Consumer! – shop for medical services….

America consumers are adept at shopping for details when purchasing consumer items for example: a TV set, new vehicle or a piece of furniture. While price is important, consumers also take into account overall quality of service: the vendor’s reputation, after-sales service etc

Medical services are no different. While we may be accustomed to simply visiting the doctor and taking his/her advice and paying the co-payment stipulated by the insurance company, this process is rapidly changing. I provide two personal experiences to illustrate, focusing mostly on price:

1. I recently underwent a root canal treatment. My dentist referred me to an endodontist. Upon arrival at the office I presented them with my insurance card and was told “we are out of your network”, bottom line my co-payment would be 50% or $575 plus $238 for a procedure not covered by insurance at all. Total out of pocket expense: $813.  In pain and sensing the urgency of the matter,  I still managed to phone the dental insurance company,  requested an in-network provider and simply walked three blocks to my new appointment. At this office, my co-payment was 10% and $110 for the uncovered procedure, total out of pocket expense: $188. The endodontist provided a most pleasant and pain-free experience with excellent after-care instructions on how to remain pain-free.

2. Following my MRI experience, which I detailed here, I received a bill for a whopping $500 co-payment. I phoned several MRI clinics in the neighbourhood and was surprised to learn that the identical procedure (I quoted the standard ICD-9 code), was 10%-40% cheaper. My co-payment would have been far less than $500 (I am currently fighting the exhorbitant cost at my clinic quoting neighbouring facilities which charge less).   Lesson learned: shop around, call for price quotes on medical procedures before undergoing any.

Bottom line, It is your body, your health-care, your money:

  • Call around for price quotes and after sales service before undergoing a medical procedure.
  • Get to know your insurance company and in particular the diagnosis code (ICD-9).
  • Provide this number to the medical services provider and you will rapidly get a price quote and know what your total out-of-pocket expense will be.


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