Kaiser Permanente question

[Muse]

I've been with them since 2004. Got on their Medicare program a few years ago. Same primary care physician the whole time. My plan allows me a free physical once a year. I see him end of July. Hadn't had that free physical since Oct. 2015 at which time he said he'd give me another free physical if I wanted because he cut this one short to save time, but I didn't take him up on that.

So I just received a bill from Kaiser for $35 for the visit this last July that I figured would be free. The description of the charge is "OFFICE VISIT FOR MODERATE PROBLEM." I call them and ask what this could possibly be about and the woman says if you bring up anything at a routine free physical that's outside of a limited range of issues you will be charged. I'm aghast. I'm supposed to:

1. Know what can be discussed for free and what's chargeable?

2. I'm supposed to keep my mouth shut about these things and then go home and email him and then I won't be charged?

I'm incensed during this conversation. I'm usually the calmest guy when talking to customer service representatives but this time I'm anything but calm. She couldn't tell me what I discussed that caused this free physical to become chargable. I did mention to the doctor that my plantar fasciitis seems chronic and that my dentist told me that one cortisone shot evidently cured him so I asked if I could get a cortisone shot. He said that Podiatry would require me to get an xray first and he puts in an order for me to get a foot xray and schedules the appointment at Podiatry, all this taking him a minute or so with his computer. After our appointment I go immediately across the street to radiology but it looked like the wait would be long so I canceled it. They told me I should tell my primary care physician so the appointment at podiatry could be canceled and I emailed him and said I would for now forgo a cortisone shot, maybe ask to get an xray and shot at a later time. There is no way of determining if this has to do with the "moderate problem" for which they wanted to charge me. I explained this to the woman and she finally offered to wipe the charge, basically for putting on my record that I'd been informed that I must only discuss certain issues and not others or I would/could be charged. I still don't know what those issues are that you can't bring up at a free appointment without incurring a charge but she said that info is online.

Anyone else deal with stuff like this with KP?

 

[Greenman]

Pay the 35 bucks and be happy they didn't stick you $3500.

 

[pete6032]

I don't have that insurance but your experience is very representative of how health care in America functions today

 

[maddogchen]

thats how all physician visits work now.

If there is any other diagnosis other than a routine physical, they will charge you. In order for him to put in an order for a foot x-ray he needs to put in a diagnosis code for the problem the x-ray is addressing. That extra diagnosis is added to your whole visit and thus the charge.

 

[brianmanahan]

imho, 35$ is far too small to be getting this worked up

then again, i'm not on medicare

then again, i doubt medicare will exist when i'm old

 

[BarkingGhostar]

imho, 35$ is far too small to be getting this worked up

then again, i'm not on medicare

then again, i doubt medicare will exist when i'm old

It isn't about the amount but the idea that they can sneak in fees without you being informed of ahead of time. How many $35 fees would you accept before saying no more, or at least why? What if Anand charged you $3.50/post? Not everyone, but just you because you didn't inquire correctly ahead of time.

 

[Muse]

It isn't about the amount but the idea that they can sneak in fees without you being informed of ahead of time. How many $35 fees would you accept before saying no more, or at least why? What if Anand charged you $3.50/post? Not everyone, but just you because you didn't inquire correctly ahead of time.

I've been with them almost 15 years, never saw anything like this before. I thought a free checkup was just that and that I could discuss anything pertinent to my health in those few short minutes. Never dreamed that a mention of an issue would result in a charge. I seriously wonder if it was mistakenly missed that this was my "free physical," the woman I talked to yesterday may not have been privy to that. I could ask my PCP via KP's electronic contact system. But that's for medical stuff, not billing, still he would respond, although characteristically tersely, I'd think. Just don't know. Maybe I'll bring it up at our next physical.

 

[Muse]

Pay the 35 bucks and be happy they didn't stick you $3500.

I had an outpatient procedure done around 15 years ago, before I had Kaiser and just after my Cobra coverage expired. I had managed to land insurance previous to having the procedure. I got a bill in the mail for a huge amount and I contested and never had to pay it. Don't recall the details, I think I still have a file on it. Moral of the story is, don't just pay every damn medical bill you might get. It's well known that the medical community in the USA very frequently tries to stick you with actually bogus charges... by intention or by "accident." Comb through those itemized bills and make sure they are legit.

 

[Dr. Zaus]

Yes, this is how the system works now. Every utterance is now regulated. Thanks Obama.

Is it worth it so people don't die in the streets?

yes.

But don't pretend that heavy handed regulation doesn't come at a cost.

 

[pete6032]

What if Anand charged you $3.50/post? Not everyone, but just you because you didn't inquire correctly ahead of time.

That would get rid of a lot of shitposting.

 

[GeekDrew]

Yes, this is how the system works now. Every utterance is now regulated. Thanks Obama.

If you think that this wasn't the case before Obamacare, you're mistaken.