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I am a long-time reader. I have learned a lot from you all. I think I have something to share that I think it's beneficial to everyone too.

One time, I got cotton stuck in my ears when that thing fell off a Q-tip. Being a FWFer, I tried to ask for the price before going to see a doctor. The receptionist asked and got all the information, and even the insurance company and plan, and said it would cost at most 60 - 100. When there, even after all the BS jokes and stuff, the doctor was done in 5 minutes. I tried to pay on the spot too, but they said the insurance company said I have no copay, and they didn't know how much to charge. But when I received the bill like 2 months later (from the doc directly, not from the insurance company), they want $180 for it. I called and asked why such a huge discrepancy, all I got was a combative, rude lip service.

I have no choice but to pay, since I don't want to ruin my credit for such a small amount. But isn't it unfair that they can lure you in with one price, and then charge you so much higher? It seems like we as a nation can tolerate this kind of situations but none other(can you imagine false advertising even for your car repair shop? Fry's ads? I know your life is a lot more precious than your Crown Vic, but hey, every doc visit shouldn't be a blank check).

I guess I can print this LA Times article out and frame it to make myself feel better:
http://articles.latimes.com/2013/jan/15/business/la-fi-lazarus-20130115

Maybe the FW way to see docs is to pay cash even if we have insurance?
http://articles.latimes.com/2012/may/27/business/la-fi-medical-prices-20120527

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Can't any people in the medical profession give us info as to whether we can get a better price trying to get a cash pri... (more)

Silverthunder (Mar. 02, 2013 @ 1:04a) |

This MD's website has some good info-- http://www.kevinmd.com/blog/2012/06/hide-health-insurance-status...

He say's:

First... (more)

boomp (Mar. 09, 2013 @ 10:42a) |

Yes there is. While intensivists (ICU staff) bill like that, you can't bill insurance companies like that in an outpatie... (more)

bytem3 (Mar. 11, 2013 @ 4:16p) |

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You might be able to call your insurance comapny and dispute this with the dr.
if you ahve no copay they shouldnt charge you.
they are probably double billing.

Fight for your $

It's common for insurance to take well over 60 days to process and pay and it's common to get a bill in the meantime. Check with your insurance to be sure it's being processed.

Did you try holding a vacuum to your ear? And it says right on the box not to stick those in your ear.

Sue the q-tip maker in small claims?

Stop using generic brand name q tips
The real ones don't. Come apart

Should have asked them the cash price and paid then. It will most likely be less than what they charge if you have insurance. Next time for something so small, don't even mention that you have insurance. They probably would have charged you $60 but they try to bill $180 when you have insurance to see if they will pay it.

If there was no mention of insurance on the bill you received, I would wait for your insurance to send you an Explanation of Benefits. Your credit shouldn't get hit at all until you at least receive this (and even then there is usually about 60 more days to the process). What you are looking for on the EOB is something along the lines of the following (it warms my heart every time I get something like this):

Amount billed for service
$X

Amount allowed
.10 x $X

Amount paid
.10 x $X

Amount you owe
$0

Talk to the insurance company and see what happened with the claim.


I had something similar happen when I was younger. Got rear ended in an accident was in PT for a couple months. The PT company charged my insurance for all the treatment then came back and tried to charge me their regular rate (not the rate negotiated with the insurance) because I got money back from the accident.

Fact is they money I got back barely covered the bills (I was young and didn't understand how to negotiate such things). Called the insurance company and the crap really hit the fan, owner of the PT company showed up at my work and personally apologized. I probably could have pushed for compensation but didn't feel like it worse worth the time. that was 15 years ago, had it happened now I doubt if they would have got off with just an apology.

In most other situations when business transactions are conducted the way doctors and insurance companies do them, it's called organized crime.

SUCKISSTAPLES said:   Stop using generic brand name q tips
The real ones don't. Come apart


Better yet, don't use them in your ear since it is stupid.

First of all if this happen you need to sue the Q-tip manufacture. Get a lawyer asap.

Hardon4life said:   First of all if this happen you need to sue the Q-tip manufacture. Get a lawyer asap.Not if it clearly states on the box not to insert into ear.


OP, can you post a pic of yourself? I want to see the guy responsible for the following warning labels:

On a blanket from Taiwan:
Not to be used as protection from a tornado.

Warning on fireplace log:
Caution -- Risk of Fire.

A warning on a pair of shin guards manufactured for bicyclists:
Shin pads cannot protect any part of the body they do not cover.

Warning on an electric router made for carpenters:
This product not intended for use as a dental drill.

On a bottle of shampoo for dogs:
Caution: The contents of this bottle should not be fed to fish.

On a hair dryer:
Do not use in shower.

On Marks & Spencer bread pudding
Product will be hot after heating.

On a string of Chinese made Christmas lights:
For indoor or outdoor use only.

On Sainsbury's peanuts:
Warning: Contains nuts.

On an American Airlines packet of nuts:
Instructions - open packet, eat nuts.

On some frozen dinners:
Serving suggestion: defrost.

On a hotel provided shower cap:
Fits one head.

On Nytol Nighttime Sleep-Aid:
Warning: May cause drowsiness.

Warning on a cartridge for a laser printer:
Do not eat toner.

A wheel 13" a wheelbarrow warns:
Not for highway use

Can of self-defense pepper spray warns:
May irritate eyes.

Warning on a Conair Pro Style 1600 hair dryer:
Do not use in shower. Never use while sleeping.

Silly Putty package warning:
Not for use as earplugs.

On a bag of Fritos:
You could be a winner! No purchase necessary. Details inside.

Baby stroller warning:
Remove child before folding.

Household iron warns:
Never iron clothes while they are being worn.

A fireplace lighter cautions:
Do not use near fire, flame or sparks.

A handheld massager warns consumers:
Don't use while sleeping or unconscious.

Warning on underarm deodorant:
Do not spray in eyes.

Cardboard car sun shield that keeps sun off the dashboards warns
Do not drive with sun shield in place

Warning on a sharpening stone:
Knives are sharp.

Bottle water label warns:
Twist top off with hands. Throw top away. Do not put top in mouth.

On a box or rat poison
Warning: Has been found to cause cancer in laboratory mice.

On a Domino's Pizza box
Caution: Contents hot!

Toilet bowl cleaning brush warns:
Do not use orally.

An electric cattle prods warns:
For use on animals only

A can of air freshner warns:
Keep out of reach of children and teenagers

Cheap rubber ball toy warning:
Choking hazard: This toy is a small ball.

Caution on a package of dice:
Not for human consumption.

In the manual of a chainsaw:
Do not attempt to stop the blade with your hand.

Stamped on the barrel of a .22 calibre rifle:
Warning: Misuse may cause injury or death.

Instructions for an electric thermometer:
Do not use orally after using rectally.

On the wrapper of a Fruit Roll-Up snack:
Remove plastic before eating.

A TV remote controller warns:
Not dishwasher safe.

Don't put anything smaller than an elbow in your ear, unless it's a tongue, which is usually retractable..

While the labels of Q-tips products *may* say (I don't have a box to check) and conventional wisdom is to not stick them in your ear canal, these warnings are put there for people like the woman who sues McDonalds because she burns her mouth on hot coffee.

While technically you reduce your risk of something bad happening by NOT placing them in your ears, they are utterly useless if you don't.

I have been sticking q-tips in my ear canal as long as I can remember. Occasionally, if I have been sick or missed a couple days without a shower I will remove a small bit of wax. Otherwise my ears are perfectly clean - and I hold this to some degree of actually cleaning out my canal on a daily basis. I had a roommate in college who would leave dozens of wax encrusted q-tips in the garbage on a weekly basis (note: I don't shove this thing down to my brain - just a little further than I can fit say my pinky in my ear). If he wasn't sticking them in his ear canal he wouldn't be able to clean them out.

You are told from an early age not to stick them in your ears in the same way you are told that scissors are dangerous. Any competent person faces minimal risk of doing any sort of damage to themselves. If I couldn't stick a q-tip in my ear canal, then what is the point? Move it around your lobe? Thanks - but I can use my towel for that.

Oh - and I second everyone who says only buy real Q-tips...they don't fall off in your ear. The cheap brand always do...

martin628 said:   Don't put anything smaller than an elbow in your ear, unless it's a tongue, which is usually retractable..

Exactly what my Dr. told when I had some pain in Ear and did not use the Earbud yet....

I never clean my ear canals. Maybe that is why my hearing is so shitty. Wonder if they have groupons for ear cleanings. haha

BenH said:   While the labels of Q-tips products *may* say (I don't have a box to check) and conventional wisdom is to not stick them in your ear canal, these warnings are put there for people like the woman who sues McDonalds because she burns her mouth on hot coffee.

While technically you reduce your risk of something bad happening by NOT placing them in your ears, they are utterly useless if you don't.

I have been sticking q-tips in my ear canal as long as I can remember. Occasionally, if I have been sick or missed a couple days without a shower I will remove a small bit of wax. Otherwise my ears are perfectly clean - and I hold this to some degree of actually cleaning out my canal on a daily basis. I had a roommate in college who would leave dozens of wax encrusted q-tips in the garbage on a weekly basis (note: I don't shove this thing down to my brain - just a little further than I can fit say my pinky in my ear). If he wasn't sticking them in his ear canal he wouldn't be able to clean them out.

You are told from an early age not to stick them in your ears in the same way you are told that scissors are dangerous. Any competent person faces minimal risk of doing any sort of damage to themselves. If I couldn't stick a q-tip in my ear canal, then what is the point? Move it around your lobe? Thanks - but I can use my towel for that.

Oh - and I second everyone who says only buy real Q-tips...they don't fall off in your ear. The cheap brand always do...


I think the reasoning behind the advice of not using Q-tips in ears is that A) a small amount of earwax is natural and shouldn't be removed and B) if your earwax is excessive, you probably have a larger health problem. In my experience, this is true, as the few times I've had the need to use a Q-tip to clean out my ear, soon after I found out I had an ear infection or something similar. YMMV

I hate doctor visits and the health care industry. Their billing is SOOO F-ed up. OP maybe next time go to an urgent care place to get it removed ususally they charge up front.

Also if you're digging for ear gold you should use those bamboo ear cleaners at the asian store at least you wont have to worry about the tip getting stuck (unless you have super hard wax). Ohh and did you try mineral oil to loosen it out?

Was the doctor in network or out of network? Was preauthorization required before the visit? Look at your benefits and tell us what the copay/coinsurance/deductible is.

No offense, but I feel like you're playing dumb here. First you say you want to pay cash, then you say you want to use insurance? You can't have it both ways. If you want to use cash don't tell them you have insurance and if you have insurance, YOU need to know your benefits and what your copay is and stuff. If you don't go into a doctor's office knowing these things, you are just setting yourself up to get taken advantage of. That's like going to a car dealer and just randomly pointing to a car on the lot and buying it for MSRP, then getting mad because you didn't get the mid-size with the $1,000 rebate.

Check your benefits, then call your insurance and have them explain to you what's going on here with this specific claim. Let us know how it turns out. Good luck!

have seen several times warnings that q-tips may push/compress the ear wax more than removal.

have wondered if the tiny brushes for teeth, such as GUM go betweens, might 'snag' ear wax for removal?

I wonder about that new wax vac - one would think that would Damage your eardrum

LOL, should I be surprised that roughly half of the responses thus far address sticking things in your ear versus the actual issue?

SUCKISSTAPLES said:   I wonder about that new wax vac - one would think that would Damage your eardrum

They probably have very low suction and are just a step above ear-candles in terms of actually getting anything done - in other words they are a crock.

Interestingly I found this device:
http://www.colonialmedical.com/ear-wiz-ear-wax-remover-P-4440.ht...

Which appears to be a medically approved device - the only reason being that it has a "stopper" on it to prevent it going to deep. Well as a functioning adult I too can gauge relative distance of a Q-tip into my ear.

I do agree that it seems reasonable that if you have heavily impacted wax, you want to put something narrower than a Q-tip in your ear to not jam it down further - somehow my ex-roommate managed it fine with Q-tips though and he obviously had some type of condition with the wax build up he had.

As far as people who say wax buildup is good for you...I don't know the medical reasons behind it - I'm sure we all have some deeper in our ear canal that we shouldn't try to dig deep for. However - I can tell you that I have on one or two occasions tasted something bitter on my finger and realized that it was because I had scratched my ear with my finger and had probably not used a Q-tip in a couple of days. Additionally, I have had my tongue in the ear of more than one person that I wish had been as diligent as me in cleaning. Also, it is pretty gross when you are standing next to someone and see chunks of wax in their ear.

So, medical reasons or not - I seem to be operating fine without wax - and will continue to remove what little I find.

dukerau said:   BenH said:   While the labels of Q-tips products *may* say (I don't have a box to check) and conventional wisdom is to not stick them in your ear canal, these warnings are put there for people like the woman who sues McDonalds because she burns her mouth on hot coffee.

While technically you reduce your risk of something bad happening by NOT placing them in your ears, they are utterly useless if you don't.

I have been sticking q-tips in my ear canal as long as I can remember. Occasionally, if I have been sick or missed a couple days without a shower I will remove a small bit of wax. Otherwise my ears are perfectly clean - and I hold this to some degree of actually cleaning out my canal on a daily basis. I had a roommate in college who would leave dozens of wax encrusted q-tips in the garbage on a weekly basis (note: I don't shove this thing down to my brain - just a little further than I can fit say my pinky in my ear). If he wasn't sticking them in his ear canal he wouldn't be able to clean them out.

You are told from an early age not to stick them in your ears in the same way you are told that scissors are dangerous. Any competent person faces minimal risk of doing any sort of damage to themselves. If I couldn't stick a q-tip in my ear canal, then what is the point? Move it around your lobe? Thanks - but I can use my towel for that.

Oh - and I second everyone who says only buy real Q-tips...they don't fall off in your ear. The cheap brand always do...


I think the reasoning behind the advice of not using Q-tips in ears is that A) a small amount of earwax is natural and shouldn't be removed and B) if your earwax is excessive, you probably have a larger health problem. In my experience, this is true, as the few times I've had the need to use a Q-tip to clean out my ear, soon after I found out I had an ear infection or something similar. YMMV


i use them because it itches if i dont, and my fat fingers are too big to scratch in there.

I'm really grossed out right now.

SUCKISSTAPLES said:   I wonder about that new wax vac - one would think that would Damage your eardrum

Saw this last week. As with most crap sold on tv, it doesn't sound like much of a winner.

http://www.wired.com/underwire/2013/02/waxvac-review-infomercial...

I bet the OP had entire Q-tip stuck in his ear.

Doctor charged him $180 to grab the stick and pull it out.

Do you have a high deductible health plan? That is typically the type of plan where you don't have a co-pay... And since it is the beginning of the year, you probably haven't met your deductible and are responsible for the entire bill (adjusted to the insurance's agreed upon rate).

When they gave you a quote, they might have figured you had a traditional insurance plan where you would only be responsible for the copay and that is probably the figure they quoted you. This is all just a guess of course. But everyone who said to wait until you see the EOB is right.

ruinedWallet said:   

Maybe the FW way to see docs is to pay cash even if we have insurance?
http://articles.latimes.com/2012/may/27/business/la-fi-medical-p...


That only works if you've NEVER gone to them before, otherwise they'll usually refuse to go the cash payment method and will instead insist on going through your insurance which they already have on file. Plus, keep in mind, that means you're not getting any of that credited to your deductible for the year, so in the event you get really sick you're going to have to pay your full copay, deductible, and coinsurance no matter how much you've spent on care previously in the year.

I certainly know how you feel though. I had a doctor refer me to a hospital to have a chest Xray done last year. The hospital told me that because I'd reached my deductible and the maximum out of pocket for the year, and didn't have a copay that I wouldn't have to pay for the Xray. Then when it comes time for the bill the hospital wanted ~$320 from me for a simple chest Xray. Mind you on their own website it said for uninsured people the cost was $90. Turned out my insurance had a clause buried in it, that while I don't have a copay, I do have a 'additional deductible per advanced imaging incident'. Somehow they consider an Xray an 'advanced imaging' procedure (and it is on tiny print on something like page 80 of the health insurance documents). They don't call it a copay though, so when the hospital asked if I had a copay the insurance company told them no. Now, like you, $320 wasn't worth my credit so I just had to pay it. Sure, we all wish we could know what healthcare will cost us before it's done, but what can any of us here really do to make that happen?

parquedematthew said:   SUCKISSTAPLES said:   I wonder about that new wax vac - one would think that would Damage your eardrum

Saw this last week. As with most crap sold on tv, it doesn't sound like much of a winner.

http://www.wired.com/underwire/2013/02/waxvac-review-infomercial...


Take a bulb syringe (typically these are used for infant noses) and a cup of water into the shower, fill the syringe with water, and flush inside your ear. Repeat steps until the wax falls out. I used to get my earwax flushed at the doctor (it got so bad I couldn't hear) but this now works every time.

BenH said:   Interestingly I found this device:
http://www.colonialmedical.com/ear-wiz-ear-wax-remover-P-4440.ht...


Add this http://www.colonialmedical.com/ear-wax-removal-syringe-P-2507.ht... to the above, and you probably will never have to visit the doc again for impacted ear was. I was having to go twice a year because it affected my hearing, until I found these two devices.

sounds like you have some sort of high deductible plan (like an HSA) where there is no copay (100%) of insured rate. You should get an EOB (explanation of benefits) from your insurance company which should show a billed rate(absurdly high), a negotiated rate(what you pay). The MDs office should bill you at the negotiated rate. Check that-call the insurance company and ask them to explain it to you and make sure the MD bill is correct. If you are indeed getting billed the negotiated rate, then you will have to pay up. It's too late to discuss a cash rate generally.

The only real way to get any break is to pay a cash only price up front- some people will generously discount this rate (might be less than your insured rate), while other people won't. Ideally you/the office staff would have a real idea what the insured rate would be. For smaller visits its really tough to know for sure. For larger visits- you really want to figure this out- but good luck with that. I've been quoted a rate X for a ultrasound by the insurance company (when I read then the order, and the facility it was to be done at) and billed 3x that when it was all said and done- the explanation was 'shrug shoulders we were wrong'.

Of course if you pay 'cash only'- it won't go to your deductible...

1)flush your ear wax with warm water/bulb as metioned above, or use debrox or something like that.
2)Many other professions get a "blank check" too- plumbing emergency=blank check, lawyer=somewhat of a blank check, etc etc. My electrician came over and looked at an outlet (stuck the ampmeter in 1 outlet, 'took him 30 seconds') and charged me $80. Most any real professions get pricey quick.

As an MD, I agree things are crazy. Without turning this into a 'the evils of medicine' thread- I think some of this anger gets directed at MDs when its more of a system-wide problem. For most of us that want to practice anything but boutique medicine, we must play in the system. In my group we lose about 10% of total revenue just in billing alone. There are a ton of insurance companies, with a ton of plans, and no one seems to really understand their plan. I'd imagine most MDs don't understand it too well either.

jfunk138 said:   In most other situations when business transactions are conducted the way doctors and insurance companies do them, it's called organized crime.

I agree. This could be solved in one day, with one bill from Congress.

This bill would require the following:

1. At the time of service, doctor presents an estimate of service to be performed, with estimated, not-to-exceed price,
2. Doctor reserves the right to send bill to insurance, but only with patient's approval. Doctor, by submitting to insurance, contractually agrees that if submitted to insurance, the final out-of-pocket pay to patient should not exceed price in #1,
3. The above is written on a paper, "This is a binding contract by Doctor according to US Code #abcd",
4. The above #1 and #2 and #3 are law. If doctor fails to provide the above, it is now a criminal matter.

Doctor can refuse service, but can not agree to provide service and skip #1 and #2.


You used a Qtip?

This doctor recommends a Super Soaker

http://www.cmaj.ca/content/173/12/1496.full

coolmind said:   why Q-Tip for ears???????


http://commonhealth.wbur.org/2012/11/q-tips-ears-danger


Interesting - but I still believe a responsible person realizes if they are putting a Q-tip in to far. FWIW - everyone has a different ear shape and canal, and it just might be that for people like me it is difficult to "accidentally" go in too far. I'm not saying it wouldn't be easy to puncture if I intended to, but it is just as easy to be careful with it.

Also interesting is the issue of BPPV that they discuss and the "ear crystals." I actually experienced a few severe bouts of BPPV several months ago, enough that I went to the doctor - especially since I had to fly in a few days. They confirmed that they "thought" it was BPPV and prescribed OTC motion sickness pills. I didn't take them and the whole thing resolved itself in a matter of days.

Point is that my BPPV was likely unrelated to my Q-tip use as I have been using them for 25+ years and have had only this one instance of BPPV.

For those that have never had it...BPPV, if severe enough, can be a really scary thing.

Skipping 94 Messages...
rmf1981 said:   Have your form all filled out to the best of your ability and know precisely what information you need from me. Probably 75% of people don't mention the form until the end of the visit when I'm walking out the door - at which time they present a four page form they haven't even looked at and say "hey I need this in 2 days." That person is definitely getting the fee.

OMG, YES! A large number of patients that want paperwork filled out check in at the front desk ~12-15 minutes into their 20-minute appointment slot. The reason for the visit is quite often listed simply as "follow up" or "I don't know". They want their 3-5 "acute" (I use the term loosely, since more often than not, it is something that has been ongoing for years) issues to be addressed immediately and wonder why you are running behind. Hint: it's because the previous person also showed up halfway into their scheduled appointment time, needs an interpreter, and also has several 'acute' issues (one of which is the chest pain they've had on and off for a year that began after they started smoking cocaine). When I finally complete history/exam/counseling, they suddenly remember that the main reason they came in to see me was to get their SSI (disability)/FMLA/etc paperwork filled out. By tomorrow. Because it was due last week. Not that they have filled anything out on the form.

Which reminds me...just last week I had a patient come in upset at me because she did not receive her disability benefits - "you didn't fill out my paperwork correctly". Upon looking at a copy of the document, it turned out that she had mailed it off with only the information I had filled out completed. There was no name, address, or anything else. She facepalmed and left, coming back the following week to drop off a copy of the form for me to fill out again.

(To anyone offended: sorry for the broad, sweeping generalization, but these things happen more often than not)

Direstraits66 said:   No reason why doctors can't charge by the minute or in block of 20-30 minutes for outpatient visits. I would rather go to a doctor who will charge me 250 for a 30 min consultation when i know the cost of my visit before the visit. A competing doctor may charge me 100 and I may choose to go see him instead. Market and skill-set will set the price. And i would push back when my school wants some frivolous form signed cause it will cost me 200.

And your expertise is valued over the other, i will be ready to pay a higher rate. You've no paperwork to file and you get to schedule your time productively.
And you're not forced to care for anyone walking in like a hospital is required to.

Yes there is. While intensivists (ICU staff) bill like that, you can't bill insurance companies like that in an outpatient setting. Like another poster mentions, the only people you can bill like that are patients that are looking to pay cash. Additionally, what is your position on all the other things that aren't currently billed for (the time for documentation, test/imaging interpretation, phone calls, etc.)? Would you want to be billed for all that, too? It's not uncommon for that stuff to take up more time than the visit itself.



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