When patients schedule routine doctor’s appointments for check-ups or consults, they usually get charged pre-determined fees. If you go to your primary care physician, for example, chances are you have a flat co-pay amount. The same probably goes for visits to the dentist or dermatologist, where the medical debt collection process is generally cut and dry, with specialists charging set fees for treatments such as root canals, fillings, or chemical peels.
For hospital or surgery center procedures requiring anesthesia, however, billing rates can vary greatly, as final payment amounts have to cover additional staff services and facility fees.
According to a recent New York Times article, one Sag Harbor, N.Y. couple learned this lesson the hard way after undergoing colonoscopies. While each patient was careful to select a gastroenterologist covered under their insurance plan, in both cases the doctor opted for full anesthesia, which happened to be administered by an out-of-network anesthesiologist. The couple, of course, was billed for the anesthesiologist’s services and is now having to deal with a debt collection agency due to thousands of dollars in unforeseen charges.
The frustrating part for patients in similar situations is that doctors often adopt more costly practices that aren’t always necessary. For colonoscopies, for example, several notable gastroenterology societies recommend conscious sedation in cases where there are no complications. Yet, more and more patients receive full anesthesia and wind up with large, unexpected bills and calls from medical debt collection companies.
For patients considering a colonoscopy – or other procedures performed by specialists who aren’t normally covered under insurance plans – it is best to find out ahead of time whether certain services will have to be paid out-of-pocket. This way, you can make necessary preparations or look for other physicians covered under your plan.