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how can they charge so much more than I do

  • 1.  how can they charge so much more than I do

    Posted 04-30-2018 00:25
    I recently took my son to a walk-in clinic for a chest xray and pulmonary issues. He has a bit of complicated medical history.

    At the visit they insisted on a flu swab and while it truly wasn't needed, I said- sure.

    I just got the bill:
    flu swab:  bill:  $190  allowed 147.08
    visit:  bill: 266.75   allowed  228.77

    Complexity wise I would guess it was a -14.  Even if they somehow thought this was a -15 ( ??!!) that's still quite a bit higher than we get.
    He wasn't a new patient as he was seen there the year prior.

    I"m curious if the allowed rate so high because it's a walk-in clinic.
    And what's going on allowing $150 for a flu swab?

    So I'm curious if anything for us to learn from this.
    anyone with insights that may help us play the game better.
    I'm going to try to search out the cpt codes they submitted.

    We offer one hour a day walk-in for our established patients- no appointments needed.
    maybe something different in billing possible?
    the group I went to states in their literature they bill their walk-in as doctor visits not as ED or urgent care.

    Melissa Weakland MD
    Ballard Neighborhood Doctors
    Seattle WA
    IMP since 2007

  • 2.  RE: how can they charge so much more than I do

    Posted 05-01-2018 08:57
    I do run a urgent care, and I do not get paid that much. If they are affiliated to a hospital, then bill and get paid the hospital rate. But that's just my guess.

    Tony Limbil


    "What is success?...Let us pursue what stands the test of time: Life, Love, Liberty."