Doctors’ Offices Overcharging for Co-Pays

In the past few years, I’ve had interesting experiences at the numerous doctors’ offices I’ve visited while managing my and my daughter’s health. I’ve discovered that a number of times, we’ve been charged too much for a co-pay, or charged the co-pay in instances when one wasn’t necessary at that visit.

For us, a primary care visit merits a $20 co-pay; a specialist visit is usually $40. So If I see my primary care physician, it’s likely I have to cough up the 20 bucks; if it’s the endocrinologist, it’s $40.

Our health insurance company sends statements via mail every time it processes a claim, and it shows when a co-pay should — or shouldn’t — be charged for each particular visit. Thanks to these statements, I’d previously learned that my ob-gyn annual checkup is considered well-care, meaning there’s no co-pay payment required. And any other visits to the ob-gyn are only $20. But I’d been told to pay $40 per visit to this doctor, each time (excepting prenatal visits).

A few days ago, Baby Frugalista’s pediatric ophthalmologist sent us a check to return our last $40 co-pay — the follow-up visit didn’t necessitate another co-pay. Bless them — $40 is nothing to sneeze at! But I had to show my ob-gyn’s office staff that my visits there should only rate a $20 co-pay. They finally switched it, but I didn’t get a refund for overpaying a few times.

Don’t get me wrong — I’m grateful that we have good health insurance coverage at a (fairly) reasonable price. But you’d think the front-end staff would know when a co-pay applies, and when it doesn’t. Especially since we have a major health insurance carrier (Blue Cross Blue Shield).

Have you ever taken a look at your health insurance statements to see if you’re being overcharged for your co-pays?