2nd Trimester

Rant! Outrageous U/S Bill

So! I have a low lying placenta and our baby has a possible bowel obstruction. I say possible but my OB says it is only a 5% chance. Still they wanted me to have my ultrasounds done at a perinatal center. That is fine! I had the same with my first daughter. But I just got the EOB from the practice that read the ultrasound and bills for the special doctor that reads it on site. They billed over $800 and my insurance allowed $700! That is just for the reading!! That doesn't include the facility and technician charge billed by the hospital!! I called the payor and pricer for my insurance and they say the allowed amount is in line with the contract rates with that clinic/provider. I am supposed to have these ultrasounds every few weeks until my due date. I cancelled all future ones and will be discussing my options with my doctor. I cannot believe that they can charge so much for less than 30 minutes worth of work!  I am beyond furious!! End vent!

Re: Rant! Outrageous U/S Bill

  • jessib10jessib10 member
    edited October 2013
    They allowed $700, but what did they apply to your responsibility? Did you have a coinsurance? Or copay? or deductible?

    Edited to correct auto correcting crazy.
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  • My responsibility is $333. It is deductible and coinsurance. The doctor that read the u/s billed for a 30 minute consult! I wasn't even in the office for 30 minutes!! I talked to everyone including their office and they are standing by the 30 minute consult because the doctor wrote a letter to my ob!!
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  • Oh also wanted to say unless the ultrasound was performed at the hospital there will be no facility bill. If a doctor performs services in their office their charges are inclusive to that.
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  • OMG. I would never be able to afford that on an ongoing basis. That is terrible. Can you get on a payment plan?

    I cannot stress how important it is for people to be familiar with their insurance to try to avoid situations like this. It can be expensive. She likely has a PPO, I wonder if the perinatologist she was referred to was in/out of network and if she might be able to get a cheaper rate elsewhere, or if maybe the insurance processed it incorrectly if it should be inclusive her any prenatal services. :( hopefully she'll get the prenatal services she needs and be able to square away the insurance issues she's having.
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  • I don't have any maternity coverage at all, so $400+ bills for u/s and bloodwork are the norm for me.  If you're responsible for $300 or so, you can probably get a payment plan.
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  • Was in a similar situation with my first trimester screen which was a fortune. I also have to get an additional u/s due to a low lying placenta. Fortunately this all goes towards dedictible but its frustrating.

    I would see of they are willing to work with you on payment plan or lowered amount. I asked the company who billed me of they woild give me a discount for paying in one lump sum, and they brought my $1100 bill to $800. I was able to use my HSA.
  • When I went for my 12 week nuchal translucency scan I was expecting a $50.00 copy (the specialist rate) but it ended up being a $100.00 copay for the visit and ultrasound.  Even the doctor was surprised.

     

    I hate my new insurance.  With DS, I had Cigna and I paid almost nothing out of pocket for my entire pregnancy.  I may have had a $20-30 co-pay for the specialist. 

     

    Nothing makes me more cranky than dealing with insurance companies at this point.

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  • I am fully aware of my insurance coverage. I have a 80/20 with a $250 deductible. (deductible met) The problem is that we have union insurance and they use Healthlink as a pricer. When I asked our union welfare fund rep how we would know that Healthlink is using correct contractual pricing she said, and I quote, "We kind of have to go on a blind faith here."!! When I pulled the eobs from when I had these same ultrasounds with my daughter the allowables were far lower. To top all of this off my bun in the oven now has an irregular heartbeat. Which means more ultrasounds. Also another bonus of my healthplan is that it is grandfathered. That means that until they make a change to the plan we have to pay for preventive care. Kinda wish I could just worry about being prego!
  • You don't have to go on blind faith. You can call health link and request that they review the pricing for you. Also I would make sure that it was processed at the in network rate. They may be using an outside pricing company if it is an out of network provider. On which case maybe you can be referred to another doctor in network. Let me know if you have more questions/concerns. :) I'm a medical biller and don't mind helping at all.
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  • Actually-if it's for a H&WF they probably always use healthlink to price claims. Unless they use several and go with the best price... Either way you should be able to get the claim reviewed to ensure it was prices properly based off what was billed.
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  • I have maternity insurance and have had two ultrasounds, both times I was billed around $400 per visit. That suckssssssssssssssssssssssssss.
    3 early losses in 2013, but so thankful that our first baby boy is due 3/29/14! <3

    Maximilian Hunt
    Born 3/19/14  //  7lbs 7oz  // 20.25in
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  • Soap1 said:
    I don't have any maternity coverage at all, so $400+ bills for u/s and bloodwork are the norm for me.  If you're responsible for $300 or so, you can probably get a payment plan.
    Ditto.  Everything except a few blood tests and my midwife visits has been out of pocket for us.  You think $300 is bad?  Try a $1500 ultrasound.

    Iris born Halloween 2013! 6 lbs, 1 oz, 18 inches long

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  • I just had a nt scan and other tests. The MFM charged insur 2500!!! 700 is out of my pocket!
    1st loss 8/31
    2nd pregnancy -TWINS lost DD1 twin at 8 weeks 6 days DD1 born 6 weeks early
    3rd pregnancy- TWINS AGAIN lost both babies at 9 week appt
    4th pregnancy- singleton- born at 38 weeks 1 day with the help of weekly 17P injections
    5th pregnancy- CP in June
    6th pregnancy It's a BOY


  • My NT scan was billed at 825 with an MFM but inonly have to pay $25 out of pocket. Sounds like it has to do with your actual OOP limits and not the original bill
  • Ummm, welcome to American Healthcare? You should always check EVERYTHING with your insurance carrier prior to, for coverage. Never trust them to just cover everything. Like I said, this is America. (Unless you aren't in the US, to that I say "welcome to healthcare". )
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  • You do not have to go on "blind faith"! How crazy for you to be told that. Always check benefits prior to getting the service.
  • Wow American health care is crazy. I am in Ireland and everything pregnancy related is free even your doctors, this includes after birth visits and child developmental tests. Don't know how ye put up with such bad treatment ye don't even get decent maternity leave or holiday leave it. European standards are much better.
  • Topsy21 said:
    Wow American health care is crazy. I am in Ireland and everything pregnancy related is free even your doctors, this includes after birth visits and child developmental tests. Don't know how ye put up with such bad treatment ye don't even get decent maternity leave or holiday leave it. European standards are much better.
    It's not free, it's paid for in taxes.
    Thank you. I was thinking the same thing. I'm grateful not to have to deal with this crap in Canada but it sure as hell does not come free.

    Sorry OP, I have no idea what to tell you but I am sorry so many of you have to worry about this kind of thing!
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  • I don't think we have bad medical here in America. I think we have some of the best!
    I don't want socialized medicine, which is what it looks like we are turning into.
    It's sad that doctors can't treat patients due to insurance not covering procedures or not allowing procedures.
    1st loss 8/31
    2nd pregnancy -TWINS lost DD1 twin at 8 weeks 6 days DD1 born 6 weeks early
    3rd pregnancy- TWINS AGAIN lost both babies at 9 week appt
    4th pregnancy- singleton- born at 38 weeks 1 day with the help of weekly 17P injections
    5th pregnancy- CP in June
    6th pregnancy It's a BOY


  • Topsy21 said:

    Wow American health care is crazy. I am in Ireland and everything pregnancy related is free even your doctors, this includes after birth visits and child developmental tests. Don't know how ye put up with such bad treatment ye don't even get decent maternity leave or holiday leave it. European standards are much better.

    Thanks for rubbing it in.
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  • I don't think we have bad medical here in America. I think we have some of the best!
    I don't want socialized medicine
    , which is what it looks like we are turning into.
    It's sad that doctors can't treat patients due to insurance not covering procedures or not allowing procedures.

    Guess what doesn't happen in countries with socialized health care?

    I don't want to hijack this thread so I'm done after this comment but I do want to say that being in Canada and being used to universal, public health care, I have a really hard time understanding why so many Americans are afraid of it. I'm happy to admit that it's not a perfect system, I have been frustrated by some of its limitations myself, but I would not trade it for the BS you all have to deal with when it comes to insurance, billing, etc. I may pay taxes out the wazoo for it but I like being able to see a doctor or have something done at the hospital and not having to worry about how much it's going to cost, whether someone is in network or not, whether a procedure will be coded right for insurance to cover it, or whatever. What exactly is so wrong with that? I don't get it.


    @spacepotatoes I think I love you.

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  • Oh relax! And before you say it I pay the highest band of taxes! But I also have been at the other end of the scale which is why I realise the importance of it!
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