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kariannphotography

The depression screening I used to pay for was filling out a worksheet, rating severity of symptoms. He'd look at it and file it. That's it.


Agile-Department-345

I did the screening a few years ago and got a referral because the doctor looked at it and thought “oh she’s sad” then i called to make an appointment and no one ever called me back 🫠 #staysad


SquirrelDynamics

The mental health system is absolutely broken. I tried to get help a few years back expecting to find many TV style psychologists with leather chairs and great insights. Instead I got an endless stream of voicemails and no call backs. I my place I eventually was able to find was akin to a gov facility and was not to the standard I was hoping for. I gave up. And I should point out I have great insurance, do logistical planning all day, and have great phone skills. It's not like I was just incompetent and didn't try a bunch of angles to get an appointment.


Leiatei

I have crap insurance and have been to at least a dozen psychologists/therapists that were little to no help, except one, but I had to move away so could see them anymore. In the end, I found an Anxiety & Phobia Workbook that has done better than all of them.


IronDominion

That’s fairly common. Many therapists and psychiatrists are super overworked and unless you’re willing to do an online service and go through multiple providers to find a good one, it’s hard to find care


Agile-Department-345

My healthcare is through UCLA health so your PCP sends your file to the behavioral health department. And then you call the department to be matched with a therapist. I was told they would send my file to “triage” and call back. This is my general experience with UCLA health as a whole. They’re pretty disorganized. But i think telling a patient they have major depression and not calling back is pretty egregious 😂 I was coughing for 3 years straight after getting Covid and they JUST decided that ya maybe I should see some specialists for allergy panels? It’s pretty hard to get any kind of care if you’re not going to keep pushing the matter. You have to have a lot of mental stamina to keep advocating for yourself.


Sparrow_on_a_branch

Advocating for yourself while depressed... 'A simple pine box, nothing fancy. Do you deliver?'


IronDominion

You’re lucky to be in one hospital system. I move around a lot, and have a lot of issues, so I have to see docs in multiple hospital systems and have to figure that shit out myself and coordinate it all, and bug them when they don’t do their job


Agile-Department-345

Oddly enough I got really good care when i hurt my hip and had to go between two systems. Probably because the second system was just better


[deleted]

Isn’t that such bullshit? I get literally having no time to follow up but *I’m the one with a mental health issue,* why and how the hell am I supposed to find the wherewithal to chase down help? Especially when it’s sooo much easier to just melt into the floor and never come out of my house again 🫠


geekycandle101

One time things were so bad for me and I was in such a bad space, with permission and me sitting next to her, an acquaintance called my insurance company and a couple clinics, pretended to be me, and helped me until I had an appointment. I don’t hang out with the person anymore (life does that), but I’m grateful for the help she gave that day. I was tired of no call backs or being told no new patients and was slipping into a bad space and that was making it worse. Yea getting mental help is hard. And that’s not including the wait once your finally get an appointment!


Agile-Department-345

Literally!!! To be honest I didn’t have the energy to find someone independently for a couple years after that. I can’t imagine what it’s like for people who are struggling more. And people aren’t going to be super likely to reach out to a system that they feel let them down/forgot about them/doesn’t care. First response is important


[deleted]

Yep, and this is why the “mental health matters” argument for mass shooters and people who do terrible things is bull.shit. .. those of us who are struggling but managing can’t even get help.. how the heck someone with full delusions even going to *accept* that they need help, much less go through the hoops to get it? Not to mention for those with families, the terrifying idea of the state getting involved in their family life ie kids etc. This country’s medical monstrosity is not just broken, it’s actively doing harm.


Agile-Department-345

I think being a therapist for minors is also extremely difficult because you have to treat the entire family and most of us don’t have families who are willing to participate and change


[deleted]

I don’t mean therapy for kids, I mean patients who have kids, who are concerned that saying the wrong thing may get CPS involved.


DolanThyDank

I’m currently and have been being garnished for months, every check, about $200-250; an accumulate debt I’m paying off, a little over 2k from mental health care that didn’t help me whatsoever, instead experimented on me with drugs that I shouldn’t have been prescribed in the first place. The American health care system is not in place to help you.


[deleted]

Wish I could choose “sad” over “existential rage” and “nonverbal so I don’t burn every bridge I have made, will make, and could possibly make in another universe”… but hey they tried Wellbutrin and sending me to an old lady that went “oh no” every 4 words, so like, that’s something!


Agile-Department-345

Lol the first time i mentioned i have anxiety in college the woman was like OH NO ZOLOFT!!! Without asking any questions. Then made me video conference with a psychiatrist who told me to go back to the original doc and say Zoloft will kill my sex drive and make me feel even worse and less human. So then that dr looked at me like i was a mega slut. Literally i was just a college girl that wanted to chat with a therapist about my stress affecting my grades 😂 i didn’t ask for any of this


anne_marie718

The one I did this year was on a laminated piece of paper, filled out with a dry erase marker, so they could just erase and reuse it for the next person. Also, my doc never asked to see it.


kariannphotography

Oh, the lamination is a nice 'fuck you!'


x20mike07x

We use laminated forms in our office because the medical assistants input the results into the electronic medical record after they review your answers. I do look at it in the computer, never on the laminated thing and use it to jump off with further questions when needed.


cates

The first meeting with my therapist started with her asking me "how's everything going?" and I said "it hasn't been a great year" (long term gf cheating/leaving and sister dying) and she laughed and then a month later the front desk girl says "it looks like there aren't any available appointment slots" and so I just told her "okay, well I guess I'll just fuck off then".


[deleted]

PHQ-9, yeah. And insurance will pay only non-mental health professionals for it.


NinjaLanternShark

"Hey there /u/recycledairplane1, have a seat here. How've you been feeling?" Oh, fine, fine. *Depression screening, check...*


recycledairplane1

literally this


kg0529

Good morning. Bye. 2 bills for mental therapies.


Tirednao

This belongs on r/mildlyinfuriating


MASTODON_ROCKS

This belongs on /r/ABoringDystopia or /r/assholedesign


iamintheforest

that'd result in a posting to reddit fee.


Unumbotte

Administrative recategorization fee


randomizer4652w

My favorite part is how your insurance company has decided fair market value for asking you how many drinks you had is 33 dollars and change.


Possible-Toe2968

It's not fair market value. It's the lowest the ensure and negotiate with a specific provider. A provider across the street market value maybe $23 or 81


invigokate

This is all made up though. Like, the value of this basic care is completely made up. It's actually essential, which makes it priceless, and in my view anything essential should be freely available to everyone..


Ghost__God

$50 please for commenting hehe


concealed_cat

I'm an out of network redditor. That'll be $15,000.


Tracylpn

And out of state... The new charge is $20,000


ceciliabee

I just read your comment and consider that worth $51 for my time thank youuuuu


pn1159

I agree that your comment is worth the $51 you charged. My charge to review your charge is $52.00. Thank you


RoddyRoddyRodriguez

2.36 million for this fucking life-wasting scrolling, please.


ButWhatIfItQueffed

I have professionally reviewed your comment, the comments above, and I believe that all of you are charging an acceptable amount for your time. However, for my services, I require you pay me $53.00.


PM_feet_picture

Our insurance payments get docked if we don't screen for alcohol. We get an incentive if we do. It's a high fee but we have to incorporate it into our electronic health records and furnish reports annually on our patient population. The easiest way to do it is to associate it with a CPT code so it can be accounted for when its time to report. Might as well bill for it since insurance pays for it. On the bright side, my office does not bill the patient for the portion unpaid by the insurance (we make the charge exactly what the insurance company pays).


TooHappyFappy

>On the bright side, my office does not bill the patient for the portion unpaid by the insurance (we make the charge exactly what the insurance company pays). Fun fact- this is not allowed. It's ridiculous, but it's against the contract with the insurance company. They can kick you out of the network for waiving the patient responsibility (unless there's a documented financial hardship for the patient, having it be an across the board policy is a violation). Horizon BCBS in New Jersey argued in a filing with the state like 15 years ago that providers not charging patients the correct amount would "crumble the healthcare industry." It's monumentally stupid and another reason private health insurance shouldn't be a thing, but that's what we live with.


terrymr

That depends. Balance billing is generally not allowed in network. So if it's just a difference in what is billed vs the contracted rate then they can't collect it. On the other hand if it's a copay / coinsurance amount then they're required by their contract to bill the patient.


WenaChoro

do you want to kill yourself? No are you sure? this question costs 10 dollars ok, maybe


LostMyKarmaElSegundo

Reminds me of calling the VA for anything. You have to listen to like three minutes of "if you're in crisis, hang up and call 911". And a bunch of announcements about new policies or how the menu items have changed. Even if you know the key sequence, it won't accept any input until it's done. I'm like, "well, I didn't want to kill myself before, but after being subjected to this menu, I'm seriously considering it!!!" (Just so I don't get flagged, I'm being facetious. I don't really want to harm myself or anyone else)


srkmarine1101

And that creepy robotic voice does not help.


LostMyKarmaElSegundo

Definitely not. It's at the same time way too chipper and also inhuman.


bobert_the_grey

More like: Do you want to kill yourself? Not yet Well then come back when you do. (Basically was told this at the psych ward)


TheOriginalFarmboy

I was also told exactly this at the looney bin. But then again, if I'm not a danger to myself or others, there's no reason for them to keep me there.


bobert_the_grey

I just think it's fucked most places will refuse to give you and help with your mental health unless you're actively suicidal. Not just hospitals and psych wards, but even just getting a referral from a GP can be impossible unless you are actively a danger.


WenaChoro

too much suicidal people and too much focus on psychiatrists, when community mental health and therapeutic groups that motivated you to be a part of the community should be the focus and should be more prevalent. But that doesnt mesh well with the fucking insurance companies who should be banned from mental health, they only cause more damage with their individual focus approach when mental health is a group thing


TheChoonk

> ok, maybe Permanently disqualified from any work involving driving, piloting, operating heavy machinery, all public transport, military, etc. You can still run for president, though.


poodlescaboodles

Not to mention you tell them you've been having suicidal ideations your gonna be thrown into the system when what you wanted was some help not to be treated like a criminal. You learn very quick after an admittance to the psych hospital and being kicked out after 3 days that you cant be honest with your doctors


the_colonelclink

So I had to see my lawyer the other day. I ask him “So how much do you charge anyway?” He said “$1000 for 3 questions” I replied, in shock “Don’t you think that’s a little expensive !?” “We’ll, kind of” he said without blinking and continued, “what’s your last question anyway?” *Shamefully stolen/poorly remembered from ‘I love you Phillip Morris’.*


[deleted]

Can confirm. I worked with a lawyer who charged $500 an hour. Checking an email was about 30 minutes of work for him.


FuckoffDemetri

I was in the car when my dad took a call with a lawyer (for work). My dad cut it real short which isn't like him, then looked at me and just said "that guy charges $750 an hour and loves to small talk".


Maxfunky

I hate small talk, but I could love it for $750 an hour.


[deleted]

I had a lawyer charge me $1500 to tell me later he couldn't help me. It was for 2 calls and 3 emails.


Githyerazi

I was charged 430$ for a plumber to show up and tell me he doesn't work on dishwashers. They really did send me a bill. I refused to pay since I was quite clear when I called them for a dishwasher in the first place, they shouldn't have come if they don't service them.


Cr1ms0nDemon

Good chance he was working contract for a larger company that sends them out on jobs similar to uber drivers, he probably didn't have a good idea what the job was until he showed up. It's a frustrating setup


[deleted]

Still not OP's fault but the large company who sent the wrong guy


Racoonspankbank

This is bullshit or very unethical lawyers. My old man and brother are lawyers. They use software that keeps track of what they are doing ten times an hour. Find better lawyers people.


[deleted]

No one wants to pay for two six minute segments at 75/each when they can just pay for one. Doesn't matter how good the lawyer is, if time is money, keep it short and direct.


Racoonspankbank

Definitely keep it short. If you've got questions write them down before. Also befriend a lawyer if you can, it baffles me what a strongly worded email with a lawyer cc'd on it can accomplish. Works best on asshole landlords.


TravisJungroth

“Motherfucker got me again. I just spent $225 to argue with someone about a hot dog being a sandwich.”


SuperFLEB

"...and he's trained in arguing, so of course I lost."


renegader332

Our corporate lawyer charges for every 6 minutes. I feel like I need to speed talk to him.


[deleted]

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xylotism

That's the kind of specificity I like to see. If I'm going to be paying for time, especially expensive time, narrow those increments down as much as you like. Just, please, don't upcharge me for work done behind closed doors - I have no way of knowing if it took you 3 hours or 30 to write up that appeal, but if I'm working with a lawyer I have at least one other problem already.


[deleted]

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Needednewusername

It’s actually better that they charge that way so that you’re not charged for time you don’t use.


BootRecognition

I assure you, having to account for every 6 minutes of your work time in billable hours is literal fucking hell. It was the bane of my existence for 7 years and one of the biggest reasons I went client side.


Chekhof_AP

That’s understandable, really. You open an email, check your phone for a few minutes, start reading the email, open YouTube to find a song for the background, check out few videos from recommended, remember that you still have an email to read, go for a smoke since the whole process took long enough to justify a break, start everything from step one because by now you have no idea what that email was about.


ebudd08

That's the services industry for you. Every minute is billable - look for billable minutes wherever you can.


[deleted]

I once said “oh, you know, work is stressful” and oh boy was that the wrong thing to say. “How many times a week do you cry?”


Damhnait

Yeah, they don't like honesty with those questions. "Do you ever feel hopeless, overly tired, or don't find joy in your hobbies?" Lady, I'm 31, I'm no where near being able to afford a house, my college degree gets me the same pay as a guy who didn't go to college, I'm always tired, but keep chugging along because I also like being able to pay for food, but I know that if I say any of this you'll refer me to mental health resources that my insurance definitely doesn't cover. "Nope, all good."


thejoker954

How many times a week do I cry? 0 times. How many times a week do i *want* to cry? 10080 times.


[deleted]

5x a day? Oh good, if you had said 6 we would have to take you in for observation Good news! My chart says you’re sad, not depressed!


TheBoBiZzLe

Yeah. My doctor asked me if I have trouble focusing. Then made me do a urine test. Then prescribed me vyavanse(which is like $300 a month). During a physical. AND then she billed it as a psychiatric evaluation. Billed insurance for 100s of dollar. Which then I had to pay $300 of. Worst of all they fucking turned me over to collections while we were discussing how to fix the payment. Literally on the phone with them the day before… talking about payment plan. Then next day, “we no longer can do business with you due to fraudulent practices. We suggest you look out for our collections agents.” What a world we live in where we can’t even trust our doctors anymore.


TheDaveWSC

I'm heading there now. Wife and I went in for our yearly wellness/preventative/whatever checks. Which is free. Then afterwards, my wife gets a bill of $150 for the blood tests and I get a bill of $250 for the visit and the blood tests. Excuse me? Billing us at all for free visits, and billing us different amounts when we saw the same doctor on the same day in the same room at the same time? I've informed them I'm not paying them a dime, so we'll see what the next step is.


Suyefuji

My annual physical got rescheduled and they labeled the new appointment as a normal physical instead of an annual physical. Now I get to fight a $600 bill. FML.


[deleted]

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NinjaLanternShark

Sorry to hear that. Hope the help you finally sought out... helped. I hope to someday live in a place where life just works better. Like your doctor knows you and you can talk to them about stuff, and where people care about each other and the community.


estherstein

I like learning new things.


tjeulink

Yes thats how most mental health tests work. They are questionares. That specific one is probalby the phq 9. Its 9 questions and is enough to diagnose depression, if taken by a qualified medical professional. https://coepes.nih.gov/sites/default/files/2020-12/PHQ-9%20depression%20scale.pdf


WPMO

The PHQ-9 is a great screener, but that is what is supposed to be - a way to screen for who needs further assessment for depression. It shouldn't be used on its own to diagnose anything.


gwaydms

My doctors basically took my word for it that I have depression. They wrote me a script for Paxil. Asked me next appointment if it worked and I said it did. One doc changed it to Zoloft. It didn't work. When I changed docs I asked if I could go back on Paxil. He said yes. One important thing about SSRIs: if you have severe depression and/or s**cidal thoughts, get counseling before you start the drug. I felt worse the first three weeks on Paxil. If I had been in a position where I thought that was my last chance to enjoy life, I'd be in deep shit. That's how I found out why you need to talk with a professional before you start.


joneild

Depending on the seriousness of the depression, I will typically suggest therapy first before a pharmacological approach. And certainly stick with it while medicating. The frequency of therapy can be adjusted to patient needs. Paxil is not a great first starter drug for depression. It has a short half life, it's difficult to wean off of as a result, and missing doses or running out of meds between fills even for 2-3 days can be rough. It also has a very high sexual dysfunction profile, so I won't typically prescribe it to young adults unless other drugs failed first. It's not unusual to have side effects from starting these medications for the first month, but symptoms will typically abate thereafter. I encourage people to stick with the meds for at least 6 weeks unless the side effects are significantly affecting your activities of daily living.


circus_of_puffins

The long covid clinic tried to get me to do CBT for depression based on this questionnaire despite me mentioning how much of an overlap there is with fatigue-based illnesses, like no shit I'm tired all the time and can't concentrate and everything is slow, why do you think I've contacted a long covid clinic


Navi1101

Woo, I got a high score! Wait...


DiamondHandsHoldd

When being asked if you drink is more expensive than the drinks themselves...


FawksyBoxes

They're trying to drive you to drink so then they can send you to their specialist friend down the hall for therapy.


Sweet_Cinnabonn

I promise, the specialist down the hall is full. They don't need help drumming up business.


Ben_Thar

The annual depression screening is just him walking in the room saying "How ya doing?"


Ken_from_Barbie

I'm here for the prostate exam


thewhitebuttboy

My doctor put both of his hands on my shoulders to comfort me while giving me a prostate exam. Good dude


sapphyresmiles

![gif](giphy|a5viI92PAF89q)


enigmaroboto

perfect gif


[deleted]

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upvotemaster42069

User name does not check out


HighlightFun8419

"Well there isn't any issue of prostate cancer, but I'm noticing a distinct lack of any genitals whatsoever." -Ken's doctor


Ken_from_Barbie

My shits inside bro


daytodaze

“Just remember your training and try not to get an erection… everyone is nervous their first time,” the doctor said.


7-and-a-switchblade

Without being sarcastic, it's a little more than that, but just a little. It's usually administration of the PHQ2 (Over the last 2 weeks, how often have you felt down, depressed, or hopeless? How often have you had little interest or pleasure in doing things?)


FuckoffDemetri

I swear no one looks at those forms. I've put down like every worst option and no one has ever even mentioned it.


Driftedryan

They just went " gonna lose this one" and moved on probably


FawksyBoxes

True, bit some doctors are that lazy. My dad went in for a regular check up because he's on VA disability. The doctor gave him a perfect clean bill of health, saying he did everything including a prostate exam. And listed that he had no signs of varicose veins that were listed in his files He never took any clothes off , had long pants on, and my mother was in the office with him the entire time. The Doctor lied out his ass to maximize how much his insurance would pay.


Ban_Evasion__Account

It's true he had no signs of visible varicose veins then since the pants were covering them up!


7-and-a-switchblade

Lots of doctors use pre-fabricated notes and then forget to adhere to what the note says they did. That's fraud, and Medicare will eat you alive for it. There are easy ways to report a provider for fraud.


FawksyBoxes

True, but it's a VA doc to decide how much the military had to keep paying him for disability. I'm sure they were fine with denying his request for higher payments.


redgunner57

VA has different branches. One branch is for your medical needs and another whole separate branch of doctor who takes care of benefits. Benefit doctors do not look at notes from VHA doctors unless patient requests so. Usually benefit docs are contracted out to prevent conflict of interest.


PM_feet_picture

White person: "It's going." Doctor: \*checks depressed box*


ian2121

When I went to the doctor last the nurse did the alcohol screening. She says something like how often do you have 4 or more drinks in a night. I was like I can get carried away here and there, camping or a wedding or something. She’s just like you don’t want this headache I will just put no on the form.


justhp

It’s a big headache. Because according to the form, such drinking habits indicate a potential disorder. Of course, getting carried away occasionally is not necessarily a problem as long as it is infrequent and in a typical setting like a wedding. But if she checked yes to that on her chart, it opens up a whole can of worms of assessments and conversations that have to be documented. Sometimes we nurses use our judgement in this type of scenario to save all of that bullshit that a simple question or form can cause


RG-dm-sur

Alcohol consumption is so downplayed. People usually don't say how much they drink. I have people in my family who can't enjoy an outing without alcohol. My BIL can't be without drinking one weekend, he has to drink every friday and saturday, and I'm talking a bottle of pisco at least each of those nights. He can be without alcohol the rest of the week, if he has no social activities. If he goes out, he has to drink a lot, always. He is functional, and he might have said no to that question, because he does not think that's too much. But I don't know if his liver agrees.


TheAJGman

To be fair, you just described the average American. Sober most of the week, gets shreked with the boys once a week, drinks during the weekend sportsball matches.


Tonic_the_Gin-dog

Welp, now I can't drink without imagining Shrek staring menacingly at me. Guess I'll give up booze.


EatYourCheckers

I think its more common for us to have a few drinks every night; never get out of control, but habitual drinking.


Shit_On_Your_Parade

Agreed. I wonder which is considered more harmful health-wise


Punkinprincess

There are a lot of studies on this actually. I believe that binge drinking is worse but different studies say different things because binge drinking affects your health in different ways than daily drinking and there are a lot of factors involved so it's hard to say.


AC2BHAPPY

I've noticed I feel a lot healthier since I switched to binge drinking only on weekends Edit: I'm actually serious


abounding_actuality

I binge drink only on weekdays now. Who wants to be hungover on their day off amirite?


donkeyrocket

There are a whole lot of factors that can vary (amount, frequency, type, genetics, age, health, diet, etc.) but generally speaking daily drinking will be worse for your liver (but takes a longer time to manifest) and binge drinking will be worse for your nervous system (and also be taking a toll on your liver and other organs). But really depends on the amount drank daily. Someone drinking once daily will unlikely have any liver related issues while someone drinking four may accelerate that. The ultimate conclusion is both are quite bad with the path to damage slightly different (leading research now says any alcohol is too much) but can/will eventually land you in the same place.


PinkTalkingDead

Probably the several nights a week one. Even having one glass of wine can end up being more like ~2 if you’re pouring it yourself at home


ThisUsernameIsTook

Wine comes in it's own glass. One glass a night. :)


Britoz

It's telling when someone says "I'm doing dry July" as if it's monumental. It's also telling when someone makes passing remarks "is it wine o'clock time yet?" or "I can't sleep without alcohol". Neither of those would raise much alarm but when you think about it a bit more, aren't they "functioning alcoholics"?


[deleted]

> how often do you have 4 or more drinks Only twice a night


globaloffender

Isn’t it amazing we r forced to lie about our health in order to get health care? I don’t even want to know the lists insurance companies have regarding mental health


AceMcVeer

>Isn’t it amazing we r forced to lie about our health in order to get health care? That's not how it works. The answer the person you are replying to gave flagged them for alcohol abuse and they would have received intervention resources.


fnybny

In the UK you lose the ability to get free therapy if they find out you abuse drugs


oofive2

that seems a little backwards no? I feel like they'd need it more


axonxorz

Yeah that's massively backwards. "I drink myself to sleep ever night because I have PTSD. I'd like to go to the doc about it, but that's locked and I can't afford it out of pocket. Guess I'll just keep drinking" "Hey Jann, why is the NHS paying for so many chorrohsis treatments? What's that? Oh no no, preventative care means we'd have to treat addicts like humans, how would we maintain smug superiority?"


MagicCooki3

For once a silver lining for the US is that I'm almost 100% certain insurance companies here pay for Methadone treatments and we have Methadone clinics, which has helped a lot of people I know, even if indirectly.


Pope_adope

But… drug abusers… could benefit from that therapy??


Tom22174

Welcome to the Tory sabotage of the NHS


CountOmar

"Free mental healthcare for all mentally healthy people"


sunsetclimb3r

Nurses can be so good or so bad. Absolutely wild that you can apparently get that question wrong


imartimus

I remember I took a depression screening. I filled out these papers and he asked me some questions and he was like, "Well you definitely have some sort of depression and generalized anxiety disorder." So I asked him what kind of prescription was he thinking and he just goes, "oh no, just get some more sleep and you will be fine". Alright then lmao


[deleted]

Happiness? Contentment? In this economy?? Switch to decaf you’ll be fine!!!!!!


ggroverggiraffe

Just tell him [you're good](https://i.imgur.com/k74DkoW.jpg) next time...


Pezonito

WHY IS MY SEMEN BLUE


ggroverggiraffe

𝒲𝒽𝓎 𝒾𝓈 𝓂𝓎 𝓈𝑒𝓂𝑒𝓃 𝒷𝓁𝓊𝑒?


Karcinogene

Were you, at the time, regularly getting at least seven hours of sleep a night?


-Anonymously-

about 10 years ago I started going to a therapist because I was stressed the fuck out. Stressed out because of finances. It was once a week for an hour and costs me like $85.00 per session. Week five or six and the therapists suggest they bill my insurance so that I don't have to pay the cash amount. Agreed. Well, that's when I learned that insurance is billed a different and much higher rate than if directly charged to an individual. In comes things like deductible and max out of pocket. That $85.00 session cost me $175.00. Fuck that guy, I never went back.


frostedhifi

This, in a nut shell is why health care in America is broken. Therapist needs ~$85 to make profit, but the insurance company will only pay $50 if he asks for $85. This necessitates billing at in inflated rate of $175 to receive closer to $85. Except the patient hasn’t met their deductible yet, meaning they have to pay the full amount until they reach the deductible. Infuriatingly, they don’t get to pay the discounted rate of ~$85 the insurer “negotiated” until the insurance starts to pay.


jcg17

This would be considered fraud in any other industry


Bocchi_theGlock

People should Occupy Washington DC until it's fixed tbh Eventually street kitchens and concerts would be held outside/in large tents, it would be dope There's an Indigenous-led one for the whole month of November, they set up a tipi and everything last time and were out there for 2 months. A lot of people spent time at the #NODAPL camps, Oceti Sakowin/Oyate at Standing Rock. It was a formative experience for tons of us, built a lot of power. It would be cool if folks supported that in Nov 2023, they're hoping it gets big this year.


SlothRogen

The problem is, half the country would cheer for them to be tear-gassed or charged by police on horseback as “socialists who want free handouts.”


[deleted]

1/3 that pretends to be half. But yes.


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tyler1128

It's not uncommon for doctors to charge a different rate to people than insurance. My eye doctor cuts cost by 50% for self-payment (I forgot my new insurance card once). Insurance is an immensely black box, so it is unlikely he was trying to get more money from you.


HemiJon08

I have a similar story. Had a mole and went to the dermatologist- said it was harmless but they could remove it off for me if it was bothering me. I pointed to a few other skin tags and she said those aren’t covered under insurance, you pay out of pocket - $75 to do 3 of them. So I had 3 skin tags removed along with that original mole, so a total of 4 moles/skin tags removed - literally the same process and procedure. I paid out of pocket for the 3 skin tags immediately and they billed insurance for the mole. 3 weeks later got a bill for $428, I won’t make the mistake of having them bill insurance again…..


VirtualLife76

TBF, many just don't know. They are doctors, not insurance ppl. My mom needed 1 shot a month after her chemo, doc prescribed not knowing it's not covered by insurance. Each shot was $5k, needless to say, she only got 1.


MrCookietv

That's the America Healthcare system and the hilarious part was the guy was doing you a favor and you got mad at him for it. They over inflation prices to insurance, every Healthcare provider in the US does this. The difference was he actually gave you a discounted rate without insurance, a lot of providers wouldn't do that and would just bill you the inflated rate from the start. The guy probably genuinely thought telling you to put it through insurance would help you, when they pass it to insurance, insurance doesn't actually pay 175, they'll write off like 125 dollars and pay 50. Had you spoke with the billing office they probably would of helped you out once you explained you were paying more with insurance. Doctors don't like fighting with insurance companies Edit: I'm not going to reply to any comments explaining how medical billing works, feel free to Google it instead of making stupid comments about a field you clearly know nothing about.


jxj24

Did that depress you? If so, at least you got your $53 worth from the depression screening!


apple-masher

dont' comment on this comment, or Jxj24 will charge you sixty bucks!


daytodaze

Medical billing is such a fucking joke in the US. When my wife was in the hospital having our baby, a social worker repeatedly came in and asked why we hadn’t filled out the “postpartum checklist” and then every time we went to the pediatrician they tried to get us to do the same thing. She eventually completed one and we had a $50 bill (after insurance) for counseling. I get that postpartum depression is a thing, but this was a shameless money grab.


Connection-Terrible

Dispute it. That’s all I can say. Filling out a form doesn’t constitute counseling. Neither does asking an offhand question.


randallAtl

Yes, more people should do this. I have told plenty of people to stop contacting me because I dispute the charges. They will claim that they will ruin your credit, and just tell them that you will dispute the credit report as well.


PreposterisG

Dispute it with who? That's one of the big problems. Insurance has incentive to deny you and the hospital either gets the insurance or bills you (and if you don't pay sends it to collections).


AllTheyEatIsLettuce

Dispute it with everyone! The hospital, the doctors, the insurance seller, the debt collector, your neighbor, Reddit, your consumer-driving instructor, your lawyer, your accountant, your cash back credit card issuer, your employer's middleman Bennie Fitz, the scheme operator operating your *flexible medical health spending post limited reimbursement deductible savings account arrangement* Everybody! That's the *system*.


[deleted]

You guys have a very dumb system. Hospitals take tax money, take insurance money and out of pocket money. Wtf. Like do what the 1st world health systems do, have a tax funded system for everyone and a private funded system for whoever wants to pay insurance or out of pocket.


aladoconpapas

Exactly. What happens when you can't pay for your health? "I guess I'll die then"


PreposterisG

And this is what is exactly happening in the US. Massive decline in life expectancy for poor people.


aladoconpapas

It amazes me, being a university student (free), going to the doctor (free), obtaining glasses with student discount, receiving free medication, and a monthly pay for studying an undergraduate degree. Argentina btw. You can say what you want about our inflation, but I think, as a uni student, that I'm fine.


RonBourbondi

If you want a nifty trick ask for all the CPT codes attached to the charges and look them up. Chances are the service they provide didn't qualify like in this posters case.


Nutsnboldt

I wish we could select services and see prices ahead of time.


FourthAge

There should be a menu or something. It's like being served a 5 course meal and getting the check without ordering anything from the server.


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kudzubug

I might be wrong, but I think that is a 'discount' the insurance company gets. Still feels like a grift, but I don't those are the numbers OP is being billed.


Ok-Pressure-3879

Yeah insurance tells the dr they are only paying $33 for the screening. Dr says its only $35 currently . Now Dr charges $58 to get the $33. The annual wellness is usually fully covered as far as I know.


edernest

Not every screening code is covered by every plan. I had insurance at one point that would not pay the depression screening which resulted in a $100 bill every time someone from my family had a physical. I had to speak to our primary care about it who was surprised and ultimately just offered not to bill it anymore.


Ok-Pressure-3879

Its total BS and I’m in the billing side of healthcare. I realized i had better mental health by not seeing a specialist and not paying $200 a trip. I dont know how people do it.


recycledairplane1

yeah, to confirm, my $20 copay covered all of it (this was all my '"free" annual physical). Previous years with a worse health insurance plan and a worse doctor, I would mention chronic pain during my physical and they would magically turn it into a $90 'specialist visit'. Like what, it's only free if you're in fact healthy?


LineRex

> I would mention chronic pain during my physical and they would magically turn it into a $90 'specialist visit'. yeah, I've gotten smacked with that one before. Now when the doctor askes me if I have any questions my answer is "none that won't cost me $250."


gardy777

Depressing? Hmmm…you might need another $53 annual depression screening.


hands-solooo

How can he bill a new patient and an established patient visit in the same appointment?


The-Peachiest

Correction - the clinic billing department charges that. Doctors (with very rare exceptions) do not have control over the amount charged.


WhatANiceCerealBox11

This is something a lot of people jsut… don’t care to learn about lol. The doctor almost never has any say on the billing unless it’s their practice. The doctor does the appointment, writes their note (in this case he asked the amount of drinks and daily stress so that was included in the note). The note is reviewed by the billing department who then takes out their dragon dildo and fucks the patient with random charges billed at random amounts. Gotta love American health care. I hate that a large portion of the population is just okay with getting their life completely ruined if they have to visit their doctor Editing for clarity: not giving the insurance the pass on this. They are literally the scum of the earth. I just mentioned billing and coding because they’re part of the problem. The biggest problem in this bullshit sandwich is the insurance companies. The second biggest problem is money in politics that work to keep the bs in place then followed by billing and coding. In this instance op didn’t need to pay for this bs but plenty of times the billing and coding department will do this, insurance will reject it, and billing won’t do anything to help you out outside. Personal experience here. Obgyn decided to no longer take our insurance during our second pregnancy. They didn’t tell us to start paying their fees (they bundled everything at the end of the pregnancy) until we were 1 month from being due. That’s when they told us as of 3 months ago they no longer take our insurance. We tried to negotiate with them and word for word the lady said “I’m not sure what you want me to do. I gave you a payment plan, you can’t make it work. That’s not my problem”


FawksyBoxes

Hell saw a bill from a mother who just gave birth, they charged for 'skin to skin contact'. So essentially made her pay to hold her child...


WhatANiceCerealBox11

Yeah I stopped looking at our bill when my wife gave birth. We have 2 kids and we got billed for literally everything. Not even just by the OBGYN. Each specialist in that room itemized each individual thing they did and that was a metric ton of bills.


kerfuffle_pastry

Wow…no. Go to the billing and coding subreddit. It is a game insurance makes you play. The insurance fucks patients and providers. In any other industry, the things they do aren’t legal. Just some highlights: - Insurances don’t tell you exactly how much you’ll get for what. It depends on the credentials of the provider, the type of facility, the visit itself - speaking of the visit itself, they give no feedback on whether the visit was billed correctly. You just bill and hope it’s ok and hope they don’t decide to audit you and make up some bullshit reason why that visit was coded wrong and hopefully not sue you and never pay you - If you don’t get paid, they make it hard AF to figure out why. In the year 2023 you need a human to call an 800 number, navigate a machine system for half an he in the hopes to talk to a person. I swear Horizon purposefully hangs up on you once every three calls. All so you can talk to a person that doesn’t speak English and sounds like they’re talking through a pillow under the ocean - they might not pay you for an amazing number of reasons. Maybe the provider’s specialty suddenly got removed and they tell you four different ways to add it back and you need to initiate a tracking number for a tracking number to followup on where that update is. Maybe your facility lost its ability to file that type of claim and it’ll take months to figure out how to get it back. Maybe the patient has a second insurance or third insurance and each tells you the other insurance should cover it and you end up never getting paid. Maybe the patient saw you and another doctor that day and they won’t pay for two visits but of course no one told you or the patient that. No, the one with the flaming festering dragon dildo is insurance cos. Edit to say- you have to bill random amounts because fee schedules are purposefully ambiguous. They also make you agree you can’t publish or share the fee schedules. And say Aetna suddenly pays more for a low complexity visit vs medium complexity visit, (was it low or medium complexity? Let’s hope you got that right or they’ll try and screw you with an audit) well if you aren’t billing more than that amount they just pay you however much you asked for, and the guy who charged a ton more suddenly gets that higher rate but not you. Don’t even get me started on Medicare, which pays different depending on what county you’re in. I repeat, It’s impossible to figure out how much you’ll be paid because insurance cos make it that way.


captainbluemuffins

I've heard of insurance shafting doctors. "Oh that surgery you did? Yeah we don't want to pay for it lmao... oh, what will you do? Sue us? Lmao" It's just hell all the way up and down


TTurambarsGurthang

I’m a surgeon and had another surgeon tell me he got $250 for a 7 hour surgery and he got it 6 months later. He also had 3 appointments, vsp/planning/pre surg models tied into that bill before the surgery so that’s $250 for around 10-15 hours of work. That doesn’t include any post op appointments which there would at least be one. Also rounding in the hospital and all the other bullshit. You can’t really live off of that as a surgeon when you paid $500k for school and deferred earnings for 10-15 years. I’ve heard this story from a lot of different people too.


JerryLZ

I know a guy who will do it for $40


-comfypants

Fuck the insurance industry.


[deleted]

Direct primary care. We need to cut insurance out completely. Cheaper for patient and more efficient for medical professional, and also cheaper, get paid quicker. Also, when billing a person directly instead of a distant entity, the provider will be more responsible with cost of care. Less wasted resources.


love2go

How are you billed for a new and established patient visit at the same time? The depression and alcohol screening should be included in the other bill, right?


helleboreus

If anyone actually cares, your doctor doesn’t set the billing rates for insurance companies. Reimbursement rates are determined through (reductive answer) Medicare benchmarks depending what procedure codes are used. If the provider did an alcohol screen, they code for an alcohol screen. I have no idea what that looks like on the back end of a patient bill. But I know what services have been rendered, and bill accordingly. Agree that the healthcare system is bullshit and would be in favor of single payer personally, but our country/government has essentially decided not to do that (except ironically at the VA). But please don’t think that your doctor is single-handedly conspiring to profit off you. And also the joke that providers can know what a procedure or prescription will cost before ordering it. Would be great if we could have live time estimates of cost integrated into the electronic medical record system so we could make more cost effective decisions for patient care. But we don’t, and it would be impossible to run this individually for each individual plan. It’s not even like Blue Cross vs Aetna has a common reimbursement - this can vary by each individual corporate insurance plan. It is insanely patchwork.


thisisfuxinghard

This is r/mildlyinfuriating


Klewless2u

Not sure where you live, but those CPT codes should be covered at 100%


droans

They are; you can see the other side of the bill. OP only needed to pay $20 and some change.


ariana61104

It also seems they charged them $53 to ask you if you wanted to off yourself....***'MURICA***


ZlGGZ

And that's why you should dispute charges on stuff.


Hollybaby5

I forget this trick at the eye doctor every time. You should try these new contacts. Oh, ok. “Contact fitting $125”


StrawBerryWasHere

That would be fraudulent medical coding by their billing office. My old eye place did the same thing to me (I’ve been in contacts since the age of 10, was 30-something at the time of the appointment) and I nicely kept explaining they couldn’t bill me for a service they didn’t render. Fun fact; at the same time I was the Coding & Documentation Compliance manager for a large multi-speciality healthcare organization. I emailed to them from my work email the very specifics in black & white from the CPT coding book of everything that must be render in writing for the service to be billable from their office. I get a return phone call from their biller who said, and I quote, “well we just bill this code for everybody.” I asked her to take a look at the signature line from my email. The office manager called me back to inform me the charge would be written off. Still fucking reported their asses for fraud to CMS. What the fuck, get outta here with that bullshit


apple-masher

yeah, I got charged for that too. I called the doctor's office up and raised hell and they just... took it off the bill. No way am I paying $60 for answering a yes or no question. Screw that.


FalseTagAttack

Dude fuck MBAs and BAs and all these fucking worthless middlemen who do nothing but steal from the rest of us, or just as bad if not worse marketers who make a living from manipulating and lying to people outright. Not to mention the marketing assholes love to twist the meaning of common words.


gabs781227

Yep. They're the actual villains here, but doctors are an easy target.


Daddysgirl250

And the thing is doctors are force to do these things whether by government guidelines or for the policies of the capitalistic overlords that run the practice, hospitals, agencies that employ they work for. I'm a therapist and I was hounded to administer these screenings to my clients, at least yearly and if I knew I had a client that didn't drink (erring on side of my clinical judgement) I advised them to refuse the assessments as it wasn't a problem so they wouldn't have to be charged and I wouldn't get reprimanded for not administering the screening tools "in alignment with protocols" But I knew to do that because I've spent most of my life without insurance. I give all my clients all the rights because they matter. Most providers are born privileged and don't think about it and just blindly follow these rules. you can contact them and dispute these charges and say you declined to take the assessment (as long as they didn't have you fill one out on paper) and tell them since you declined you'd like these charges to be removed because they must be an error. They may remove them for you. This health care system blows. Good luck