Hi Moms! I am 23 weeks pregnant with my second child. I have been going to the same OB/GYN for both kids. Both pregnancies I have had a vein that has caused me some problems. It bulges and is painful when I stand up or walk. During my last pregnancy, it actually became a blood clot on the surface (superficial phlebitis) and I was put on "bed rest" until I delivered or it got better. Long story short, I noticed that I got a charge for a copay for a normal visit that I should not have been charged for. They are now telling me that if a pregnant woman comes in with any problems above and beyond the normal pregnancy, they record it and report it to insurance as an extra visit. This makes NO SENSE to me! I came in for my normal check up, they asked me how everything was going, and after telling them about my vein, they looked at it for two seconds and that was it. I can understand if I came in with a cold and they treated me for that, but this is a complication of my pregnancy. Isn't it their job to know everything about my pregnancy so they can deal with it properly? I shouldn't have to be afraid to tell them any problems because I will get an extra charge. Do they expect all their pregnant women to be perfect??? What does your OB/GYN do?
I had chronic yeast infections while pregnant and was billed for the extra office visits this caused. I think it is normal. The rate they charge for pregnancy is a set rate based on a certain amount of appointments etc so if you go beyond that they will charge.
You would think they would want to know everything about your pregnancy to make sure it is as smooth as possible. My OB/GYN didn't charge me a per visit co-pay while pregnant. They charged (billed insurance) a flat "pregnancy" rate for all the normal checkups, blood work, etc..anything associated with pregnancy. This also included her fee for a regular vaginal birth. If in the end you had to have a c-section there would be an additional 'charge' billed for that. There were several times I went in to see her, not at normal check up times, for horrible migranes I was having towards the end of my pregnancy and she never billed me anything extra for these additional office visits. I would suggest talking to the office manager or business manager. The doctors themselves don't handle billing problems. It could be the receptionist or nurse keyed it in wrong as an office visit and it shouldn't have been. Or maybe dispute it directly with your insurance company. We once had Aetna and they were awesome about handling any billing or payment problems on our behalf (but why wouldn't they, if they find out they don't or shouldn't have had to pay the claim they should be helping you fight it).
I was never charged for anything extra... not pregnancy induced migrianes... or issues with my urine... nothing. I don't think your office is being fair. I pay my copay in the beginning and it is their job to take care of me and my pregnancy. I am sorry that you are dealing with this :(
yes...they charge.. you cant expect them to charge the same price for a normal routine pregnancy with zero complications and a pregnancy with complications that needs weekly visits with monitoring..(I was at the dr every week from 28 weeks on hooked up the monitor for 30 minutes)
I do remember that my bill after pregnancy said something like "9 visits" and then there was a more than 9 visits.. of coruse the insurance pays whaterver they will pay and the patient pays the remainder..
Mine did if I came in for a regular check up and there was extra work involved. For example, I had an allergic reaction (serious rash) to something and I had an appt the next day and figured I would just mention it. Because they had to give me meds outside the norm, it caused me to have a copay I would not normally have had. It's like a well baby visit. If you take your child in for a well baby and they have a cold, they are not well and you get a different set of charges.
speak directly to your OB/GYN and to the office manager about this - If I had been charged for every little complication/abnormality of each of my pregnancies the bill would have been 4x's that of a "normal" pregnancy. Also speak to your insurance company and let them know that this issue was brought up during a "regular" OB Appt
It sounds a little suspicious. If you have an extra vist because of a complication I can see that they would charge for that. I can see if you needed some type of extra test ot treatment or something that might be charged as well. But how they are doing it doesn't make sense without more explanation. I suggest you talk to the billing person at the Dr.'s office for more information and/or the insurance customer service (depending who you mean as "they" in your post). Usually someone can help make sense of things but it may take some follow up on your part.
I do billing for midwives, and it is very common to bill an extra office visit for anything other than a routine visit. We still bill globally or bill the prenatals and delivery separately but any visits that have an added diagnosis have to be billed separately if that diagnosis doesn't apply to all the prenatal visits. It wouldn't hurt to bring up that you don't think enough time was spent to warrant the extra office visit charge and ask them if they will write off your copayment for that visit, considering they probably got something from the insurance for the visit. Most offices are happy to work with you!
I had a very well respected OB office do the same thing to me in GIlbert. For their good reputation that led me to their office, unless you have a 'normal' complication free pregnancy, they were terrible to work with. I ended up switching offices during my last pregnancy because of the frustration and hidden fees at every visit. My new OB is wonderful and I always see my same Dr! No more bouncing around and trying to create a relationship in the 5 minute appt with a new Dr. This is now my 3rd pregnancy and I have a lot of complications. There are no additional fees for additional appts and my phone calls are always returned within 1-2 hours and usually by my Dr.
If you want any more info, e-mail me at ____@____.com
good luck!
When you get your EOB (expaination of benefits) from the insurance on how/what they paid on it will explain it. I'm guessing that is where you found this info from, and then asked the office if they coded it correctly. If that is what you did, the next step is to call your insurance and ask them if this is coded correctly, as it was not an additional office visit only an added diagnosis code.
I had a pretty complicated first pregnancy including pre-term labor, bed rest (with medication and at-home monitoring) and quite a few "extra" appointments and I was never asked to pay more than that initial co-pay at the beginning of my pregnancy.
So long as it's a regular scheduled visit, they should not be charging you a copay. When they first confirmed you were pregnant (typically @ 8 weeks), they should charge you a one time copay and bill it as a global charge. The only time they should charge you an additional copay is if you are in between appointments and are having any issues (i.e., bleeding) and go in for a special appointment. Definitely speak with the office manager or call your insurance. You definitely want to stop anything shady early in your pregnancy so you can switch doctors if necessary.
