Are Doctors' Offices Double Dipping?
A doctors' office charges $25 for every test/procedure requiring pre-authorization. This is above their office visit and procedure charges. It is an out-of-pocket expense not covered by any insurance.
The office staff routinely spends an hour on the phone with insurance companies to obtain pre-authorization. The $25 charge is to recoup for their time. The doctor gave a recent example: administrative staff spent one hour getting Medicaid approval for an $8 urine test. I've been on the phone with insurance; I don't doubt that.
The Obvious Solution:
Patients do their own pre-certifications. Unfortunately, insurances often will not allow this.
Insurance's Point of View:
The insurance customer service representative is also on the phone for that same hour - often because the doctors' office, despite having done it hundreds of times, does not have all the necessary information together. The staff has to either put the call on hold or call back later once they have the information.
Many insurances don't require any phone time. Introducing electronic submission! Doesn't matter - $25 fee still applies.
What do you think of additional fees for medical offices to file insurance? What are your department's financial practices? What are your personal experiences with financial policies of doctors' offices?