An insured patient checking out form the physician’s office paid $100 for just 10 minutes with the doctor. What exactly this $100 covers? Why patients get shocked seeing this type of bill? Here is what that $100 is covering…
- First, doctor office schedules an appointment. It took several people to take the message, pull the medical record (paper charts), call the patient to assess the problem, determine the need for the appointment and schedule it.
- When the patient arrives, staff double checks the patient’s contact info and insurance details to make sure that it is updated on the file. The nurse gets notification of the patient’s arrival.
- The nurse called the patient from the waiting area, measures blood pressure and weight. And then patient goes into the exam room where nurse again takes vitals, make notes around the visit reason, medication, last visit, etc.
- The physician came in to see the patient, asked about any changes since last been seen, reviews history of present illness and examines the patient. He talks about the illness and the treatment plan and prescribed a medication. He updates patient’s medication list and makes a copy of the diagnosis form and hand it out to the patient for the records. The patient goes to the check out desk.
- The physician refiled the medication reconciliation in the chart, finished documenting the visit, and placed the chart in the bin to be refiled. The chart was filed, and the encounter form was sent to the billing office.
- At the billing office the charges and any payment gets posted and the claim was filed. If there is no problem with the claim, it electronically gets processed.
- If payment was not denied, the payment arrives at the billing office and would be posted.
- If patient did not pay at the check-out desk, the patient-responsible balance is billed to the patient. If the patient pays on the first statement, it has taken 45 to 60 days to receive complete payment.
The 10 minute office visit involved the work of the phone operator, the medical records clerk, the triage nurse, the check-in person, the nurse, the doctor, the check-out person and the biller. It took 8 people, and at least 45 minutes of work to make that appointment happen. In addition, that visit paid the expenses for the rent, the utilities, malpractice insurance, medical supplies, computers, phones and janitorial services. We all want efficient and quality health care but it is not cheap.
Thanks to KevinMd for giving this useful insight.