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BAYVIEW SURGERY CENTER PRICING/BILLING OF SURGICAL SERVICES JOYCE GRIFFIN IS an accountant who is also an avid tennis player One fall afternoon, after an inspiring
BAYVIEW SURGERY CENTER PRICING/BILLING OF SURGICAL SERVICES JOYCE GRIFFIN IS an accountant who is also an avid tennis player One fall afternoon, after an inspiring win at the tennis club, she noticeod a sharp pain in her knee. The diagnosis was a torn tendon, which could be easily corrected by arthroscopic surgery. After consultation with an orthopedic surgeon whom she knew from the club, Joyce asked the phy- sician to schedule the surgery for the following week at Bayview Surgery Center (the Center), a local ambulatory surgery center Being an accountant and detail minded, Joyce called the Center as soon as the surgery was scheduled to provide the required insurance information and to ascertain the amount of the charge. The patient accounts clerk at the Center quoted a charge of $1,500 for the surgery and told Joyce to bring a check for $300 the day of the surgery to cover the 20 percent copayment called for by her health insurance policy Joyce paid the $300, and, fortunately, the surgery was a resounding success. In fact, Joyce was extremely pleased with the medical care provided by both the Center and the surgeon The problems began the following week when Joyce received a copy of the bill that was submitted to her insurance company. Her eyes almost popped out when she read the total-$2,657, which should have required a copayment of $531. Equally strange was that the insurance claim form showed no sign of her $300 copayment; the "Amount Paid" space had a zero. Confused by the inconsistencies between what she had been told carlier and the claims form, she confronted the Centers usiness manager for an explanation. The best answer she could get was, "This is just the way we do it. Everybody does it this way." 233 HAP, 2014. Reproduction without permission is prohibited
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