Doctor visit but pay twice since you don't see a doctor but instead a FNP?

[sdowney717]

First 2 visits to the Rheumatologist, I saw a medical doctor.

My out of pocket specialist cost is $40, I expected that.

But my next 2 visits, same office, I see an FNP, who works in same office. I have to pay the $40 specialist doctor deductible, AND last bill was a $60 fee for the FNP, comes in the mail months later, which after another month, insurance says I now have to pay $38. I just looked and my upcoming visit is with the FNP again. She is nice enough, but they force me to pay basically twice to go in for a visit. Instead of $40, it is $40 and $38, AFAIK, I will call office and ask about this., see if I am really paying twice. What is your experience?

[PMRpro Ambassador]

Not a problem in Europe - all specialist care (all care actually) is free at point of delivery.

[sdowney717 in reply to PMRpro]

I have been wondering if I am paying twice, or if they waived the copay of $40. I need to call the insurance company. What often happens is they won't charge you right away, medical bills show up months later when your memory is hazy about the events, and I have seen 3 different medical groups this year.

To me, it would not be fair to charge a person twice for a visit. Pay your $40 copay for the office visit, then a FNP (family nurse practioner) bill shows up 2 months later, from a pathology group practice, not from the rheumatologist's group practice. She, the FNP, apparently works in that office to relieve the doctor's duties.

[nallufl24]

I’m in the US also. Years ago I went to a specialist and was charged a copay. Later I received another bill. When I called I was told it was for the privilege of seeing this particular doctor. When I called my insurance company they said yes, that some hospital systems do that. I really liked this doctor but stopped going because of the extra fee.

That was about 10 years ago and I never encountered anything like that again.

[Karenjaninaz]

Are you on Medicare? So me plans called Medicare Advantage charge like this.

I have a Medicare Medigap plan and haven’t seen that.

If you are in the deductible phase charges will be higher. Best to call the practice’s billing.

[cranberryt]

We actually pay less to see an NP or PA usually. You should receive a “statement of benefits” from your insurance company that tells you whay your copay should be. I always check that against any actual bill I receive. The bill should show the cost of the visit, minus the insurance discount, minus the insurance payment, minus copay made at visit, leaving a balance due, if any. Usually there isn’t any unless there is labwork. If their bill doesn’t match the insurance, then call their billing office and ask. Yes, it’s hard to remember all this months after the visit when the paperwork finally shows up!

[Purple-Owl in reply to cranberryt]

What is an FNP?

[PMRpro Ambassador in reply to Purple-Owl]

I don't see FNP - but anywhere you see NP it is usually Nurse Practitioner - a highly qualified specialist nurse.

[cranberryt in reply to PMRpro]

Family Nurse Practitioner

[sdowney717]

I figured it out. The FNP ordered a uric acid blood test to rule out gout which I knew I did not have. Silly me, she talked me into it. The charge was a lab fee and had her name on it as the referring 'physician'. I would not have agreed to the test if I had known the cost was that high. It was the only lab work she ordered, and completely unrelated to PMR diagnosis, but she thought I also had gout due to my middle fingers, but I laughed and said my big toes are fine... Original cost was $60, we got a bill for it, and we waited, and a month later insurance paid $22 making our cost $38. I used to do all these blood work lab tests in a medical lab for decades being an MT. Prices have 'gone thru the roof' since I retired 20 years ago when I was 41 after not needing to work for financial reasons. I am 64 now and inflation has really been pushing up costs of everything. I am invested in dividends and funds myself, plus this year I claimed SS at 64. Wife still works. I can see though now just SS check would not be enough for an older person to live a decent retirement. I did also earn 2 pensions, one for working at Glaxo Smithkline and the other a large regional hospital. but the hospital pension I have to take at normal retirement age which is about 3 years away.