Nuances of an office visit

By law, health insurance companies are required to cover some services such as annual physical exams. However, KFF Health News covered one patient visit that turned out to cost the patient much more than expected. A big part of the confusion was the blood work to test for a previous condition, which ended up being sent to a hospital for processing.

While the patient in this case ended up paying what was billed, this experience highlights how awkward future physician-patient interactions might need to become to avoid billing surprises. As presented, the patient's expectation of a preventative visit completely covered by insurance seems reasonable. This episode seems to encourage patients to ask at every step of a visit whether something will be billed outside of what the insurance company will cover. Then, if a doctor does not know the cost of a specific procedure (e.g. non-preventative visit, or blood work), the patient is placed into a difficult situation of being asked to make a decision about his or her health without knowing the cost (and probably only having a vague notion of the benefit).