Secret services: Why is it so hard to find out what your doctor’s visit will cost?

It’s not that easy to find out what a doctor’s visit will cost, especially at the appointment. Photo by SKYCLAD Aerial It’s not that easy to find out what a doctor’s visit will cost, especially at the appointment. Photo by SKYCLAD Aerial

When you buy a house or a car, you know how much it’s going to cost. That’s not necessarily the case when you go see a doctor, especially if you don’t have insurance, a local woman discovered on recent visits to a UVA clinic.

Sara Ensey is a self-pay patient, and when she went to UVA Primary Care Riverside December 12, she asked twice what the cost would be before she saw a healthcare professional, and was told, “We cannot give you that information,” she says. One person added, “You don’t have to pay all at once.”

“This is an outrage and a disgrace, and it should not be legal,” says Ensey.

Too many people have to choose between medical care and other necessities, and UVA Health System should be transparent about costs, she says.

She had a similar encounter in June, and later received a $385 bill for a 10-minute primary care visit that involved no labs, blood work, or x-rays. Worse, she says, the bill had none of the codes that categorize the services she received.

“We do provide price estimates upon request,” says UVA Health System spokesperson Eric Swensen. Patients need to call or visit for an estimate, which can take up to two days, according to the website.

Ensey questions why the burden is placed on a patient to log onto a website or place a phone call to obtain the information. “If they are so forthcoming with pricing information, why the hurdles? I asked in person and was denied—twice.”

Swensen says the estimate depends on several factors, including the complexity of care a patient needs and the details of her insurance coverage, and it can take some time to develop an estimate that is as accurate as possible. “The estimate review process is detailed to capture procedures and tests that may be needed together with the patient’s insurance coverage to best determine the patient’s out-of-pocket estimate,” he says.

But Ensey thinks the information should be available at a patient’s appointment. “How is a patient to self-advocate and make a cost-benefit analysis if no one can tell you what the cost will be?” she asks. “That’s ridiculous.”

Ensey recently moved here from Vermont, and she says the University of Vermont is required to provide patients estimates at the time of the visit. And some health systems offer online calculators specifically designed for just this purpose.

“It surprises me UVA doesn’t have something similar,” she says.

Charlottesville’s other main health care provider, Sentara Martha Jefferson, doesn’t seem any different. Spokesperson Jenn Downs says in an email, “Our patient financial service customer service representatives can provide an estimate of total charges.” But as at UVA, that must be done in advance.

Ensey wants to make it clear that the issue is not about pointing fingers. “This is about raising awareness so that the situation can change for the benefit of patients in the greater community and beyond—because it won’t if no one calls attention to it.”

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