Medical/insurance - one fee per visit or one per service?

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dm200
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Joined: Mon Feb 26, 2007 2:21 pm
Location: Washington DC area

Medical/insurance - one fee per visit or one per service?

Post by dm200 » Wed Aug 16, 2017 7:42 am

As we know medical billing and insurance is very complicated, confusing and inconsistent.

Some plans charge a copay or fee for each service - no matter when the service is done, while others charge "per visit", even if more than one service is done. It can be important to know and understand so that you can be billed properly and, perhaps, schedule visits to reduce such fees.

My current plan charges a copay of $150 for a CT scan. I had two scheduled and done in one "visit". When I checked in, I was charged only $150 and was told there was just the one fee if both were done at the same time. Good :)

Then, I received a bill for $150. I called and they checked the details of my policy and it is "per visit". I can ignore the bill. Glad I called - saved me $150.

I had the same experience with Ophthalmology where I was charged one copay when during that visit they did several types of tests. If I had the tests done at a different time/day, I would have to pay more.

runner3081
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Joined: Mon Aug 22, 2016 3:22 pm

Re: Medical/insurance - one fee per visit or one per service?

Post by runner3081 » Wed Aug 16, 2017 12:53 pm

You must have good insurance. I haven't seen that type of thing for imaging studies before.

HIinvestor
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Re: Medical/insurance - one fee per visit or one per service?

Post by HIinvestor » Wed Aug 16, 2017 1:03 pm

My optometrist wants me to return so he can charge for another visit rather than doing everything in one day and getting less payment. It's not convenient for me. I now go to an Ophthamologist instead and get it done at one time but also need the optometrist for the vision checks.

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dm200
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Joined: Mon Feb 26, 2007 2:21 pm
Location: Washington DC area

Re: Medical/insurance - one fee per visit or one per service?

Post by dm200 » Wed Aug 16, 2017 1:17 pm

runner3081 wrote:
Wed Aug 16, 2017 12:53 pm
You must have good insurance. I haven't seen that type of thing for imaging studies before.
It is the Kaiser Medicare plan (standard option) in the Washington DC - Baltimore MD area.

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