Pediatricians

persephonerose

MH and I have been compiling a list of possible pediatricians we would be interested in interviewing before our first child arrives. Most seem to have some standard extra fees for certain services such as after hours help, no show fees, ect.

But one place that was recommended to us actually charges an Annual fee to every patient on a per child bases in addition to the fee for after hours help. I was a bit taken back by this. The fee is not a lot of money, around 135.00 per year per child. One of their reasons for the fee is that they have an onsite lab for blood work and an X-ray department. The other reason is that they blame insurance for not paying enough of a percentage for office visits/labs/x-rays.

Part of me feels like it might be worth it to pay the fee to have the services of the lab and x-ray onsite.

However, another part of me is annoyed by the annual fee. They have to negotiate their contract with the insurance companies, therefore they accept the terms and amounts. This means to me they should be able to plan their office budget accordingly.  If they haven't planned for these extra services then it makes me wonder how poorly the rest of the office runs. 

So as a new mom I would have to pay the annual fee, after hours fees (which I am sure I will use a lot being a FTM), and every copay as well as the other 20% for labs/x-rays not covered by my insurance if I want to use this particular Pediatricians office. 

So my questions.

Would you guys be willing to pay an annual fee for the having the lab and x-rays onsite?

Is this normal? Do a lot of pediatricians charge annual fees? 

General Opinions?

 

azzyberry

No. I think that's ridiculous. I have never heard of any physicians office doing this and I worked in the medical field for 10 yrs before I became a SAHM.

stdldb29

No, I would not pay that. My DD is 2 and has only been to her pedi for well checks. She has never been for anything else, I would be pretty ticked that I had to pay that much for nothing.

DS hasn't been to the pedi in the past 3 years, there is no way I would pay that for him either.

That is not normal where I live... 

violaplayer

No, I wouldn't pay that and it isn't common at all. 

IrishEyes0530

I wouldn't pay that. I've never heard of that and it seems crazy to me. I shell out enough for Dr visits, there's no way I'd pay an annual fee.

laurakaz13

I have worked in healthcare for years and have never heard of a fee of this sort. 

HenHen25

My pedi's office has onsite lab work and pharmacy but doesn't charge those kinds of fees. That is 100 percent ridiculous and there is no way I would go. None. What happens when you have 2-3 children? That's a lot of money to pay for services that you will very rarely need.  

penguingrrl

That sounds like they're switching to a concierge style practice. The theory is that the annual fee helps offset costs so they can lower their patient load and give a higher quality of care to each patient. Yes, they should try to determine their costs based on what insurance reimburses, but the insurance reimbursement is often pitifully low (ever examine your explanation of benefits; sometimes the amount our insurance covers is a joke) and that would mean no nurses, no front desk staff, etc. I remember seeing what my insurance paid the anesthesiologist for my c-section delivery and my sister (who works in operating rooms and knows costs) said it wouldn't have covered the drugs he used, let alone giving him an income or covering an office staff. He billed $4,000 and was paid $200.

I personally have not switched to a concierge service because it's not something we can afford to do, but if I had the money and knew we would get a higher level of service for it I would in a heartbeat. I'm tired of myself and my children feeling like numbers with no name.

klondikebar

No, I wouldn't pay that. None of my children have ever needed an xray yet or lab work and my oldest is a teenager. If my child had a condition that required those services for frequent monitoring, I might consider it.

Also, my rheumatologist has xray and lab in office and I'm not charged extra.

nosoup4u

I've never heard of an office charging an annual fee before. Lab work and X-ray have never been a big deal to do somewhere else (our current doctor's office has a third-party lab in the same building). If you really love the place and can afford it, why not? Though I've switched doctor's offices a lot, and would be pissed to pay $135, and then finfd out the office wasn't a good fit for my kids...

persephonerose

Thank you all for your input.  I went back and looked at their website after a few people mentioned that this might be a tool to lighten their patient load. I wanted to see if this was mentioned any where in their FAQ. Unfortunately the answer to almost every question in their FAQ regarding the Annual Fee places the blame on insurance companies.  I get it, a lot of insurance companies are paying pennies on the dollar and its hard for practices to make profit.

I think I will just have to go with my first gut reaction that this type of practice is not for me. I feel like they want to nickle and dime me more than some of the other practices I've talked to.  And I get the general impression that this practice is really worried about money, I don't want to take my child some where that they are so openly stressed/focused on how my insurance company is going to shaft them each visit. If that makes sense.

I think I could understand the fee more if like some people mentioned it made it so that the doctors have more time to focus on individual patients or if the fee offset things like cost for after hours phone calls or paper work fees, but the Annual fee doesn't include anything other than the privilege of having the lab and x-ray onsite. 

Once again, thanks for all the help. Being a FTM I never thought it would be so difficult to find a pediatrician. 

MrsSR

Not normal and crazy, IMO.

WTH is an after hours fee?  Really?  Our pedi always jokes that the first 50 or so thousand questions are free. 

ATMmom324

That sounds crazy.  I would keep looking elsewhere.  

persephonerose

The after hours fee is for calls to the doctor after hours. Quite a number of Pediatricians here charge a fee if you call the on call doctor. It ranges from 35.00 to 50.00 per after hour call from what I have seen so far.

smerka

Our ped just started charging the after hours fee.  It's for appt. after normal business hours (9-5).  Our insurance picks up the difference.  We usually go for well checks in the evening so DH can come and I don't have to wrangle both kids by myself.  

esthergreenwood14

The only fee that my Pedi charges is a missed appointment fee. Anything else is included. I have never heard of such a thing and would not be paying it. 

ppants

I'm a nuclear medicine tech and also registered in x-ray. I don't know about your state licensure for these types of professionals, but if no license is required, it could be a person off the street taking xrays. Before my state had a state license requirement, I saw many films from offices that could have decreased the patient's radiation exposure, weren't marked properly, etc. Also, as auntie stated, you want a radiologist reading films. Kids images can be more difficult to read anyway. The fees are crazy IMO.

MonkeySender

persephonerose:

The after hours fee is for calls to the doctor after hours. Quite a number of Pediatricians here charge a fee if you call the on call doctor. It ranges from 35.00 to 50.00 per after hour call from what I have seen so far.

This is crazy to me, too. I know the office we go to does charge more for Saturday appointments, but they never charge for phone calls.  And I believe it is only a little extra, no where near $50.

kendra223

That is ridiculous! What is that 135.00 a year per patient going towards exactly? I couldn't care less about on site x-rays. If I need one for LO (which I have), I just go to the hospital... it's not that far of a drive lol! I'd rather use a little bit of gas than pay 135 a year extra. And I can call my Pedi's office after hours for no fees, they always have a nurse line available.

The way I found my daughter's pedi was I got a list of pedis from my doctor. He highlighted the ones he knew/recommended. I started calling their offices. The ones who never picked up and/or had inconvienent hours, I said screw it. No one ever said anything about fees, but if they did, I would have definetly said no.

numeria11

MonkeySender:

persephonerose:

The after hours fee is for calls to the doctor after hours. Quite a number of Pediatricians here charge a fee if you call the on call doctor. It ranges from 35.00 to 50.00 per after hour call from what I have seen so far.

This is crazy to me, too. I know the office we go to does charge more for Saturday appointments, but they never charge for phone calls.  And I believe it is only a little extra, no where near $50.

Ours is 25 for a call after 7pm on the weekedays, after 3 on Saturdays or Sundays.  However the trade off is my pedi office has a huge staff of docs and NPs so they can stay open til 7-8 three nights during the week and now have weekend hours at 2 of their offices (they have 3) so I'm fine with paying after hourse fee knowing the likelihood of actually needing it is low.   I think we've paid one 2 times, both times when DD had croup.

 And OP no way would I pay that fee when as others said their charges for performing those services may not actually get paid by your insurance and may entirely fall on you since many insurance companies require a specfic lab to do the testing.  GL I know it seems overwhelming but once you find a good one hopefully you wont have to do this again until you move someday.