Some months ago I injured my shoulder with repetitive activity. After it didn't get better for several weeks, I went to my doctor about it. As I signed in, I paid my $10 co-pay for the visit. Even though he decided that it was only stressed tissue, he had me get an x-ray also. Today, my insurance company sent me an "explanation of benefits".
The "amount you owe" is a $9.22 co-pay for the x-ray.
I have two questions.
First, why wasn't I asked to make a second co-pay at the time of my visit? This also happens when I have the ultrasound check of my heart. The cardiology department asks only for a $10 co-pay for the doctor visit, but I always get billed for a co-pay for the ultrasound.
Second, how much does it cost the clinic and the insurance company and Medicare to calculate all this, move the information among themselves, and mail me an "explanation of benefits? I bet it is far more than the co-pay and probably a good chunk of the total cost.
The good side is that I have been getting this care without "prior approval", from the insurance company or Medicare. Others are not so fortunate. Read "Deadly Spin" by Wendell Potter. Some might die because an insurance company came between them and their doctors.
