Help me understand billing for two ENT visits
My insurance plan is setup with co-pays. All office visits are charged a co-pay:
Specialist charge is a $55 copay Diagnostic Lab & X-ray is noted as deductible, then 70%.
My Primary care doctor set me up for the following two visits for some dizziness I was dealing with. I was under the assumption each visit would be $55. When I scheduled the appointments they said each visit is a separate appointment and a separate doctor.
Is the insurance coverage here correct? and why was the co-pay not applied to either of these two visits? Lastly, the second visit, went something along the lines of, 'Let me take a look inside your ears…Oh, you have a little sand in your ear'. Next thing I know he is sucking it out with a vacuum thing that looks like those lights he shines in your ear, nose, and throat. Total time to get the sand out was like 10 seconds. I thought nothing of it and he didn't ask me if he wanted me to take it out, it just started happening as he was doing his inspection.
I feel like the second visit should of had the co-pay applied to it, and I can see where they would do a second line item for the vacuuming, for lack of a better word. I could also see where the first visit is not an 'office visit' and it is a diagnostic lab visit. I think it's a little cheesy that they spring a bill on you without saying this costs extra do you want us to proceed, or something to that effect. I don't work in the medical field, but if I provided services for one of my clients and then did something extra and charged them 5x what they were expecting to pay I would get an earful and not have them as a client anymore…
I've been dealing with this type of stuff for the last 4-5 years as I'm getting older and seeing a doctor more often, and I've been getting better at trying not to trigger extra expenses on these office visits, but it's almost to the point of where I need to ask, is this included in the office visit for every step they take…maybe Ijust have bad insurance.
Visit one:
Tympanometry – 92567 $48.00 Comprehensive Hearing Test – 92557 $107.00 Insurance covers a total of $32.76
Visit two:
Remv Ext Canal Foreign Body – 69200 $468.00 Office/Outpatient New Low Mdm 30 Minutes – 99203 $324.00 Insurance covers a total of $549.00 submitted by /u/OG_pooperman
[comments]
