Every month I dutifully open my doctor's bills. Every month I dutifully pay at least $10 to all my doctors. I dont make a dent really, but I like to think I have integrity.
This month I opened my neurologist bill with confusion. I don't usually owe them any money. I had a bill for $100. I called them and they confirmed that my pharmacy had faxed them prescription refills for each of my prescriptions. Their office charges $20 per refill. No exceptions.
They are POSITIVE that they wrote out enough prescriptions until I see them next and it was "irresponsible" of my pharmacy's computer to lose it. Therefore, faxing them to get a refill sooner before my next appointment takes away their time, thus, they charged me. I was never informed that my pharmacy was faxing them for a refill, and I was never informed of the charges.
Meanwhile, I now owe my neurologist an additional $100. This is in addition to the $200 per page I often pay them for forms verifying that I can return to work, or that just asking for a signature.
I realize that doctors now are often seeking compensation for services for their time because insurance doesn't compensate them. However, chronically ill patients have more doctors, forms, and prescriptions than "healthy" patients. Thus, doctors who charge for such services at such a high cost are passing on inequalities of insurance on to people who already have less and pay far more.
We pay more for expensive medications that are over priced and not in generic. We pay more for doctors to write a form justifying that we need to be on the medication, even if it saves our life. We pay for patient assistance forms. We pay when the pharmacy faxes in a prescription refill. And we pay for an authorization that we can go back to work after we have been in the hospital. Each time a doctor charges $20-$200 for such things, they continue to do what insurance does to them.
Rather than changing our litigious culture and working to get their medical practice insurance rates lowered, working to get insurance reimbursements to be fair, working to keep people living equitably, doctors are simply passing on the inequality to people who can ill afford it.
It feels like the dad who beats the mom who punishes the child who kicks the dog who chases the cat. It feels like a never ending system of inequality and financial distress.
After I called my neurologist to discuss the bill with the receptionist who called my pharmacy "irresponsible" - she said I could pay my bill over two months. Instead of that or even a $10 check like I would normally do, I didn't pay anything at all. It isn't in my budget and I already pay for brand anti-seizure medicine. They will have to wait.
I feel burdened and upset. As a patient I feel I should have at least been informed of the charges and had the right to ask another doctor to fill out these prescriptions for me. Using non-electronic methods to keep track of prescriptions and keep track of forms is so last century. I don't like being charged for it, but I like the lack of choice even less. I have to decide if my pocket book can afford this neurologist.
I'm seeing my doctors perspective, but my doctor isn't seeing mine. Though I understand WHY it is happening - the fact that patients like me are being charged for necessary forms makes me trust my doctor less with my health.