Gouged Through the Heart

Jack has this tendency to cry so hard that sometimes he almost passes out.  Like his lips turn blue and he's not breathing- scary.  He's done it a few times, and of course we consulted our doctor about it.  To rule out anything more serious than a behavioral issue, we were sent to see a pediatric heart specialist.  We went (he's totally fine, by the way, it's apparently behavioral- still terrifying, but nothing to worry about).  We were there for about an hour, had an EKG, echo-cardiogram (heart ultrasound) and a visit with the nurse practitioner.

I just got the bill.

We were charged $2,788.80 for this visit.

Yes, that's right.  Almost $3,000 for a 60 minute outpatient office visit.  The breakdown:  $2,205 for the echo-cardiogram, $69.30 for the EKG, $183.75 for the pulmonary function test, and $330.75 for the office visit.  ARE YOU KIDDING ME?  Ok, sure, the u/s tech needs to be highly specialized and trained to get proper pictures of the heart.  So that can cost the most, but $2,205? And the pulmonary function test?  That was this little sensor that you clip to a toe or finger for about 5 seconds.  Jack wouldn't sit still for it, so my husband actually did the clipping on and holding.  $183.75?!?!

But it gets better.  First, when I called to get some explanation about the charges, I asked who sets the rates for these services.  Apparently it's neither the medical office or the insurance company, but the state! What?  I can only imagine that this is supposedly to insure fairness or to avoid gouging or something, but really?  This is the result?  Then, I looked more closely at the bill.  Our account was credited $1,983 for "payments/adjustments/charity".  That's right.  The hugely inflated costs were then written off, presumably for tax purposes.  Or so I figure...I'm still thinking this through, and I don't really know how all this works.  But I think this is how they get us- precisely because we don't know how it all works.   So now our "real" bill is $805.80.  Insurance took care of $330.75, leaving us responsible for $475.05.  Since, according to my doctor, she rarely sees even a third of what insurance bills us for her time, I'd prefer to just pay the medical office the $475.05 directly and cut out the middlemen. That seems to make much more sense to me, AND keeps our money in our local community.

And they say our healthcare system isn't broken?