no longer can bill it as "preventive" - it's now billed as any other medical procedure (subject to deductible and the like).  So you don't know how much it's going to cost you till after the procedure, because you don't know if they are going to find anything or not till they look.  The whole thing is a pain the butt, pardon the pun.

Anyway, this situation brings up a few things...

1. The physical wasn't "free", the cost for it is baked into your premiums already.

2. A $280 charge (what the doc wanted to charge, and would have without insurance) is ridiculous.  Utterly ridiculous, and you should ask your doc why they feel justified in billing you $280 for 2 minutes of telling you that your vitamin D is low.

3. Your insurance lowered that $280 right off the bat down to $90, which is also a ridiculous amount for what it was.

 

[matttyl]

How is this a "new diagnosis"? Isnt this the point of having a physical? To make sure everything is good and you dont need something?

Sure, but everything isn't "good", and he does need something.  Finding that out, and being told what steps to follow to make it good costs $280 in the doctors eyes (and was reduced to $90 by insurance).

 

[Phil Elliott]

Many plans consider colonoscopy "preventative" at no charge...unless they find polyps and remove them, then its considered surgical and and you get charged several hundred dollars.   

 

[Peyton Marino]

Doctors are the worst. They think they are entitled to obscene amounts of money because they acted like bookworm nerds until they were 35 years old. 

haha hell ya!

 

[comfortably numb]

Hmmm

This vitamin D sounds like a Johnson rod to me

 

[B Maverick]

Sure, but everything isn't "good", and he does need something.  Finding that out, and being told what steps to follow to make it good costs $280 in the doctors eyes (and was reduced to $90 by insurance).

Right, and maybe I stated that wrong.  Would seem that you get the physical to be told either "you are good" or "here is whats wrong and how to fix it".  The follow up visits are then separate and billable as needed.  If your "free" physical doesnt provide you the ability to get the results then whats the point of offering?

 

[Sinn Fein]

I'm not entirely sure what you're implying.

I am saying - that everyone pays for medical expenses when you go get a $500 physical.

 

[gianmarco]

Doctors are the worst. They think they are entitled to obscene amounts of money because they acted like bookworm nerds until they were 35 years old. 

Yeah, that's exactly it. Especially the insane debt many are straddled with after training. 

 

[Binky The Doormat]

My old (ex) doctor was a real **** about this kind of stuff.  Looking back, I can't believe I didn't dump his ###.  

I didn't pick him, I was/still am on Aetna and had a great doc that we selected and just lucked out on.  Well, this doc was so much like what I remembered as a family doctor growing up, that he actually got out of the clinic partnership and went out on his own to be real-life country doctor.  Then I got to pick another guy from the clinic.

Things started ok, the new doc was a little older than me, and did the lecture everytime about smoking/drinking/eating/exercising.  He was a runner, almost tee-totaler, health nut type and no ####### fun.  Then after a couple of years, the guy starts giving me #### for rescheduling appointments.  I explained that I travel a lot, and his office ran a couple of months in scheduling so I never knew exactly when I would be in town.  His attitude ...his time was a lot more important than mine.  (If you didn't cancel within 24 hrs - they charged you anyway ...and insurance wouldn't cover it).  

I think he/his partners were pissed about cancellations within 2-3 days since they may not have been able to quickly fill the spot.  People were lined up man - 2pm appointment?  Yeah, they want you there at 1:30 ...get into one of the treatment rooms around 2:30 - 2:45 and then the doc shows about a half hour later.  

Costs?  Eh, didn't mean #### to him and he got in my #### for asking.  I was telling him that a whole bunch of my quarterly blood tests weren't being covered - and I didn't know what most of them were for or what the results meant.  He says, "I haven't ordered any testing for you that isn't standard, I can't know what insurance covers what tests." ...Ok, that is understandable, but meanwhile Aetna is telling me to work with my doc to better manage my costs.  I ask him to go over the tests and he sighs, then goes glosses over a bunch of it.  

THEN his nurses would #### up my prescriptions with Aetna - they weren't used to the 3 month ordering, and several times cost me either $200+ or a giant hassle in working through the correct ordering (if they ordered 1 mo. to the mail order - it gets charged for 3 mo.).  You cannot ever talk to him by phone, you can't leave him a voice message either - it all goes through the nurse voicemail ...and they get back unreliably.  

At the end, he and I got into a pretty emotional argument - no yelling but we both were red-faced.  We decided to part ways - but he said he was retiring anyway, he had had enough with the business ...that it just wasn't what it used to be.  #### that guy  

I am now with an independent family doctor who practices with his son.  They were full up and I only got in because a good friend of mine, who has been a patient for years, got me in.  Love the guy.  I can talk to his nurse anytime (gets back with a couple of hours always) and him if I feel I need to (haven't yet).  They work closely with me on medication ordering, tests being covered, etc.  

 

[matttyl]

Right, and maybe I stated that wrong.  Would seem that you get the physical to be told either "you are good" or "here is whats wrong and how to fix it".  The follow up visits are then separate and billable as needed.  If your "free" physical doesnt provide you the ability to get the results then whats the point of offering?

It did provide him with the results.  Everything is fine.  Except for your vitamin D - and the information and the way to fix it will cost you $280 (actually $90).  He pretty much got the "follow up visit" needed, and it was billed as needed, at the same time.  I'm not saying it's a perfect system, I'm just trying to explain how the system we have operates.

 

[B Maverick]

It did provide him with the results.  Everything is fine.  Except for your vitamin D - and the information and the way to fix it will cost you $280 (actually $90).  He pretty much got the "follow up visit" needed, and it was billed as needed, at the same time.  I'm not saying it's a perfect system, I'm just trying to explain how the system we have operates.

Oh I get it thats what happened, just makes little sense to me and seems like a poor manipulation. Guess the physical is just like the "Credit Monitor" commercials, I dont actually do anything, just monitor.

 

[matttyl]

Yeah, that's exactly it. Especially the insane debt many are straddled with after training. 

link - "the cost of becoming a doctor has soared, with higher education expenses leaving the average newly minted physician with $166,750 in medical school debt."  

Average income for a family physician - $167k.

Yeah, the average "insane debt" you talk about, is one year's salary almost exactly. 

 

[kevzilla]

They can bill the sick visit at the same time because it makes no sense to have you come back in a week. 

It sounds like some of you are anti-wellness visits. Which is fine, except they might find that painless lump on your left one, saving a million dollars in care, and very possibly your life. 

 

[FUBAR]

My doctor said most people that get blood work in the winter in NYC have low vitamin D.

Shocking

makes sense.  less sunlight hours and probably less parks in a big city.

I take a vitamin D supp daily unless I have extended time outside in the sun.  try to take it with a fat to help with absorption.

Plus it's a good excuse to eat fat!  

 

[CurlyNight]

Must be an insurance loophole. Everyone I know that goes to my doctor tests low for Vitamin D.

Low vit D is common in the winter months where people stay in more and there isn't much sun...

 

[CurlyNight]

I always have low vit D. Doc says just get min 2000 iu D3 supp otc.

 

[CurlyNight]

Yeah, that's exactly it. Especially the insane debt many are straddled with after training. 

and the malpractice insurance they need to have..

 

[gianmarco]

link - "the cost of becoming a doctor has soared, with higher education expenses leaving the average newly minted physician with $166,750 in medical school debt."  

Average income for a family physician - $167k.

Yeah, the average "insane debt" you talk about, is one year's salary almost exactly. 

You think that's normal debt? And do you think that gets paid off in one year? 

Any other professions you know of that require you to have that much debt? And require decade+ of training? 

Is a 167k salary luxurious? 

Serious question: Assuming you could, would you be willing to enter the workforce at age 32-35 with almost 170k of debt so that you can earn 170k/year? Keep in mind that will likely take 5-10 years to pay down, so you don't get to start "saving" until you are at least 40.  

ETA -- If almost $200K isn't insane debt, what would be? Do you realize how that affects things like being able to purchase a home or get financing?  Or, as mentioned above, additional costs such as malpractice? 

 

[James Daulton]

Doctors are the worst. They think they are entitled to obscene amounts of money because they acted like bookworm nerds until they were 35 years old. 

Is it wrong of me to pray that MOP get's really sick and needs the help of doctors but all the doctors in the world have read his posts about how much doctors suck and they all refuse to treat him.  And MOP dies.  Is that wrong?

 

[Ministry of Pain]

Yeah, that's exactly it. Especially the insane debt many are straddled with after training. 

That's why they sell Chemotherapy the same way an urban yooth sells heroin or marijuana, same thing just different pay grades. 

 

[Ministry of Pain]

Is it wrong of me to pray that MOP get's really sick and needs the help of doctors but all the doctors in the world have read his posts about how much doctors suck and they all refuse to treat him.  And MOP dies.  Is that wrong?

Only you know the answer to this. Strike me down and I will become more powerful than you can possibly imagine 

Easy on the well wishes there, works both ways JD.

 

[matttyl]

You think that's normal debt? And do you think that gets paid off in one year? 

Any other professions you know of that require you to have that much debt? And require decade+ of training? 

Is a 167k salary luxurious? 

Serious question: Assuming you could, would you be willing to enter the workforce at age 32-35 with almost 170k of debt so that you can earn 170k/year? Keep in mind that will likely take 5-10 years to pay down, so you don't get to start "saving" until you are at least 40.  

ETA -- If almost $200K isn't insane debt, what would be? Do you realize how that affects things like being able to purchase a home or get financing?  Or, as mentioned above, additional costs such as malpractice? 

I don't know what you'd consider "normal".  And of course it doesn't get paid off in one year.  Lots of professions require additional schooling, which has a cost.  Law school isn't free. 

The 167k number was for simply a family physician.  It was the second lowest paid type of doctor on that list in my link.  If you get into internal medicine the average is 182k, ER doc was $202k, and a radiologist (as many specialist docs) are close to $300k. 

So yeah, I'd love to get into the workforce in my mid 30s earning $200-300k a year (I have many clients who did just that) with almost $170k of low interest, tax deductible debt.  I mean, the average student debt (non-med school) is already over $37k.  So you're asking if I'd like to add $130k in additional debt to that, when the average starting salary of your basic college grad is only $50k?  You mean I can make an extra ~$150k-250k a year and only take on $130k in additional debt?  I'd consider that a no-brainer.

As for medical malpractice insurance, depends on what you feel is "expensive" - but most internal medicine docs pay around $5k a year in premiums.  Specialists and surgeons pay more, family practice type guys can pay less.  Some tort reform would obviously help.

 

[DA RAIDERS]

matttyl,

if i have a full physical with bloodwork and something shows up in said bloodwork, i now have to pay for the bloodwork?  jesus christ that's ####ed up.

 

[belljr]

You think that's normal debt? And do you think that gets paid off in one year? 

Any other professions you know of that require you to have that much debt? And require decade+ of training? 

Is a 167k salary luxurious? 

Serious question: Assuming you could, would you be willing to enter the workforce at age 32-35 with almost 170k of debt so that you can earn 170k/year? Keep in mind that will likely take 5-10 years to pay down, so you don't get to start "saving" until you are at least 40.  

ETA -- If almost $200K isn't insane debt, what would be? Do you realize how that affects things like being able to purchase a home or get financing?  Or, as mentioned above, additional costs such as malpractice? 

Dunno - the guy I coach with is early 40's Family Doctor and drives a Maserati as his 3rd car.

 

[IvanKaramazov]

Doctors are the worst. They think they are entitled to obscene amounts of money because they acted like bookworm nerds until they were 35 years old. 

And don't even get me started on pediatric nurses.  They think they're all high and mighty just because they work with little kids who have cancer.  

 

[Bogeys]

And don't even get me started on pediatric Hemonc nurses.  They think they're all high and mighty just because they work with little kids who have cancer.  

FYP

Not all pediatric RNs work with cancer patients.  

ETA:  Not meaning this to make fun of the patients... I lost a bet with one of the nursing units (pediatric hospital) so had to buy the unit lunch today so feeling snarky towards RNs at the moment.  

 

[CurlyNight]

Dunno - the guy I coach with is early 40's Family Doctor and drives a Maserati as his 3rd car.

You think this is the norm? The surg I worked for 10 years spent his first years as a surg renting a small modest home with his wife and fam. He's quite specialised performing minimally invasive hip and knee replacements only and does very well for himself now, but it wasn't like that for a long while. He went to Harvard and Stanford. The amount of debt blew my mind. And if you have your own practice, which most are coming out of, you have high overhead.

I pay cash to see my oncologist because she went to a very good school, has tons of experience, is certified (most are not) and participates in research and clinical trials. I could have chosen the one that takes my insurance (the one who looked out of touch), but with something like cancer, it's worth my paying cash.

 

[matttyl]

matttyl,

if i have a full physical with bloodwork and something shows up in said bloodwork, i now have to pay for the bloodwork?  jesus christ that's ####ed up.

Are we going in with the assumption that the physical and bloodwork are "free"?  And in the above example he didn't pay for his bloodwork, he paid for the doctor's "treatment" for low vitamin D. 

 

[DA RAIDERS]

Are we going in with the assumption that the physical and bloodwork are "free"?  And in the above example he didn't pay for his bloodwork, he paid for the doctor's "treatment" for low vitamin D. 

correct.   'free' physical with routine blood test.  test shows, high blood pressure or whatever.  does the test now cost 'extra'?

 

[matttyl]

correct.   'free' physical with routine blood test.  test shows, high blood pressure or whatever.  does the test now cost 'extra'?

The test doesn't, the treatment for what was found does.

 

[DA RAIDERS]

The test doesn't, the treatment for what was found does.

well that's totally normal.  wtf is this thread about then?

 

[Johnny Rock]

It sounds like some of you are anti-wellness visits. Which is fine, except they might find that painless lump on your left one, saving a million dollars in care, and very possibly your life. 

The great thing is that it saves the insurance company even more, because the insurance company is going to be paying 80% of that million dollar+ cancer bill after deductible. 

That's why they want us to get "free" physicals. So why not call that OTC vitamin D deficiency "diagnosis" an investment and call it good, mmmkay?

 

[belljr]

You think this is the norm? The surg I worked for 10 years spent his first years as a surg renting a small modest home with his wife and fam. He's quite specialised performing minimally invasive hip and knee replacements only and does very well for himself now, but it wasn't like that for a long while. He went to Harvard and Stanford. The amount of debt blew my mind. And if you have your own practice, which most are coming out of, you have high overhead.

I pay cash to see my oncologist because she went to a very good school, has tons of experience, is certified (most are not) and participates in research and clinical trials. I could have chosen the one that takes my insurance (the one who looked out of touch), but with something like cancer, it's worth my paying cash.

Don't know.  My neighbor that lived across the street. A spinal surgeon.  Left my neighborhood for a huge house in another town after he made partner.   Wife didn't work and they had a decent house and cars

Our family friend makes crazy coin.

 

[James Daulton]

I don't know what you'd consider "normal".  And of course it doesn't get paid off in one year.  Lots of professions require additional schooling, which has a cost.  Law school isn't free. 

The 167k number was for simply a family physician.  It was the second lowest paid type of doctor on that list in my link.  If you get into internal medicine the average is 182k, ER doc was $202k, and a radiologist (as many specialist docs) are close to $300k. 

So yeah, I'd love to get into the workforce in my mid 30s earning $200-300k a year (I have many clients who did just that) with almost $170k of low interest, tax deductible debt.  I mean, the average student debt (non-med school) is already over $37k.  So you're asking if I'd like to add $130k in additional debt to that, when the average starting salary of your basic college grad is only $50k?  You mean I can make an extra ~$150k-250k a year and only take on $130k in additional debt?  I'd consider that a no-brainer.

As for medical malpractice insurance, depends on what you feel is "expensive" - but most internal medicine docs pay around $5k a year in premiums.  Specialists and surgeons pay more, family practice type guys can pay less.  Some tort reform would obviously help.

I'm not sure which side you're on, but who should be more highly paid, physicians who literally can hold the life of loved ones in their hands, or Wall St. guys or lawyers or Rx salespeople?  Who really contributes more to society?  If anything, physicians are criminally underpaid.