I am SO angry at what is happening with this doctor's office. My old ortho retired last year and I was forced to find a new one. Nowadays, it seems that every doctor is affiliated with a large medical group and it is so frustrating. So, I asked the PT for his referral and he gave me a local ortho who is with one of those big, multi city medical groups. Honestly, the doc was great.....and he ordered lubricant shots for my knees.....initially Euflexxa. For the next 6 weeks, I had to basically hold the hand of the office preapproval person to get the approval from my insurance company. Honestly, the insurance company was NOT the problem. I spent numerous days on the phone with the office manager complaining that nothing was being done. Fast forward....insurance company approved a different drug (no big deal to me....they are all basically the same and I've had good results with Hyalagen so I was fine with that). The drug was approved and I 'purchased' it from our insurance company's pharma....CVS/Caremark and they sent it to the doctor's office. Had my first shot on 6/22 and when I went it, I was emphatic that the staff find MY pre-filled syringes that were sent to their office. Next visit on 6/29....I did the same thing. Now, backtrack a minute.....when I talked to CVS/Caremark to give them my credit card info....they told me for 10 syringes (both knees), it would cost me a flat $200....without insurance it would have cost a little less than $900 (or slightly less than $90 per syringe).
The other day, I went on my insurance website to check on the claim and while the EOB isn't up yet, the 'claim' was.....and it was broken into two parts. One was for $390 and the other was for $1360. Today, when I went in for my third set of shots, I asked billing what the claims (now there are two being worked on) were for.....could they explain the two components of the claims. She said that the $390 was for the PA to administer the shots and the $1360 was for the two syringes. I was so totally TICKED off. After everything I had gone through, isn't the office competent (guess not) to realize that I had the SYRINGES SENT TO THE OFFICE??? We finally got it straightened out but....then I started to realize that the office was charging $680 a syringe!!! OMG! That's 7.5 times more than the CASH cost of the pharmacy.
CVS/Caremark cash price was just under $90...and here the doctor's office jacks up the price to $680 for the exact same (same brand...no generic available)thing! No wonder our insurance premiums keep going up and hello, no wonder why my insurance 'rewards' me with a flat copay if I purchase the meds through them instead of 'purchasing' the meds at the doc's office!!!
Total out - of -pocket cost for 10 syringes (5 per knee) = $200 (or $20/syringe)
Total CASH price for 10 syringes = $900
Total billed price for 10 syringes from doc's office - $6800
Totally and absolutely RIDICULOUS!
Dx 6/22/2006 IIA rectal cancer
6 wks rad/Xeloda -finished 9/06
1st attempt transanal excision 11/06
11/17/06 XELOX 1 cycle
5 months Xeloda only Dec '06 - April '07
10+ blood clots, 1 DVT 1/07
transanal excision 4/20/07 path-NO CANCER CELLS!
NED now and forever!
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