Thursday, December 4, 2008

Why Health Care is Expensive (?)

When I moved up to NoVA about a year ago, I started seeing an ENT doc to deal with my allergies and sinus issues. The doctor told me I had excessive wax in my ears and told me he'd clean it out for me. It was a 5-10 minute job scooping the wax out of my ears. Few weeks later, I got an "Explanation of Benefits Payments" from the insurance company and on it was a line item for "EAR SURGERY" w/a claim for 2-300 bucks by the doctor. I was thinking... surgery??? To get a ball of wax out of my ears?? This line item was on top of the charge for my office visit, which was forced upon me as a "follow-up" to the allergy drops I'd started taking some time ago. Again, it probably was a 10-15 minute discussion on whether or not my symptoms were improving. So for roughly a 20-30 minute visit, the service provider walked away with like $300. Since I only had to pay the copay, I didn't think twice about it. However, I then went to another ENT because I wanted a doctor closer to home. He talked to me about 10-15 minutes and then sprayed some numbing thing up my nose so he can look at my sinuses using a wiggly stick with a camera on the end. Guess what? Yep. Few weeks later I got another explanation of benefits from my insurance with a line item for "SURGERY - SINUSES". Between that and the "office visit", they claimed a charge of $570!!!!! They only got about $400 of that but seriously... surgery??? Now my dilemma is this. I'm starting to think insurance companies jack up their premiums because these darn doctors are exaggerating their claims. While I'd like to say something to the insurance company, I worry that if my doctor finds out I snitched on them, they won't give me the proper medical attention. So now what do I do? Anything? If any of you are a doctor and think these are valid charges, I'd like to hear an explanation. I'm also annoyed at the insurance companies for not doing a better job keeping the doctors in check. They're quick to avoid payment for treatments that are really necessary for some people, but they sure don't seem to mind overpaying for minor procedures (I'm not sure I'd even go so far to call it a "procedure"). Something doesn't seem right here.

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