1st Trimester

How does your ob bill?

I just got a call from my doctor's office to let me know how much my monthly payments are for the next 5 months, so that everything for the doctor is paid by month 6.  They didn't mention this at my first appointment.  Is this typical? 
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Re: How does your ob bill?

  • They bill my insurance - whatever isn't covered, I get a bill in the mail for the balance.
  • Are you uninsured and paying everything out of pocket?

    For me I just pay my copays and then the hospital will bill me what my insurance doesn't cover of the delivery costs after the birth. 


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  • image Gina418:
    They bill my insurance - whatever isn't covered, I get a bill in the mail for the balance.

    Me too.

    OP- are you going through insurance? That sounds like a common arrangement for an out of pocket, flat fee situation. Otherwise, it sounds weird to me.

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  • They bill insurance, then I get to pay what's left. I am very thankful for insurance!
  • image Gina418:
    They bill my insurance - whatever isn't covered, I get a bill in the mail for the balance.

    This is how I thought it should happen but they figure out what they bill and then what my insurance covers and want me to have everything paid off by the 6th month.  I don't want to pay more than I owe in 2010 because I was planning to use my 2011 FSA money for most of this. 

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  • image Birdies08:

    image Gina418:
    They bill my insurance - whatever isn't covered, I get a bill in the mail for the balance.

    Me too.

    OP- are you going through insurance? That sounds like a common arrangement for an out of pocket, flat fee situation. Otherwise, it sounds weird to me.

    My insurance covers 80%.

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  • When I have the baby my insurance copay for the hospital stay is $100 per day, if I have to stay more than 5 days then the rest of the stay is covered 100%.  The hospital will bill me, I don't pay my OB directly.
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  • Our birth center has a global fee that includes all prenatal and birth-related costs.  Because they're in-network, we're only responsible for our deductible (mine is $750) plus one co-pay, and the rest is paid by insurance.  Of the deductible, $500 is due at the first prenatal appointment and the remainder is due by week 36.  The co-pay is paid at the first prenatal appointment.
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  • This must be your deductible for your Hosp. insurance. I have a $500 deductible I have to pay over the next few months. Check with your insurance company and they can provide all the details for your plan.
  • image waterfall11:

    image Gina418:
    They bill my insurance - whatever isn't covered, I get a bill in the mail for the balance.

    This is how I thought it should happen but they figure out what they bill and then what my insurance covers and want me to have everything paid off by the 6th month.  I don't want to pay more than I owe in 2010 because I was planning to use my 2011 FSA money for most of this. 

    How could they know what they're going to bill you for before it happens? That sounds really sketchy to me. I would tell them you aren't comfortable with that billing arrangement, and maybe get your insurance involved (if necessary).

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  • image Birdies08:
    image waterfall11:

    image Gina418:
    They bill my insurance - whatever isn't covered, I get a bill in the mail for the balance.

    This is how I thought it should happen but they figure out what they bill and then what my insurance covers and want me to have everything paid off by the 6th month.  I don't want to pay more than I owe in 2010 because I was planning to use my 2011 FSA money for most of this. 

    How could they know what they're going to bill you for before it happens? That sounds really sketchy to me. I would tell them you aren't comfortable with that billing arrangement, and maybe get your insurance involved (if necessary).

    My guess is they use their average cost for patients.  They said I would be refunded if anything is overpaid or billed if there are additional charges not covered by insurance.  I'm sure they are tired of chasing down patients for payments (I own a business and understand how that is) but I shouldn't have to pay now because of a handful of people who evade them. 

    I am going to fight this.  A couple years ago I had sinus surgery and was quoted $2,100 oop.  It ended up costing me $700 oop.  I would have been really upset if I had paid that extra $1,400 up front. 

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  • image waterfall11:

    image Gina418:
    They bill my insurance - whatever isn't covered, I get a bill in the mail for the balance.

    This is how I thought it should happen but they figure out what they bill and then what my insurance covers and want me to have everything paid off by the 6th month.  I don't want to pay more than I owe in 2010 because I was planning to use my 2011 FSA money for most of this. 

    I'd bring this up. Also, if your plan has a yearly out-of-pocket max and you are using your plan for other services (which assist in meeting any yearly deductable you have), they really don't know how much you'll owe them and I doubt they'll be keeping track to the point where they would refund you. You pay more until your deductable is met. Once it met - you pay less. They can't keep track of that - only your insurrance company can.

     
  • image waterfall11:

    My guess is they use their average cost for patients.  They said I would be refunded if anything is overpaid or billed if there are additional charges not covered by insurance.  I'm sure they are tired of chasing down patients for payments (I own a business and understand how that is) but I shouldn't have to pay now because of a handful of people who evade them. 

    I am going to fight this.  A couple years ago I had sinus surgery and was quoted $2,100 oop.  It ended up costing me $700 oop.  I would have been really upset if I had paid that extra $1,400 up front. 

    Yeah, I would not trust the accuracy or timeliness of a refund. GL talking with them!

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  • this is how my old doctor did it for DS. Whatever ended up being out of pocket, they divided up to monthly payments. I mentioned this in another post, but just double check what you are "pre-paying" for. Mine was for all my appointments through the entire pregnancy and my doctor delivering the baby. However, I had to have an on-call doctor that for some reason wasn't billed under their practice and I got a second bill from him for delivery. I had to fight for months with my doctor to get money back since one, I was two weeks early and had pre-paid for 2 appointments that didn't happen, and two pre-paid ALOT for my doctor doing the delivery which didn't happen. DH and I made sure at our new doctors that whoever delivers is still billed under the group and what happens if we are early...
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  • image babywing:
    this is how my old doctor did it for DS. Whatever ended up being out of pocket, they divided up to monthly payments. I mentioned this in another post, but just double check what you are "pre-paying" for. Mine was for all my appointments through the entire pregnancy and my doctor delivering the baby. However, I had to have an on-call doctor that for some reason wasn't billed under their practice and I got a second bill from him for delivery. I had to fight for months with my doctor to get money back since one, I was two weeks early and had pre-paid for 2 appointments that didn't happen, and two pre-paid ALOT for my doctor doing the delivery which didn't happen. DH and I made sure at our new doctors that whoever delivers is still billed under the group and what happens if we are early...

     Are you prepaying with your new doctor as well?  I have had several horrible experiences with doctors' billing departments.  I know either way I will be dealing with them, but I would rather be paying (and having any adjustments that need to be made done) than trying to get my money back. 

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  • This is also how my OB bills.  I have to pay a specified amont at each of my 5 monthly visits until paid in full.  All visits are included in this amount up to 2-4 weeks after the baby is born.  It is extra for hospital bill and tests performed which are required to be sent offsite.  I feel like i'm always getting another bill in the mail...ahhhhh
  • My OB does this also. I have 5 monthly payments that are for all appointments, regular tests and delivery. (after my deductable). I kind of like it, because I have baby paid for before he/she is even here.  With DS I was early and got a refund check for one appointment about a month after he was born. I wouldn't have even thought about asking for that money back, they sent it all on their own.
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  • Yes. This is normal. They write up your OB budget plan based on your current health insurance, which shows them (and you) what your total out the door cost will be to have the baby (and everything leading up). They then make you pay monthly until it is paid off. I hate this for a few reasons.. one main reason being what if your insurance changes? I am due in May. Open enrollment is February. I am changing to a HMO.

      but yeah, it is normal. My payments are $450.

  • image waterfall11:

    image babywing:
    this is how my old doctor did it for DS. Whatever ended up being out of pocket, they divided up to monthly payments. I mentioned this in another post, but just double check what you are "pre-paying" for. Mine was for all my appointments through the entire pregnancy and my doctor delivering the baby. However, I had to have an on-call doctor that for some reason wasn't billed under their practice and I got a second bill from him for delivery. I had to fight for months with my doctor to get money back since one, I was two weeks early and had pre-paid for 2 appointments that didn't happen, and two pre-paid ALOT for my doctor doing the delivery which didn't happen. DH and I made sure at our new doctors that whoever delivers is still billed under the group and what happens if we are early...

     Are you prepaying with your new doctor as well?  I have had several horrible experiences with doctors' billing departments.  I know either way I will be dealing with them, but I would rather be paying (and having any adjustments that need to be made done) than trying to get my money back. 

    I have to talk to them. I'm in a different situation this time. I had surgery in January so I've met my deductible and owe nothing for the rest of the year but my co-pay. In theory, if they "pre-bill" be what they think it will cost through June,  I'd owe nothing. I'm not sure if they could do this. Before all this, DH and I had said if we were with the same doctor from before, we wouldn't. We'd just pay each copay and each visit as it went through insurance. It's not saving us anything by pre-paying and in the end cost us extra.

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  • I pay my taxes to the government and my doctors send the bill to them :)

    I love Canada.

  • I got a bill after my first appointment for my estimated cost of delivery AFTER my insurance. It was about $900 and had to be paid by week 24. The worst part about this aside from the SHOCK was that my FSA won't release my funds since it's a procedure that hasn't taken place yet and my baby is due in March, therefore starting a new year and the $1300 in my FSA will be GONE to the Government. I'm still quite upset over the whole ordeal. At least we were able to pay it.

    It's good that they gave you a payment schedule, I tried asking several times for one and got blown off every time. Aside from my rant (sorry) the simple answer, from what I understand from everyone I've talked to is that yes, this is normal....unfortunately !!

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  • That actually sounds a lot like mine.  The way mine bills is that they determine approximately what my total payment just for the OB will be (not the hospital, etc.), based on what my deductible is and what the percentage breakdown is after the deductible is met (for us, it's 80% / 20% after deductible is met...our portion being the 20%).  Once that amount was determined, they divided it by 6, so that we would have 6 monthly payments, which makes paying the doc more manageable.  They do not actually bill the insurance until after the baby's birth because you never know when your baby may come (early...late), or what the final cost for the doctor may be, depending on if the deductible is in fact met, etc., so to bill the insurance now would be premature.  This is fortunate for us because we're due 1/25/11...if they were billing all along the way, we'd have virtually nothing built up toward our deductible in the new year.  This way, though, it will look (for insurance purposes) as if all services were incurred in January 2011, so our deductible will already be met for the year after the birth...yea!  Hope that helps to answer your question at least a little...even if just to provide a direction of inquiry for you at your OB's billing department.  Good luck!  Smile
  • Pre and post natal care plus my hospital stay are covered under one copay ($150) that is charged after delivery.
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  • It depends on your insurance status.  Most OB's have a flat fee for all pregnancy related services (to a point).  Mine bill $5200 for all prenatal appointments and up to 3 ultrasounds.  If you have insurance, you would be responsible for meeting your deductible/ copays.  Our deductible is $3000, so we pay $500 a month until our deductible is met (through this or any other medical service).  If you're unsure call your doctor's office and ask to speak to the insurance or billing department.  You don't want to overpay because it can be very difficult to get that money back.
  • I got a bill shortly after my 1st prenatal appointment.  It detailed my monthly payments for the next 4 months, so I would be paid in full by week 28.  I asked around, and this is very common.  The bright side is we won't have to worry about the money after the baby is born!  Oh, and I do have insurance - very good insurance. 
  • I am 36 weeks pregnant. At my first appt, I paid my normal co-pay. After that, my dr doesn't charge me until the baby is born. Her office does the universal billing. They will send my insurance company the charges and they pay their portion and I am sent the bill for the rest. This is just office visits. As far as my hospital stay, the birth of the baby, and such, the hospital sends my insurance company the charges, what they do not pay, I pay. I can set up a payment plan that I can afford with both, dr and hospital.
  • This is why I love my Kaiser HMO. No copay, no deductible, no money out of pocket. It costs me $0 for my appointments, $0 for my hospital stay, $0 for labor/delivery, $0 for my child's first 24 months of well baby visits. And my first two children were delivered by a wonderful midwife. Very happy with my experience.
  • I would find a new doctor. I have never heard of this if you have insurance. Anyway, you should not have to pay for services BEFORE you even receive them. I would suspect some type of insurance fraud.
  • I don't think it's unsual at all.  Most of the doctors in my area bill exactly like this.  They have a flat rate for all costs involved with a pregnancy, they figure your insurance and bill you monthly through your pregnancy.  Mine charges $3800 for a c-section with all visits included.  The doctor will bill seperately from the hospital.  

    We have a $2800 deductible and the company pays $1000 of that, after it is met we pay 80%.  Then I have secondary insurance that will pay everything to the hospital my primary does not.

    If your concern is your flex plan I would have a talk with them, I'm sure they should be able to work something out.  That was my concern and we worked out seperate payments for this year and next to not effect it.

  • Never heard of such a thing.  What if you switch OBs?  What if you move?  What if something happens and you don't make it to delivery?  You will never see the money again.  I'd talk to my insurance company and or find another practice.
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