Question on the cost of 2 skin biopsies and an immunostain

[SEpathguy]

A friend of mine got a bill for the pathology charges on two skin biopsies she had recently. Seemed pretty high to me, $439 total ($272 for the two 88305 and $167 for a 88342). Does this seem high? I don’t do billing and I’m in academics so don’t see my collections but from looking online seems like Medicare rates would put the total for what she had around $250. She’s essentially self pay. I said she may want to call and see if they’d take the Medicare rate - would this be crazy?

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[deleted314957]

Charges seem pretty reasonable to me for someone w/o insurance.
They don’t get the benefit of a contracted rate like Medicare
and other insured folks do. It is entirely reasonable to ask if
they will accept the Medicare contracted rate. But, realize that
the Medicare rate is generally crap and far less than the
“Usual and customary “ ( if that concept even still exists) and
they are under NO obligation to accept such fee in this case.
It helps if the uninsured patient discusses their situation
BEFORE tx is initiated.
This is why people need to be insured OR be ready to pay
the piper. Someone’s decision to go uninsured should NOT
penalize the provider of services in my opinion.

 

[octopusprime]

Yeah that seems pretty normal for someone without the benefit of insurance-contracted rates--actually not a bad rate at all...every pathologist (every physician/hospital/health care entity) in the country charges more than they know they're going to receive from insurers, whether it's the US Govt or private. Seriously, we charge more than that for 88305 and 88342. "charges" are not what we expect to receive...if our net collections were actually on par with our charges, i'd be sipping daiquiris on a beach somewhere.
Sticker price is not actual price, unless you're uninsured.

 

[SEpathguy]

Thanks for both of your input. I told her to ask if they'd take the medicare rate (or around that) and see what they say.

 

[LADoc00]

Charges seem reasonable, if someone called me up though I would tell them to pay me Medicare. If someone called me up and said Medicare was too high and they have legitimately a small child to feed, I typically wave charges completely. I figure I do absolutely deserve to be rich but not on the back of children not getting proper care they need.

 

[AZpath]

That's about the way we handle our self pays. We try to get medicare but we often write them down to zero if situation warrants it.

 

[deleted314957]

Just as an aside, we called “self pay”, “no pay”.

 

[Daddydoc]

We give a cash discount, which I believe is 40% off of the charge.