Paying fees to OB above and beyond global fee?

bobbydsgirl · April 2009

Hi -

I wanted to benchmark my OB's fee structure with some others on this board. His global fee is $3400, which seems to me to be in the normal range, but *in addition to my portion of this fee* he is estimating that I will owe him $800 more (it would be part of my deductible so it will be out of pocket) for services that he does not include in the global fee, which include fees for ultrasounds among other services (not really sure what else because the estimate of patient responsibility was not itemized).

I am not high-risk - just a normal pregnancy.

I just wanted to know if these additional fees are normal or if most other doctors roll most typical prenatal services into the global fee and if I am being overcharged.

Thanks!

Pennylane824 · April 2009

I don't know a whole lot about insurance by my office gave me one price for vaginal and one price for c-section. This included all care (ultrasounds and all) up until the delivery. I have a $500 deductible and owe 10% after that which ends up being about $750 for vaginal. This does not include the epidural or hospital.

amor133 · April 2009

I'm not sure what the standard fees are but just make sure that everything he bills you, he puts through insurance first!!! This is really important. All doctors are paid on a fee schedule which is based on a lot of factors including their location. A doctor in a big city would be paid more than a doctor in a smaller town. Once the doctor bills the insurance company you will receive an explanation of benefits from them that will indicate how much you are responsible for!

DanielsWife · April 2009

Ours is set up differently, with lifetime medical benefits limits (I think it is up to 5 million), so between PPO agreements, things being applied to benefits, etc., so far, I'm only paying my $1000 deductible, and if anything is extra, it is due to the few out-of-network docs in the office - but there are agreements in place there to reduce the charge as well.

chiromommyMichelle · April 2009

At my OB's office, ultrasound and lab fees are separate from the doctor's fee. Be sure that all feeds are billed through your insurance first, and be sure that no one is trying to balance bill you if they are in network with your carrier. When they commit to be a provider, they agree to take the negotiated amount for the services, and cannot charge you the difference.

bobbydsgirl · April 2009

Thanks for sharing your info. I put a call into the billing person at the office and she explained that the discrepancy was because they were collecting my deductible (I thought that the hospital bill would pick up the deductible portion). But she said that they submit the bill more quickly than the hospital and thus my insurance applies the deductible to their bill. That's fine with me - it all adds up to the same out of pocket expense in the end so it doesn't really matter where it goes. Smile

cstw · April 2009

This is very similar to mine. My portion of $2,800 for v-birth, $3,400 for C + any ultrasound payments not covered by ins and in addition to my hospital charges, etc.

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