New Member price shock

[oldgoat]

My eyes had been severely watering for about 6 mounths, so I went to a eye dr. I was in his office for no more then 30 min. I had a regular exam, dilation lacrimal punctum, and two closure's by plug (suggested by the dr.). The bill I recieved yesterday was foe $1365.00!! Is this about right? Needless to say I'm shocked

[Rebecca Petris]

oldgoat, welcome to Dry Eye Talk!

Was your bill itemized? If not, I'd ask for an itemized bill. I would guess that the big cost item on your bill is the punctal plug insertion. This can sometimes run up to several hundred dollars per plug. If you do a search on this bulletin board you'll probably run across some earlier discussions about this.

Dry eye evaluations can vary dramatically in cost, depending on the type of specialist and what tests they do. Yours certainly sounds on the high end of the range, though I've heard of higher ones too. I hope most of it is covered by insurance?

I think it is reasonable to expect a doctor's office to discuss any unusual cost items with you beforehand, and particularly so if it's not covered by insurance.

[kaypeeoh]

I wonder, if your eyes are already watering why someone would put plugs in. That just makes the eyes water more, I would think. I paid $500 for plugs about 5 years ago. They were put in by an optometrist. They fell out in less than a month and since they hadn't helped anyway I didn't get them replaced.

Are these some special type of plug? Something designed with a shunt to let the puncta drain better? I don't know whether something like that really exists.

[Cindy]

The bill I recieved yesterday was foe $1365.00!! Is this about right? Needless to say I'm shocked

Hi oldgoat and welcome! For Pete's sake, I'd be shocked too!! I've had every procedure you've listed and none of them cost me anywhere near what you are being charged. As Rebecca suggested, get an itemized bill if you don't have one.

Were you given an explanation for why you have excess tearing (epiphora)?

[ronnyp]

luckily my insurance covers everything and every test that i have had done, so i really dont pay attention or ask what anything costs. I could only imagine the bill i have racked up. The perscription drugs are probably way out of control, considering the over the counter stuff is very expensive. I just bought the muro drops and ointment at giant eagle, and it was a 50 dollar bill!!

[oldgoat]

thanks all

The reasoning for the plugs I was told is that my eyes are too dry and my body makes up the tears to compensate and the plugs are suppose to retain what water there is in my eyes so they won't tear as bad.? I'm not sure that makes sense but I was willing to try. The itemization is: exam-$160. dilation lacrimal puntum-$275. closure by plug ea.-$465 (twice). Seems kind of high to me. And no I was not told of the prices before (or after) he did it.

[Rebecca Petris]

The reasoning for the plugs I was told is that my eyes are too dry and my body makes up the tears to compensate and the plugs are suppose to retain what water there is in my eyes so they won't tear as bad.?

Yes. Excessive reflex tearing can be a symptom of dry eye or some kind of tear film imbalance, and punctum plugs are a pretty standard treatment. I hope that they help. I'm sorry that you weren't told beforehand of the cost.

[DrG]

The reasoning for the plugs I was told is that my eyes are too dry and my body makes up the tears to compensate and the plugs are suppose to retain what water there is in my eyes so they won't tear as bad.? I'm not sure that makes sense but I was willing to try. The itemization is: exam-$160. dilation lacrimal puntum-$275. closure by plug ea.-$465 (twice). Seems kind of high to me. And no I was not told of the prices before (or after) he did it.

Medicare typically sets the standard, with insurance companies following suite. When billing medicare, the first eye is charged at the full price, with additional plugs billed at 50%.

Of course, if your doctor is not billing medicare or an insurance company, then they can charge whatever the market will bear. It appears as though you are living in either Beverly Hills or Palm Springs.

This reminds me that I need to review my fees.

[Lucy]

ask

oldgoat, you should tie a string on your finger when you see your doc. Remember what that's for?

You always have to sign something, at least I do. Whenever you sign something, ask for a copy of it for your files. Some physicians make a practice of this - but I don't think they all do. At the prices you posted, you need to see where the $$ went.

I was charged $750 for two plugs within the past five years. It's been awhile and I don't remember the breakdown.

[markL]

..

No one else seems to want to say it, $1365 is totally absurd. Ridiculous. Can this guy not be reported or something. You may think your insurance company is paying for it but ultimately you pay for it through your insurance premiums.

[Lucy]

Mark, for many of us, having lasik was just the tip of the iceberg. It's supposed to cut down on future expenses on glasses and/or contacts.

I can't even begin to say how this opened a floodgate of expenses for me. The fee oldgoat was talking about is apparently typical. If I add a consultation fee of $500 (which is a normal amount) plus the $$ for my two plugs (from my lasik doc), I'd be right there with oldgoat.

We are dependent on medical professionals to help us cope, get well, be the best we can be. That price IS ridiculous. Would I bite the hand that helped me by reporting him/her for excessive fees? Our vision is comprimised, we are in physical pain in some cases, emotional stress in others and we just aren't into reporting those helping us (or trying to help). A few have taken out malpractice cases, but there are but a tiny fraction of us. (No, I did not.)


We are between a rock and a hard place. I, personally, really can't care (too much) about taking on the customary fees set by doctors. It's unfortunate, but it's the way it is. I believe our in-house vising doc explained about Medicare setting fees. It's just that we are plumb out of steam, money and effort to beat up the medical field. I think I feel a lecture coming on..........

[Rebecca Petris]

The prices - and the wide range for this kind of service - are what they are. The only thing in oldgoat's story that seems to me out of sync with normal medical practice is the lack of information provided to the patient before treatment was performed. Again, if the bulk of the costs other than office visit fee are covered by insurance, it's probably immaterial as far as oldgoat is concerned. But if not, then I think the lack of information is indefensible.

[oldgoat]

Price check

I went to my insurance co. today to ***** about the high cost and they looked up the prevailing price, and low and behold...... it was actually higher than want I was charged! What's the world coming to? My fishing lures have gone from$2.50 to $8 and gas is $2.29; what can I say. Regardless, thanks everyone.

[kitty]

I will be getting Herrick plugs in two weeks. I have already had the exams which my insurance paid in full, except my $15 co-pay. I was quoted $312 for each plug. This supposedly includes the trial collagen plugs. My insurance pays 90%.

[kitty]

Correction/Updated cost info

Well, I was a bit off on my previous post re the cost. The cost quoted today was $312 per plug. That equates to $624 for 2 temporary plugs; or $1248 for all four temporary plugs. Same price if you go permanent from the get go. Today I was temporarily quadriplugged. I will expand on that in a different post. So, I go back in two weeks and if all goes well, get two permanent plugs in the lowers for $624. Later, it's two more temporary plugs in the uppers at another $624, then about another $624 for two permanents in the uppers. The scale changes based on the total number of plugs, but I remember the max grand total at about $3400 for 4 punctum, or about $1700 for two punctum. Thank goodness for insurance!