This entire post is born out of a recent frustrating experience we had with ProMedica, one of our local health systems. We had to go to a specialist and in the process he suggested we get 3 different tests done to eliminate possibilities. The tests were scheduled and we had a idea of the cost of them in our mind (and from doing some research). One of the tests was to be done at the office of a different specialist. While at the other specialists office, they did an additional test that we weren’t aware they would be doing. It’s their standard practice to perform the test on new patients.
When we received the bill later, there was a huge charge with a general description (it literally said “General” with the name of the department in the title). Turns out it was for this additional test they do for new patients. Before insurance, the test would have cost over $4600, and after insurance it still cost $2100.
We’ve went back and forth with them for a couple of months now, trying to explain the craziness of this situation, especially when the same procedure could have been done other places had we known we needed it, for a fraction of the cost. I’ve talked to multiple different people at ProMedica – some of them call you back, others you have to keep following up with and sometimes you still don’t receive a call back.
What I’ve Learned
Ask What Will Be Done
When scheduling the appointment, ask what they will be doing as part of the appointment. This will give you an idea of the procedures involved which will help with the next tip. If they can give you the procedure codes, it may make looking them up easier too.
If you’re talking to a scheduling person, they may not know the procedures that will be done. In which case, talk to someone in the office, perhaps even their billing person.
Ask About the Cost
I know, this may feel uncomfortable. You may say, “but the doctor said I need this, if I ask how much it costs, does that mean I don’t care about my or my loved one’s health?” No! Look at it this way. If you ask how much it’s because you’re budget conscious. If you need multiple procedures or tests, wouldn’t you rather spend less so you can get ALL of the ones you need done instead of only a few because you’ve spent too much on the first ones?
If the person you’re talking to can’t tell you the cost, then ask to talk to the person who can. I’d even suggest getting it in writing.
Insurance providers sometimes provide a cost tool that tells you all the providers in the area that can do the procedure or test and how much it costs to go to them. Find a lower cost provider, check their ratings on various sites, and then go there if it checks out.
If you can’t get pricing information from your insurance provider, then do a search online for other providers and call them to see what they charge.
When you arrive for the appointment, be sure to ask again what they will be doing and how much it will cost. I know this sounds crazy, but the best time to make sure you get the best price is before they charge you for it. You may even need to do what you would do when negotiating a large purchase, and walk away. I know that seems extreme, but it’s incredibly difficult to get them to do anything after the procedure is done. They have all the power at that point, and absolutely no reason to negotiate it afterwards.
An informed consumer, is a dangerous consumer – dangerous for those selling the goods and services. Healthcare is no longer competitive because we tend to believe that “if it’s for my health, how can I say no?” However, it’s that kind of thinking that causes us to overpay and not question it, which allows healthcare systems to build bigger hospitals, fancier office buildings, while neglecting customer service.