Coffee heat rising

Awww, C’mon! Am I really that dumb?

Seriously. How dumb DO they think we are? And more seriously: could they be right??

Late in October I dropped by my doc’s office to get a flu shot. I was there for all of 10 minutes, 8 of them spent in the waiting room.

Friday, comes a statement from my insurance company: the doctor has charged my insurer $86. The insurer is disallowing it, claiming the Her Doctorness is not in the RAN+AMN network. So now I’m expected to pay this bill.

Yup. You read that right. EIGHTY-SIX BUCKS for a $10 flu shot.

So I shot off an e-mail to her, she also being one of my coreligionists who sang in the choir with me ($86 for a flu shot: ain’t that Christian?). She replied that she was shocked and would get after the office manager. And so she did. Yesterday morning, comes this missive from that worthy:

I am very sorry for the inconvenience. We deal with hundreds of insurance plans and our front office MA should have known that we are out of network for Ran+Amn. You must understand however that your card also has BENEFITOPTIONS and BEECH STREET in large letters. We do participate in these plans and it is the ultimate responsibility of the patient to make sure hisor her primary care physician is on the plan.

Grocery store flu shots are less expensive because they are purchased in extreme bulk for the masses. They also have a greater incidence of sideeffects, Dr. Wallbanger [my doc friend’s senior partner in the practice] tells me.

In our practice, we normally do a nurse visit taking the vitals of thepatient receiving the flu shot. Insurance billing requires that we bill $40 for this procedure and insurance pays whatever they like.

Billing code 90471 is administration of the flu vaccine and the going ratefor insurance billing is $26. The rate for the vaccine itself is $20.

We administer flu shots in our practice as a service to our patients, andwhen billing insurance there are set amounts for each service provided.

As our front desk did make the error, we will write off all but $20 of the remaining balance for your flu shot.

Total price for a cash pay flu shot is $30, you already paid $10, so
remaining balance is $20.

Again I am very sorry for the inconvenience.

Okay. Are you following this?

Item 1: The head partner in this practice is actually suggesting, with a straight face, that the vaccine he’s getting is BETTER than the second-rate vaccine dispensed at Walgreen’s or Safeway, where, if I’d had the time and patience to track down a flu shot clinic event, I could have had the shot for a $10 copay.

Oh, dear Dr. Wallbanger: can you spell S-P-E-C-I-O-U-S?

You understand: he and his office manager assume I’m so stupid I will buy this story.

Item 2: We’re told the insurance company requires that the practice overbill, in the amount of $40, for a grand total of 2 minutes of a junior college graduate’s time.

And Item 3: We learn that really, we shouldn’t believe anything we’re told by the front office staff. Just because the staff says the practice is in-network doesn’t mean it is in-network. In other words: it’s the patient’s responsibility to read our minds. And BTW, try to read RAN+AMN’s corporate mind, too, since that worthy organization does not publish a list of participating providers online, at least not that three Google searches will bring up.

What’s being said here is either “we try to gouge your insurance company and if we can’t get away with it we still overcharge you but only by about half of the overcharge we try to extract from your insurer” or “we think you’re dumb as a post.” Or maybe some combination of those.

Okay, okay, I admit it: They could be right!

This afternoon I donned some garden gloves and rolled the compost bin into the alley by way of trying to salvage it after the Great Bee Fiasco. By the time I got it where I wanted to dump the contaminated compost, wisps of white vapory stuff that looked like smoke were leaking out around the lid. It kept on leaking. “Is it on fire?” I wondered. Felt the side to see if it was hot: no, not especially. So I waited a while till this phenomenon settled down.

Finally opened the lid. White airborne powdery stuff was still floating around inside.

Waited a while longer. Then rolled the thing upside down and tried to dump out the compost.

No luck. It really needed to be pulled out a fistful at a time, not a practical option with weird (stinky!!!!) white powdery stuff drifting in the air.

Went into the garage to drag out a little hand-sized pitchfork-like thing. Held my breath and tried to fork out the bin’s contents without inhaling any powdery vapor.

This did not work well, and soon I was fairly certain that if I breathed much more of the “beekeeper’s” crud, it was gunna make me good and sick. Rolled the composter over to the bulk trash pick-up place, where it will sit for the next two and a half months, providing the Trash Cop doesn’t wander up the alley before the next pick-up is scheduled. He hates that.

By the time I finished, my throat was burning and I felt dizzy. Luckily, I’m going to dinner at the home of friends, one of whom is a nurse-practitioner. A psychiatric nurse-practitioner (where was she when I was busy hiring the bee dude?), but a nurse nonetheless. Matter of fact, this is the very friend who gave me the composter as a lovely and much-valued gift, some years ago. She should be able to recognize if I start to croak over during the salad course.

The bee dude’s bill is in hand: Contrary to his listing online as such, this guy is no “beekeeper.” He works for an outfit called “Atomic Exterminating Company.” Atomic, indeed: young Dr. Strangelove nuked my bees, nuked my composter, and damn near nuked me.

Well: Dumb tax, eh?

I’m still left with the question of how we’re supposed to know when service people are lying to us! I guess that requires you to be smarter than this Ph.D. is.

6 thoughts on “Awww, C’mon! Am I really that dumb?”

  1. The flu vaccine should be the same in either case. Perhaps they meant that the administration of the vaccine may have been better through their office than at Safeway? Considering that the flu vaccine is very safe and that it’s not hard to give IM injections to people, that’s a possibility, but not a very likely one.

  2. Wow — that first one is a showstopper — arguing that the vaccine is different. They are LYING about this. Being in public health, I am horrified that anyone is casting aspersions on grocery store injections, because it is our first line of defense against a massive flu outbreak. My doctor’s offers them for free — no co-pay, no nothing. Just get one. All vaccines come from the same companies.

    Secondly, if you have any proof that the atomic exterminator lied about being a beekeeper (advertising? An email?) I would sue him in small claims, at least for the cost of the composter. I’m cranky this morening though, but oh, that whole story just makes me mad for you. Hope you are feeling better now.

  3. Yah, unfortunately I’ll have to quit patronizing my friend’s office. This means I have to traipse to the Mayo for everything–and it’s a good 20 or 25 miles away. However, they’re in the process of building a new structure within striking distance of my house, so, by the time I’m on Medicare and so allowed to go there without question, my real doctor’s office will be closer.

    The beekeeper did admit that his day job was working for an exterminator. So it would be hard to prove–unless he lives in an apartment building–that he doesn’t do beekeeping on the side. The dumbness part here has to do with my failing to register that a guy who really does beekeeping would likely consider the exterminating business neither helpful nor ethical, and so would probably clean houses or work as a security guard before he’d do that. duh!

  4. Hey, thanks for dropping by, great point about giving the gift of no-reciprocation:-) I can completely relate to your $86 flushot. I recently had surgery and at every 1 minute “follow-up” where I go in, they take a glance at the area and ask how I’m doing, I’m charged a $40 co-pay. Nevermind the $150 they charge my insurance company.

  5. Thanks for posting this…I am frantically google-searching RAN/AMN in the middle of the night looking for a provider list for my sick daughter and pulled up your blog.

    I had a similar frustrating experience with them. After changing from Schaller Anderson, I didn’t realize our pediatrician didn’t contract wtih RAN/AMN. My husband was mistakenly told that there would be no change in the provider list. I was shocked to recieve bill for $552. $490 of that was for vaccines. The salt in the wound was that I didn’t even *want* to vaccinate my child. I allowed the doctor to convince me reluctantly, a $490 mistake.

    We ended up paying the bill–we are saving to buy our first home and I didn’t want the collections to go on our credit report. We were told our only other choice was appealing to HR and choosing another (much more expensive) insurancde provider.

    Anyway, thanks for posting this. Misery loves company. Tomorrow, I hope I can find a pediatrician that takes this plan, and is open on Christmas eve.

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