Less than a year ago, my mother experienced acute chest pain for about a week. She went to see a local cardiologist in private practice. Accompanying her to the doctor’s appointment, I heard the cardiologist strongly recommend that she undergo diagnostic tests for her heart. Since we were eager to figure out if anything was wrong, my 53-year-old mother obediently listened to his advice and proceeded with the recommended tests.
Two weeks later, we were astonished to receive more than $1,200 in medical bills in the mail. None of these costs had been disclosed to us during our visit. Even with health insurance coverage through my father’s workplace, the insurance company only agreed to pay an insignificant $30.
We carefully read the bill: talking to the doctor for less than 15 minutes cost $400, performing an electrocardiogram cost $95, and performing an echocardiogram at a follow-up visit cost $750. Because the cardiologist recommended my mother undergo all of these tests, she had trusted his knowledge and expertise, submissively going through all of these diagnostic exams without thinking twice, all the while expecting our insurance to cover most of these costs.
Startled by these steep costs, we went on the Internet to check the market price for the services rendered. For other people who underwent similar tests in the local vicinity, the first doctor consultation cost about $95-200, the electrocardiogram cost about $35, and the echocardiogram cost about $500. We were shocked to discover that we were billed almost twice the price for the same exact procedures that other doctors were charging!
We called the clinic, flooding the counter staff with the following:
“First of all, the echocardiogram was ridiculously expensive, so why didn’t your office try to gain insurance authorization before proceeding? Even if the insurance companies refused authorization, why didn’t your office tell us what our out-of-pocket payment would be up-front, rather than sending bills later asking for money? Our dentist always obtains permission from medical insurance companies before performing anything. If the insurance company refuses to pay, our dentist at least makes it transparent to us what the out-of-pocket payment will be.
Secondly, if the insurance company does not authorize payment, then I am essentially receiving the same treatment as an uninsured patient. There should be a price reduction as we cannot afford these payments.
Third, why are your inflated costs double that of other clinics?”
The receptionist said that she could not answer our questions, so we asked to talk to the manager. Finally, after many days of heated debates, they agreed to cut down our bill by 50%. Although this was a relief for our wallets, we still ended up paying a whopping $600 out-of-pocket.
This was the first time where we had to go to the doctor’s office to bargain for medical services, but this scenario is all-too-common in the United States. I recently heard a similar story from a family friend. She took her 14-year-old son to the doctor’s office to treat a cold. The medical bill ended up costing $1,700. Her husband was unemployed, she was juggling two part-time jobs at the time, and they had three children to raise. They eventually reached an agreement with the clinic to pay $100 per month, but even now they are still paying the bill off.
We were lucky to have enough savings to pay off the medical bill, but all too often we’ve heard of stories where people go bankrupt just trying to access the high-quality health care that they deserve. The medical industry needs to keep prices reasonable and affordable for patients. Especially in times of economic downturn, patients have the right to be informed of the costs of their medical bills before any procedures are performed.
We want to remind everyone how important it is to understand insurance company policies, to receive insurance approval before undergoing any procedures recommended by doctors, to gain transparency about how much medical bills will cost, and to confirm that your doctor is not charging exorbitant fees above the market price.
And the results of my mother’s tests? All negative. After one week, her chest pain resolved, which the doctor attributed to stress. We sometimes joke that seeing the high medical bill made her instantly get better. But in all honesty, seeing these high medical bills—which could easily lead to bankruptcy if something more serious came up—now makes us scared to even get sick in the first place.
Melody Chung was a contestant in our 2011 Costs of Care Story Contest.