Toddler urgent care visit & bill frustrations
I just want to scream/cry at the health insurance situation in this country (US)! It’s such a racket!
My son (toddler) fell down and cut his chin, next to his bottom lip. It was really small but pretty deep and bleeding a lot. We have insurance and decided to take him to the urgent care at an in-network “preferred provider” urgent care, which is a $25 copay.
Luckily, by the time we were seen by a doctor, it wasn’t bleeding anymore and he was in a good mood. The urgent care doctor assessed it and determined he didn’t need stitches, but because it was close to his mouth, they put some glue over it to keep it clean while it healed. Especially since it’s a difficult spot to place a bandaid on a toddler.
30 days later, we got a $400 bill for “surgical services” which is not covered by our insurance. This is on top of the $260 invoice for the urgent care visit, which was covered.
When I called to ask insurance why this $400 bill wasn’t covered, they claimed that while the urgent care visit is covered, the services in that visit aren’t. And that the services were coded as “professional surgical services”. For a 2cm dot of glue that probably could have been handled by a bandaid instead!!!
I called the urgent care and requested a coding adjustment since this was absolutely not surgical and no way would it cost $400 even if they decided to call it “surgery”.
I understand not all surgery involves a gown/sterile operating room, but this is really pushing it.
I’m waiting to hear back from the urgent care for them to “review the request to change their coding” so it can be reprocessed by insurance, but I’m just shocked by this.
We already pay over $600/month just to have insurance, and then get this kind of run-around for a standard urgent care visit. No wonder people avoid the doctors at all costs.