A New York woman named Alexa Kasdan recently went to see her doctor because she had a cold and a sore throat. Her insurance company was billed $25,865.24 for the visit.

The lack of transparency and completion in the over-regulated health care “industry” leads to abuse and exploitation

Like all other service providers, we should know what we are paying before the service is performed.

 

 

Alexa Kasdan had a cold and a sore throat.

The 40-year-old public policy consultant from Brooklyn, N.Y., didn’t want her upcoming vacation trip ruined by strep throat. So after it had lingered for more than a week, she decided to get it checked out.

Kasdan visited her primary care physician, Roya Fathollahi, at Manhattan Specialty Care, just off Park Avenue South and not far from tony Gramercy Park.

The visit was quick. Kasdan got her throat swabbed, gave a tube of blood and was sent out the door with a prescription for antibiotics.

She soon felt better, and the trip went off without a hitch.

Then the bill came.

Patient: Alexa Kasdan, 40, a public policy consultant in New York City, insured by Blue Cross and Blue Shield of Minnesota through her partner’s employer.

Total bill: $28,395.50 for an out-of-network throat swab. Her insurer cut a check for $25,865.24.

Service provider: Dr. Roya Fathollahi, Manhattan Specialty Care.

Medical service: lab tests to look at potential bacteria and viruses that could be related to Kasdan’s cough and sore throat.

What gives: When Kasdan got back from the overseas trip, she says there were “several messages on my phone, and I have an email from the billing department at Dr. Fathollahi’s office.”

The news was that her insurance company was mailing her family a check — for more than $25,000 — to cover some out-of-network lab tests. The actual bill was $28,395.50, but the doctor’s office said it would waive her portion of the bill: $2,530.26.

“I thought it was a mistake,” she says. “I thought maybe they meant $250. I couldn’t fathom in what universe I would go to a doctor for a strep throat culture and some antibiotics and I would end up with a $25,000 bill.”

www.npr.org/sections/health-shots/2019/12/23/787403509/for-her-head-cold-insurer-coughed-up-25-865?utm_source=pocket-newtab