Re: Health insurances in the US - how do they work?

From: Griffin (nospam_at_here.net)
Date: 08/29/04 

Date: Sun, 29 Aug 2004 01:51:32 GMT

On 2004-08-28 17:15:44 -0400, ifsnduhdfi <ifsnduhdfi@xyz.com> said:

> - How much does a doctor's office visit cost in US on average (both for
> Primary Care Physician and a Specialist please) if I don't have an
> insurance?

A huge "it depends." The fee will vary depending on geographic region,
type of physician, and length and complexity of the office visit. Many
physicians will offer discounts off their regular fee schedule for
patients who pay cash, or at least may "downcode" to make it more
affordable. Generally, we're probably talking somewhere between $30 and
$150, not including any lab work, x-rays, procedures, etc.

> - If at the visit it turns out that I didn't actually have anything
> (that would be diagnosed as "hypocondriasis" I suppose), will the
> insurance deny the payment for the visit claiming that it was "not
> medically necessary"?

Nobody would code "hypochondriasis." They'd code symptoms, and the
insurance company would likely cover the visit.

> - Suppose this situation: I have an insurance and I go to a doctor of
> the PPO. At the visit it turns out that I have to pay the full cost of
> the visit because it's precondition or not medically necessary or
> anyway not covered by the insurance.
> In this case will the visit be the same price as not having the
> insurance at all, or it will be discounted (and by how much % ?)
> because the doctor belonged to the PPO so they have anyway agreed on a
> reduced price?

You'd have to ask the doctor in question. If it's a hypothetical
question, there's no answer...sorry.

Relevant Pages

  • Re: {OT:} Question for people covered by national healthcare
    ... It might shock all of you that (and every physician I've ever ... the doctors and HMOs, but how does this protect the patients? ... I can assure you that my wife considers insurance ... companies and HMOs as much as the malpractice lawyers. ...
    (rec.music.classical.guitar)
  • Re: Royal Pains "Nobodys Perfect" (spoilers)
    ... It may very well be that the law requires doctors to have minimal ... According to the State of New York Insurance Department, no, they ... May a physician practice medicine in New York State without having ...
    (rec.arts.tv)
  • Re: All of this health care bullshit
    ... I've always been insured through my wife's insurance and it's getting ready to evaporate. ... I do have a close friend who is a physician and I can tell you a LOT of the costs of our health care come from our own legal system. ... If someone dies, sue the doctor, if someone doesn't get better, sue the doctor, if the treatment doesn't work, sue the doctor. ...
    (rec.motorcycles.harley)
  • Re: OT: worried about DD
    ... Your DD, at least, needs to be seen by a physician, insurance or no. ... Dizziness and funky blood pressure should be looked at by a doctor--all us friendly folks at RCTQ can do is send prayers and hugs. ... So no trips to the Dr. until next year ...
    (rec.crafts.textiles.quilting)
  • Re: So, who are the uninsured?
    ... it says that the fee is negotiable ... But insurance companies fight this. ... which is cost plus. ... charge anyone less than a set fee, otherwise that lower fee then would ...
    (soc.retirement)