Tips from patient advocate doctors
Medical bills come as a shock to many. Some simple examples/information may help.
An echocardiogram, an ultrasound of heart, in a doctor's office is half the price of the same test in a hospital's department. The same holds true for many ultrasound and other tests. The high overhead of the hospitals can be avoided.
A chest X-ray in an urgent care center can cost you up to $250, but not in non-urgent setting. Why? The place of service makes a difference in approved charges.
Some testing such as urine tests ordered by the doctor may cost a fortune. Ask the doctor if all the tests are really necessary at that time and if you can get the tests done in steps and only when necessary.
In-network services should be cheaper than out-of-network services is a reasonable assumption. But it is not always true. Sometimes an MRI in an independent facility not participating with the network can have a total charge less than the patient's portion to be paid for the same service in an in-network facility. Lesson: Do the price comparison.
Getting completely put out is a common desire for a colonoscopy procedure. If this means about $1,500 of additional charge by the anesthesia personnel, then you may want to rethink about 'getting completely put out'. Routinely, a colonoscopy can be done with 'moderate sedation' in almost painless fashion by an experienced gastroenterologist in more than 90% of the patients. If you do not meet the criteria set by your insurance for anesthesia service during a colonoscopy, then the whole payment has to be made by you.
Some inexpensive medicines are very good and effective compared to very expensive new medicines. Pharmaceutical companies incur expenses to develop a new medicine and would like the consumer to pay for it in some way over a period of time. It does not mean that the new medicine is better than the older one. For example, Metformin is a very cheap medicine for diabetes. But some of newer medicines for diabetes are twice or more expensive and are not more effective than Metformin. Many new medicines get approved by FDA after proving 'non-inferiority'. What is 'non-inferiority'? It means that the new medicine at least as effective as the medicine it is being compared with.