OB Requiring delivery payment now?!?

wilburbud · May 2013

I just got a letter from my OB. Its a BILL for my delivery. Yeah. Im 5 weeks along. apparently, they arent getting paid by a lot of their patients, so now, they are requring that you make payments on your estimated delivery bill (they run your insurance) or they wont schedule subsuquent appointments.

Has ANYONE Else heard of this happening??

mben1119 · May 2013

This is becoming standard in many places.

NataliasMOM0214 · May 2013

I have never heard of this before in this particular instance, but I was formerly (now in Compliance) a Manager of a Special Investigations Unit for a healthcare insurance company, and this is what I would define as fraud. They cannot bill you for services that have not yet been rendered...that is illegal!

I would complain to the office and tell them they can be fined, AND penalized even further for charging their patients for services that aren't provided for MONTHS! and if they laugh you off or whatever, I'd definitely consider switching offices (and then I'd report them!)

That is insane!

AnchorsUp · May 2013

What happens if, God forbid, you miscarry? Do they send the payment back?

NataliasMOM0214 · May 2013

Exactly...it would be like pulling teeth to get your money back. and worst of all, your insurance company/healthcare provider couldn't help you b/c the dr. didn't defraud the insurance company, they defrauded the consumer! I guarantee you that no insurance company would pay for the delivery charges 8 months before the delivery...therefore, the patient cannot be held to different standards!

I have spoken!

leahraewku · May 2013

My practice doesn't bill this way, but my sister is due at the end of the month and has already forked over a few thousand dollars to her OB to cover her delivery charges.

rlyttle · May 2013

This is how mine was 3 years ago when I was pregnant with DS. It was about $500, but they broke it up into payments over my pregnancy. So it covered prenatal care & delivery. Don't get this confused with your actually hospital bills that you will receive after you stay in the hospital.

sarahharmintx · May 2013

mabenner1:
This is becoming standard in many places.

MY DD is 8 and it happened to me. My co-worker is due in July and has paid close to $2800 to her DR to cover her costs. Then there are about a billion other bills that come up after delivery (hospital, drugs, baby, etc). Its something Ive been saving for for a while now. I never got a bill in the mail, it was discussed and planned for at my first appointment.

I think you pay their fee up and if its more than your deductible the insurance takes over or something like that.

lollipoppoop · May 2013

Yes I will owe 431 four times for a total of 1722. I knew this was coming since my best friends have told me so I wasn't shocked.

PrimRoseMama · May 2013

Standard.

NataliasMOM0214 · May 2013

wow, I am so surprised that many women have gone through this before! Sadly, just because so many OBGYNs do this to their patients doesn't make it right, or legal. If every patient just pays without putting up a fight, none of them will change their ways.

I still don't think this is right (on many levels), but if you are comfortable with your physicians, then do as they request...

My physicians didn't do this when I gave birth 4 years ago, but knowing my luck, they recently have incorporated this into their practice....with my hormones, they better watch out! LOL.

earychener · May 2013

Yes, I have to do this as well. I believe it is becoming more of a standard. Lots of surgeries that are scheduled in advance require this type of payment, too.

They run your insurance, and then estimate your OOP cost and bill you for it. Trust me, if anything, they will under bill and you will still owe. I've never heard of them over-billing with this type of thing.

earychener · May 2013

NataliasMOM0214:
wow, I am so surprised that many women have gone through this before! Sadly, just because so many OBGYNs do this to their patients doesn't make it right, or legal. If every patient just pays without putting up a fight, none of them will change their ways.

I still don't think this is right (on many levels), but if you are comfortable with your physicians, then do as they request...

My physicians didn't do this when I gave birth 4 years ago, but knowing my luck, they recently have incorporated this into their practice....with my hormones, they better watch out! LOL.

They are not so much "billing" for the services. They are estimating your OOP cost and then having you pay that amount. In my OBGYN's office, it then goes into your "account" as a credit. This is then applied to the bill when they bill for it.

earychener · May 2013

NataliasMOM0214:
I have never heard of this before in this particular instance, but I was formerly (now in Compliance) a Manager of a Special Investigations Unit for a healthcare insurance company, and this is what I would define as fraud. They cannot bill you for services that have not yet been rendered...that is illegal!

I would complain to the office and tell them they can be fined, AND penalized even further for charging their patients for services that aren't provided for MONTHS! and if they laugh you off or whatever, I'd definitely consider switching offices (and then I'd report them!)

That is insane!

In my OB's office they do this as well. It isn't fraud because they aren't billing for services that aren't provided yet. They do global billing, so they are seeing you throughout your entire pregnancy and not getting paid until you deliver. They bill one time. They estimate your OOP based on your insurance, and you pay that amount to the office. It then goes into your account as a "credit". They do not bill for the services until you deliver. The only difference between my OB and the OP's is that they won't refuse service without payment. They just stipulate that if you do not pay within 10 days of delivery they will not allow you to return as a patient for the next pregnancy.

Kay6519 · May 2013

It's pretty stardard at most hospitals. They require you to pay their estimate of your delivery and post partum care costs before delivering. My OB even requires payment up front for any testing and operations (such as circumcision) before delivery.

artistlife · May 2013

NataliasMOM0214:

I have never heard of this before in this particular instance, but I was formerly (now in Compliance) a Manager of a Special Investigations Unit for a healthcare insurance company, and this is what I would define as fraud. They cannot bill you for services that have not yet been rendered...that is illegal!

I would complain to the office and tell them they can be fined, AND penalized even further for charging their patients for services that aren't provided for MONTHS! and if they laugh you off or whatever, I'd definitely consider switching offices (and then I'd report them!)

That is insane!

You may want to brush up on your consumer law. I worked in insurance for 6 years and this is my second child.

This is common practice. It is the same thing as any other company requiring a down payment before rendering goods or services. It is an esimate of your cost based on how much they would charge your insurance and how much your insurance will pay out. The money you pay in is then credited to your account. Watch your bills. Not everything is covered in the package price. For things that are covered my bill list them as non billable covered under maternity package. If it is not covered it will list it as billable.

I have had to pay OOP for a couple of blood test that weren't covered and part of my U/S because it cost more than the allowable charge for my insurance company.

NataliasMOM0214 · May 2013

earychener:
NataliasMOM0214:

I have never heard of this before in this particular instance, but I was formerly (now in Compliance) a Manager of a Special Investigations Unit for a healthcare insurance company, and this is what I would define as fraud. They cannot bill you for services that have not yet been rendered...that is illegal!

I would complain to the office and tell them they can be fined, AND penalized even further for charging their patients for services that aren't provided for MONTHS! and if they laugh you off or whatever, I'd definitely consider switching offices (and then I'd report them!)

That is insane!

I see what you are saying, and the differences here....it is just, from my background, viewed a little differently.

I'm still not a fan b/c I don't think you should be charged until each service is provided/rendered and completed, but if this is how things are done at many practices, can't do too much to change it!

Thanks for the information!

In my OB's office they do this as well. It isn't fraud because they aren't billing for services that aren't provided yet. They do global billing, so they are seeing you throughout your entire pregnancy and not getting paid until you deliver. They bill one time. They estimate your OOP based on your insurance, and you pay that amount to the office. It then goes into your account as a "credit". They do not bill for the services until you deliver. The only difference between my OB and the OP's is that they won't refuse service without payment. They just stipulate that if you do not pay within 10 days of delivery they will not allow you to return as a patient for the next pregnancy.

lashagu · May 2013

My doctor's office gave me a notice with the amount that my delivery will come up to and broke it down to several payments during the pregnancy; we still don't know if we'll do the payments because I have an HRA account so we might wait until we're close to the due date to see how much we have on that account and just pay the rest. I don't feel that is legal to require all the money for the delivery upfront and when you only have like 5 wks, at least I think they should wait until you're on the third trimester to start collecting something.

NataliasMOM0214 · May 2013

gardennymph:
NataliasMOM0214:

I have never heard of this before in this particular instance, but I was formerly (now in Compliance) a Manager of a Special Investigations Unit for a healthcare insurance company, and this is what I would define as fraud. They cannot bill you for services that have not yet been rendered...that is illegal!

I would complain to the office and tell them they can be fined, AND penalized even further for charging their patients for services that aren't provided for MONTHS! and if they laugh you off or whatever, I'd definitely consider switching offices (and then I'd report them!)

That is insane!

You may want to brush up on your consumer law. I worked in insurance for 6 years and this is my second child.

This is common practice. It is the same thing as any other company requiring a down payment before rendering goods or services. It is an esimate of your cost based on how much they would charge your insurance and how much your insurance will pay out. The money you pay in is then credited to your account. Watch your bills. Not everything is covered in the package price. For things that are covered my bill list them as non billable covered under maternity package. If it is not covered it will list it as billable.

I have had to pay OOP for a couple of blood test that weren't covered and part of my U/S because it cost more than the allowable charge for my insurance company.

Ok, I see what you are saying...it is just not something that I'm familiar, and in many ways, it is frowned upon.

and just b/c it is common practice, doesn't make it the right or best way to go about doing things.

The way it was first explained in the inital post was she was being charged for her delivery fees (as if it was from the hospital, and thousands of dollars), not a bundle of various fees incurred throughout the pregnancy...they are not the same thing.

Thank you all for the clarification b/c this really hit a nerve with me! I've seen some types of crazy health insurance fraud out there so I immediately go off the deep end!

rowanthefrog · May 2013

Most OBs charge what is called a "global delivery" charge, which is essentially one charge for all your OB visits and delivery, rolled into one. If your insurance doesn't cover it, then usually they bill you up front and you can make payments so you are paid in full by the end of your pregnancy. My dad is an OB and I worked as his office manager for a few years. You would be SHOCKED by how many people don't pay their bill, or just pay a few hundred dollars of the $1500-2000 that they owe. You can thank those people for the bill you are being handed now.

A

MAtoNC · May 2013

NataliasMOM0214:
I have never heard of this before in this particular instance, but I was formerly (now in Compliance) a Manager of a Special Investigations Unit for a healthcare insurance company, and this is what I would define as fraud. They cannot bill you for services that have not yet been rendered...that is illegal!

I would complain to the office and tell them they can be fined, AND penalized even further for charging their patients for services that aren't provided for MONTHS! and if they laugh you off or whatever, I'd definitely consider switching offices (and then I'd report them!)

That is insane!

It is common practice and known as the "global maternity fee." You pay the office in installments for your care which includes prenatal, labor and delivery, and postnatal. It should be noted that this fee just applies to uncomplicated pregnancy expenses and does not include things like diagnostic testing, c-section, etc. Those are all billed and covered separately.

By the way, they can only ask you to pay installments up to what you will have to pay out of pocket. So, for example, if your insurance will only make you pay $500 deductible for the whole thing, then that is what you will pay to the doctor's office. They can't charge you anymore for that TOTAL in their installment payments.

For the poster who asks what happens if you miscarry...the answer is "yes"--the fee is prorated and insurance is billed (and you pay your part) for the services that they have rendered up until your miscarriage (office visits, ultrasounds, etc). I found this out with my first miscarriage.

ETA: Oops, this is what I get for letting a post sit on my screen for a while. Looks like all of this was covered by others....

NataliasMOM0214 · May 2013

MAtoNC:
NataliasMOM0214:

I have never heard of this before in this particular instance, but I was formerly (now in Compliance) a Manager of a Special Investigations Unit for a healthcare insurance company, and this is what I would define as fraud. They cannot bill you for services that have not yet been rendered...that is illegal!

I would complain to the office and tell them they can be fined, AND penalized even further for charging their patients for services that aren't provided for MONTHS! and if they laugh you off or whatever, I'd definitely consider switching offices (and then I'd report them!)

That is insane!

It is common practice and known as the "global maternity fee." You pay the office in installments for your care which includes prenatal, labor and delivery, and postnatal. It should be noted that this fee just applies to uncomplicated pregnancy expenses and does not include things like diagnostic testing, c-section, etc. Those are all billed and covered separately.

By the way, they can only ask you to pay installments up to what you will have to pay out of pocket. So, for example, if your insurance will only make you pay $500 deductible for the whole thing, then that is what you will pay to the doctor's office. They can't charge you anymore for that TOTAL in their installment payments.

For the poster who asks what happens if you miscarry...the answer is "yes"--the fee is prorated and insurance is billed (and you pay your part) for the services that they have rendered up until your miscarriage (office visits, ultrasounds, etc). I found this out with my first miscarriage.

Thank you for this! It makes a great deal of more sense! Like I said, I've seen some crazy insurance/consumer billing fraud, and this just seemed to strike a nerve with me when I first read the post!

Thanks!

l5e3a2h4 · May 2013

Lurking.

I have made a payment every month since the first appointment. Although it's kind of irritating, I guess I'd rather pay it in small portions rather than one lump sum at the end. However, I'm not a fan of the "they wont schedule subsequent appointments" rule.. that just sounds crappy.

waTracy · May 2013

Wow. My OB is completely different. In fact, I only paid a copay for my first appointment and won't have to pay anything else till after I deliver. Happened the same with my daughter too. I feel weird that I'm one of the few on here that this is shocking too. Guess I only know what I know form my own experiences. I mean we do save and plan for this cost, and if it costs more this time around as my insurance is slightly different, I know we can do a payment plan after delivery.

stever · May 2013

It depends on your insurance. I had to make payments toward delivery at every appointment when I was pregnant with DS1.

AnchorsUp · May 2013

I'm on TriCare Standard and according to what I've read, all I owe is a co-pay at the time of the appointments. All maternity (prenatal, L&D, and postnatal) are covered.

HerbanMom · May 2013

This is pretty common, when I had DS2 it was referred to as a "Global Fee" for OB care, it would not include the actually hospital bill which was dealt with separately. They charge a certain fee for their services of taking care of you throughout your pregnancy, they will check your insurance and break your deductible down usually to be paid over the course of your appts and final payment due in full around 20-24 weeks.

I'm with a midwife this go around so it's certainly alot different. She works with her patients, insurance isn't covering anything so it's all out of pocket. There's a discount if you pay cash or are able to pay it all by a certain time or you can extend payments out throughout your 6 week PP visit.

And yes- if something were to happen and the pregnancy ends the practice does refund you. Oftentimes, the global fee assessed can also be more and they'll refund any difference after receiving payment from the insurance company. I had a friend whose OB actually refunded the ENTIRE fee because insurance ended up covering everything.

NataliasMOM0214 · May 2013

GhostMonkey:

waTracy:
Wow. My OB is completely different. In fact, I only paid a copay for my first appointment and won't have to pay anything else till after I deliver. Happened the same with my daughter too. I feel weird that I'm one of the few on here that this is shocking too. Guess I only know what I know form my own experiences. I mean we do save and plan for this cost, and if it costs more this time around as my insurance is slightly different, I know we can do a payment plan after delivery.

That has zero to do with your doctor and everything to do with your insurance coverage.

Christ, people really are this clueless aren't they? Even people that work in the effing industry have no idea what they are talking about. That is terrifying.

Please settle down...

the way this post was initially presented was as if the dr./hospital was charging for the delivery of the baby as she is only 5 weeks along, and this is considered 'fraud' to bill for services not rendered. I've seen similar instances occur, and the physician collects millions in fraud or abuse, and never reimburses the members (or insurance carriers) if the service does not occur. and when asked for medical records, they have nothing to show.

what has been further explained since in this post, is something totally different, and decided upon each individual practice.

Not what I consider to be the best practice, but as long as the dr. is providing the service to the patient, and the patient has a certain percentage to pay based on their coverage, that is appropriate.

Kfran84 · May 2013

LoisLayn23:
NataliasMOM0214:
Please settle down...
the way this post was initially presented was as if the dr./hospital was charging for the delivery of the baby as she is only 5 weeks along, and this is considered 'fraud' to bill for services not rendered. I've seen similar instances occur, and the physician collects millions in fraud or abuse, and never reimburses the members (or insurance carriers) if the service does not occur.  and when asked for medical records, they have nothing to show.

what has been further explained since in this post, is something totally different, and decided upon each individual practice. 

Not what I consider to be the best practice, but as long as the dr. is providing the service to the patient, and the patient has a certain percentage to pay based on their coverage, that is appropriate. 

The best practice is getting the patient to pay their bill, which after delivery, many do not. A shocking number of accounts get billed to bad debt and turned over to collections because they don't pay their deductible and OOP. We can't take that hit for every patient.

So yeah, we get a deposit on procedures based on their estimated liability, which is calculated by looking at their specific insurance plan and determining their deductible, coinsurance, and remaining OOP.

I don't mind this. I was going to pay eventually anyway so I really don't care about paying it all up front. They offered me several options, the only requirement was that it be paid up by the time you are 7 months along. The time value of money on the amount I paid is worth pennies in my savings account.

RobbyLexy&Binky · May 2013

I'm so happy I live in NYC where hospitals would NEVER try to pull this! When they suggest paying anything beforehand it is to work out a plan that provides the consumer with a greater discount. I have never been so happy I left middle America. If it is not illegal to require payment before making an appointment then it should be!