posted
I don't want to start a huge controversy, but I would like to know why some llmds charge such high fees. My first doctor (J clinic) took insurance and I understand if you did not have insurance they would charge a reduced rate.
We then changed to a doctor closer to home (when one became available) and were charged VERY high fees with monthly visits mandatory.
My daughter needed a preop physical, internist was out of town, so I asked if it would be a problem for llmd to fill in. They charged me $275.00 for a 30 minute visit and told me I had to rebook the lyme appointment (at $175.00).
We are lucky; we have a very good doctor who just started accepting patients again so we changed to the new doctor (their fees are reasonable).
I feel I get similar levels of care from all three, although the very expensive LLMD did not return phone calls; everything had to be done by appointment.
What gives, or are my suspicions correct that in every career there are just some people in in for the money? (by the way the expensive doctor has lyme, somehow in my mind, this makes it more difficult to accept that they may be in it for the money.)
Posts: 132 | From Kentucky | Registered: Dec 2004
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posted
Lyme disease is like the wild west of medicine. Docs who take insurance have to yeild to their guidelines, including less therapy, less face time with patients, cheap tests, less of everything.
Docs who don't take insurance have to be true entrepreners. They can't load up patients into ten minute segments, they must spend time!
I also think that there are exclusive lyme experts (names are on all the scientific papers) who are asked to speak, research and write papers and articles. They may feel that their time is worth more.
My feeling is that now that I have my diagnosis, I can do most of the work in deciding what to try next myself.
Again, in the wild west, we have to take charge of our own care and find someone to partner with. I don't trust any docs anymore not even the top dogs in the field.
There just simply are not enough studies for them to know exactly what to do with this monster disease.
Sorry so long, my two cents.
-------------------- We are spiritual beings on a human journey...
SForsgren
Frequent Contributor (1K+ posts)
Member # 7686
posted
It's hard. If you really see some of these doctors that have hundreds and even thousands of patients. Some of them work 7 days a week all hours of the day. I have seem more LLMDs that have a passion for helping us than any other group of doctors. It may seem expensive, but it is worth every penny.
-------------------- Be well, Scott Posts: 4617 | From San Jose, CA | Registered: Jul 2005
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MagicAcorn
Frequent Contributor (1K+ posts)
Member # 8786
posted
Where I live $275.00 is a reasonable fee for 30 minutes no matter what the doctor's specialty is.
-------------------- Posts: 1279 | From In hiding | Registered: Feb 2006
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posted
Mine charged $180 for the first visit. I thought this was very reasonable. Fortunately, my insurance covered
Posts: 340 | From Ohio | Registered: Oct 2005
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Nal
Frequent Contributor (1K+ posts)
Member # 6801
posted
My dr usually charges about $50.00 per 15minute appt. I don't think thats too horribly bad.
Nancy
-------------------- Life is 10% what happens to you, 90% how you respond to it!
-Chuck Swindoll Posts: 1594 | From Colorado | Registered: Jan 2005
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posted
Yes, but this particular doctor works from 11 to 3, no Saturdays, doesn't speak, etc.
My new doctor (who is VERY well regarded) works regular hours and charges over $50.00 per visit less.
Yes, I think the law of supply and demand is a work here, but I also think that, in some cases, some doctors take advantage of a class of patients who have no where else to turn.
In addition to the high fees, this particular doctor refused to try to get medications approved through insurance (as a matter of fact said insurance would not cover bicillin). In fact my insurance DOES pay for it, just need an explanation from the doctor (which my NEW doctor took care of).
I guess doctors are like everyone else, some are honest and ethical, some are in it for the money. Perhaps some think the risk of treating lyme justifies the fees.
I've seen it in other specialties, but for some reason expected a higher standard in a doctor who treats lyme. Just as I expect a higher ethical standard in someone who treats any life altering illness (cancer, etc).
Just my $.02
Posts: 132 | From Kentucky | Registered: Dec 2004
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I would be estatic if my doctor charged $50 per 15 minute appointment.
As I said, this was $275.00 for 30 minutes. A normal lyme appointment is 30 minutes and $175.00. I guess marking a couple of check boxes on a form is worth $100.00?
By the way, that works out to $550 per hour. With a nurse practioner working the same hours that comes to $1100 per hour income. Expenses are office rental and minimal equipment, insurance and one office staff. Very lucrative!
Posts: 132 | From Kentucky | Registered: Dec 2004
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timaca
Frequent Contributor (1K+ posts)
Member # 6911
posted
My LLMD charges $175 per half hour. He is worth every penny. He spends time reading my faxes in between time (doesn't charge for that time--even though he should).
He has saved my **** several times by catching a fungal infection in my picc line, and catching C. diff in me. He prescribed meds for C. diff when my PCP went home, even though she knew I had a + C. diff test.
My LLMD is worth his weight in GOLD. And I sure hope he knows how much I value his time and expertise!
Timaca
Posts: 2872 | From above 7,000 ft in a pine forest | Registered: Feb 2005
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Foggy
Frequent Contributor (1K+ posts)
Member # 1584
posted
quote:Originally posted by Lymetoo: The law of supply and demand always figures in.
This is a pet peeve of mine.
A LLMD's assistant admited to me that they had plenty of "full-frieght" paying customers, thus they didn't need to accept the ins cos low reimbursement. Sad to say that along with the H-Oath, it's a profit game, too.
Because my schedule C deductions weren't above $5k, I couldn't deduct all the fees etc. what a figgin screwing! This is on top of $5k for health insurance.
Posts: 2451 | From Lyme Central | Registered: Aug 2001
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posted
You also have to realize that each state has different malpractice insurance for the doctors. If their insurance is very high, the drs have to charge accordingly.
Then there's the cost of living in the state where the dr is. If the cost of living there is very expensive, the drs will be also.
I have no beef about what my dr charges. He is worth every penny.
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96222 | From Texas | Registered: Feb 2001
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cantgiveupyet
Frequent Contributor (1K+ posts)
Member # 8165
posted
Ive found that my LLMd charges less the the ducks i go to see. I get enraged sometimes that my insurance pays the ducks for some of the visits...when they have often done nothing for me.
I think my LLMD charges a resonable amount for his services. You have to look at the whole package too. Like if they are availble for phone calls, fill out paperwork etc.
Also have to compare the LLMD fee to other duck specialists in your area.
Most duck specialists in my area charge 275 per visit...ive seen up to 535 recently. Most ducks are robbing the insurance companies blind..when all the do is check off boxes.
-------------------- "Say it straight simple and with a smile."
"Thus the task is, not so much to see what no one has seen yet, But to think what nobody has thought yet, About what everybody sees."
-Schopenhauer
pos babs, bart, igenex WB igm/igg Posts: 3156 | From Lyme limbo | Registered: Oct 2005
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posted
my LLMD has been worth every penny as well...
As already said above, there are lots of factors that go into the fees...
My first vivsit with My LLMD lasted almost 3 hours...
And follow ups are a half hour at $175..I think very reasonable considering I also get a phone call back every time if I have questions or problems that come up and I am not charged or made to feel pressed for time.
I feel fortunate to have someone like that in my corner.
Posts: 437 | Registered: Sep 2004
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posted
Thanks for listening to my complaining. My new LLMD returns phone calls, gives refills, doesn't require an office visit for every question (yes the old one did, and I mean every), will spend as much time with me as necessary and is NICE on top of it all.
As an added bonus, the office staff is pleasant, professional and competent. (We refer to the secretary to old LLMD as the "GORGON"; rude, loud, and just generally unpleasant. She also took it upon herself to answer medical questions. I finally got to the point where I would say "did Dr. So and So state that in exactly that way". More than half the time she would admit she hadn't asked the doctor.
So all in all, I guess one bad apple among the two wonderful LLMDs I have seen is not too bad. I don't know why I expect a higher level of ethics and caring from LLMDs.
I am just very happy the new LLMD was taking patients. As a side comment, my daughter and I have been patients for years with this new doctor for endocrine related problems and the practice referred me to the LLMD I was so unhappy with (they are no longer referring patients to the "expensive" LLMD.
(Sorry that was so long winded; I didn't know how else to say it without names or gender.
As you all know the good doctors are few and far between. Glad I bumped into one!
Posts: 132 | From Kentucky | Registered: Dec 2004
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posted
OMG, don't get me started! I paid $650.00 for my very first visit and $175.00 for hour follow-ups.
Right now I am fighting Blue Cross to get that money back because I wasn't in Network with my HMO; However; and this is my opinion is a big HOWEVER; I was treated in my close surrounding area for a year and I was not better.
Keystone/Blue Cross could not provide me with any doctors in my area that excepted Keystone within driving distance and I called prior to my appt with the new doc on 3 separate occasions.
Customer service stinks and my point of my whole case is that Keystone customer service/benefits should be knowledable about who is in NETWORK and who isn't in NETWORK.
In addition they changed their story by telling me the first time around that my new doc was a holistic doctor which is not true. She might give herbs but she does treat with real prescriptive medication.
Then they told me after I had already seen this new doctor and had a referral that they found doctors in my area. I then told the case manager if that was the case then why didn't your customer service make me privy to that information!
I have a letter of medical necessity from my prior doctor referring me to the new doctor, a letter from my lawyer and a letter from myself to file a second appeal.
My only point is that their are alot of Lyme patients out there who are right there with you in the trenches and are sick of having to pay large medical bills and fighting insurance companies.
THESE INSURANCE COMPANIES NEED TO STEP UP TO THE PLATE! Posts: 204 | Registered: Jan 2005
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posted
I called my llmd once for a problem and her office staff had me come in. I drove 3 hrs over and back to be told I was having a herx. I was irritated at best.
I pay $150 per 15 min. I have only gotten better and seen good results with this doctor. It has not been an optimal situation but it is one that I have chosen to stay in because the benefits outweight the negatives.
My llmd office was my second (primary knew nothing) stop after being bit. I read all the time of people that went through many docs and had horrible mis dx. I recently read a doc who said his patients avg 24 physicians before being diagnoised correctly with lyme disease.
I recently attended the lyme symposium in MD. In attendance were my llmd, my new primary who is learning (treats my kids & hubby for LD) and the llmd gyn that I will see for the first time this week. I couldn't help but feel truly blessed by the overabundance of lyme knowledgeable medical professionals that are in my life.
As more cases of lyme disease are identified and more docs become knowledgeable, the exclusitivity of care will dilute. I personally think that those physicians that are obviously gouging will either have to change the way they practice or move aside. . . .because supply/demand will dictate this.
In the meantime, you need to do what will gain you better health and you need to evaluate how you are spending your money to make that happen.
Nothing about lyme disease is fair.
-------------------- When I feel blue . . . . . . its time to take another breath Posts: 296 | From East Coast | Registered: Aug 2005
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posted
You're right, nothing about lyme disease is fair. My daughter saw at least 43 specialists before she was finally diagnosed (by her internist, god bless him). He (and the Johns Hopkins urology fellow, go figure) stuck with her and was determined to find out what was making her so ill. The both kept saying it was something infectious, they just couldn't figure out what it was.
Overall, I'm sure the charges to my insurance company were more than $275.00 for a 30 minute visit, BUT every other doctor(including J Clinic) participates in insurance and accepts a discounted fee. I guess I was spoiled.
I was diagnosed after my daughter. I don't know if I ever would have figured it out without her diagnosis.
We started with the J clinic and made huge progress (with a big backslide on my daughter's part for a little while). I'm feel blessed to have found two wonderful LLMDs and a wonderful internist.
Posts: 132 | From Kentucky | Registered: Dec 2004
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lpkayak
Honored Contributor (10K+ posts)
Member # 5230
posted
i thought it was 400-800 for the first visit-and then about 175 for follow ups every 2 months
-------------------- Lyme? Its complicated. Educate yourself. Posts: 13712 | From new england | Registered: Feb 2004
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posted
Im sure I pay at least $325 for 1/2 hour visit. My insurance company reimburses(at least sometimes, it depends what diagnostic code is listed) 70% of what they think the going rate in this area is. I think I get something like $89 back. It is too expensive for me, so I go in every other month, even though it is supposed to be from 4 to 6 weeks at the latest that she wants to see people.
So, I guess at going in every other month, and the partial reimbursement, Im out about $100/month for the LLMD, which is almost doable. It's the supplements that add up too much. My prescription coverage is real good, I pay between $5 and $15 max for each prescription.
Trying to get answers between times is pretty difficult. When I was going completely crazy last year, she did a few schedualled phone calls between visits. The doctor does try--it's that I find the office staff there to be pretty difficult to go thru.
Posts: 222 | From Santa Cruz Mountains, CA USA | Registered: Nov 2004
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posted
Yes, some doctors chage $400 to $800 for an intial visit and then a lower fee. I think the whole point I was trying to make is that 4 week visits are required. Prescriptions are written for only 4 weeks. You HAVE to come in for another prescription. Lab work must be done 3 days before visit. If they don't have it you have to come back (and pay for another visit, because the doctor "doesn't make phone calls if the lab results come back and the patient needs a change in medication".
If you have a problem, you HAVE to come in for a paid visit. Etc., etc., etc.
It's not so much the regular fee I was protesting...I was paying that willingly. It was all the extras. I felt like I was in a very expensive restaurant and everything was a la carte!
As I said before, I have never had this experience with any other doctor (where I feel like they are in it soley for the money). I certainly don't begrudge them a good income. I happily pay my new doctor $125 to $150 for each visit and think I'm getting wonderful care.
I do believe, in this particular instance, that the doctor is overcharging because people are so desperate that they will pay anything and put up with almost anything to get well. And I think, IF THIS IS TRUE and it is the motitivation, is contemptible.
Posts: 132 | From Kentucky | Registered: Dec 2004
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posted
Yes, most doctors chage $400 to $800 for an intial visit and then a lower fee. I think the whole point I was trying to make is that 4 week visits are required. Prescriptions are written for only 4 weeks. You HAVE to come in for another prescription. Lab work must be done 3 days before visit. If they don't have it you have to come back (and pay for another visit, because the doctor "doesn't make phone calls if the lab results come back and the patient needs a change in medication".
If you have a problem, you HAVE to come in for a paid visit, no phone calls. Etc., etc., etc.
It's not so much the regular fee I was protesting ($150 to $175)...I was paying that willingly. It was all the extras. I felt like I was in a very expensive restaurant and everything was a la carte! The $275 for a preop physical was the topper! And we still had to come back for a lyme visit at $175.
As I said before, I have never had this experience with any other doctor (where I feel like they are in it solely for the money). I certainly don't begrudge them a good income. I happily pay my new doctor $125 to $150 for each visit and think I'm getting wonderful care.
I do believe, in this particular instance, that the doctor is overcharging because people are so desperate that they will pay anything and put up with almost anything to get well. And I think, IF THIS IS TRUE and it is the motitivation, is contemptible.
Posts: 132 | From Kentucky | Registered: Dec 2004
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posted
My LLMD doesn't take insurance. He doesn't carry malpractice insurance. He charges $500 first visit, $100 for follow-ups.
This isn't way out of the range other specialists charge in this state.
I don't care. I've wasted years and $$$ on ducks who take my insurance. I want to get well.
I drive an hour and a half to see him. If at some point, I find myself disagreeing with him on some important part of my treatment, I'll go somewhere else, or figure out what to do on my own.
I like him and trust him for the most part, and I'm glad I found him.
My heart goes out to those of you whose children have this.
SOMEDAY MDs will be told by the government that Lyme Disease is a serious problem. Then they'll all have to change the way they look at treating it. Why so many of them are so short-sighted, or nervous, about something that's just basic science (an infection) is just our bad luck.
Posts: 353 | From Florida boonies | Registered: Nov 2005
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posted
Lymelaura - I agree that requiring a patient to make monthly appts is something that I would question.....
I have never had an LLMD say that to me....
Although there have been times in the beginning of treatment where I needed to see him monthly b.c it was all so new....
Its tough.... we have to be our own advocates.
Posts: 437 | Registered: Sep 2004
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lpkayak
Honored Contributor (10K+ posts)
Member # 5230
posted
lymelaura-i don't like the sound of what is going on with your doc. the more i hear on here lately about supposed llmds-the more i wonder. the ones i know well are fair and ethical...but i did have a problem early on with one and refused to go to him again...the ones who are doing the right thing are in a really hard place...and so are the patients...i guess it's just and open door for a few(or more) to come in and clean up. sad.
-------------------- Lyme? Its complicated. Educate yourself. Posts: 13712 | From new england | Registered: Feb 2004
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posted
I can't say if monthly visits are a medical necessity for everyone or not, but it may be a way for the doctor to protect himself against charges of substandard care (lack of follow-up) when patients are on long term antibiotics.
Don't forget that these doctors are risking their licenses by treating beyond 30 days. If they need to see us monthly to stay out of trouble, so be it.
-------------------- Suzanne Shaps STAND UP FOR LYME Texas (www.standupforlyme.org) (Please email all correspondence related to protecting Texas LLMDs to [email protected] with copy to [email protected]) Posts: 977 | From Austin, TX, USA | Registered: May 2004
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posted
Everyone loves Dr. J(NC). Why is he the only llmd who accepts ins. and medicaid? He is as good as any other llmd out there.
I have said it once before and I will say it again, if they will not treat the poor then they are it it for the money! If I was a Dr. I would treat everyone.
Think about it for a minute people, what would you do if you lived paycheck to paycheck. Who would you see? I guess you would have had to settle with a cfids/fm dx. I know for those of you who are very fortunate it would be imposible to think of yourself as being poor and needing treatment for your lyme. Please just think about it for a minute, now ask yourself why it is that your Dr. refuses to treat the poor!
Posts: 208 | From Greenville SC USA | Registered: May 2005
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posted
LymeLaura, That sounds horrible, maybe dats cause I a po boy!LOL.
Why did you leave Dr.J? You would probably save money, including airfare, going back to NC.
Posts: 208 | From Greenville SC USA | Registered: May 2005
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My LLMD takes Medicare patients and if you have a PPO, your insurance will reimburse you for most of the charges.
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96222 | From Texas | Registered: Feb 2001
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JimBoB
Unregistered
posted
ONE problem is NOT everyone who is retired can get coverage for the doctor. You have to pay for it. Medicare just covers the hospital, or part of the hospital. Drugs are not paid either.
SO, IF you have to live on about $500 per month for everything, have no savings, you are SOL. Period.
So you either suffer with Lyme untreated, or go to a cheap alternative the best you can.
Here in WIsconsin, you can get help for drugs, etc., however you can have hardly any assets, no savings, etc.. I would qualify, however my current wife got into IRA's before we met and married, and though she can't touch it for three years, when she too turns 65, it is considered community property, even though I will never see a penny of it, so I lose.
So the choice is, DIE or Self-Treat as best I can.
LLMD's are NOT even a consideration for me and people like me.
My DUCK will take me now for free office visits, but since he won't treat me for Lyme, what good it that?
Typical rock and a hard place many of us are faced with.
JillF
Frequent Contributor (1K+ posts)
Member # 5553
posted
$450 each for first visit for myself and husband
$150 each monthly since
Our insurance covers nothing. Between the cost and the 2 hr (each way) trip EVERY month, it's getting slightly annoying
Posts: 1485 | From USA | Registered: Apr 2004
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Andie333
Frequent Contributor (1K+ posts)
Member # 7370
posted
I credit my LLMD with helping to save my life.
Whatever the cost, it's been worth every penny!
Andie
Posts: 2549 | From never never land | Registered: May 2005
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shazdancer
Frequent Contributor (1K+ posts)
Member # 1436
posted
If you can't afford an LLMD, ask one before you go in if there is any way they can give you a break financially: sliding fee scale, small payments over time, research study, etc. If not, ask if they know an LLMD who would.
If I were a doc, I certainly wouldn't advertise that I give freebies to the poor, or suddenly every one of my patients would be "poor." But it doesn't hurt to ask....
And BTW, there is the LymeAid4Kids fund, to help children with Lyme who have financial need. No child should go undertreated.
Regards, Shaz
Posts: 1558 | From the Berkshires | Registered: Jul 2001
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posted
Our health care system is such a mess.... Its not fair to those who need help and treatment to have to suffer b.c of lack of finances or insurance...its a crime in my opinion in this country....
I thank my lucky stars that I found my LLMD....
Before him I was spinning my wheels shelling out cash to ducks.
We are thousands in the hole and had to refinance our house to pay off some debt...That just shouldnt have to happen but its the sad truth for a lot of us.
My heart always goes out to the families with more than one perosn sick with this.....I cant imagine the hardship.
I guess there arent any good answers,,,, Like I said before unfortunately we have to be our own advocates and make our own health care decsions.
Posts: 437 | Registered: Sep 2004
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posted
My LNP charges $150/15min f/u and she's not even an MD! I'm happy that I'm being treated and getting better, but to be honest, I've always felt this was a bit of a rip off, esp when she forgets things about me or doesn't seem to ask me many questions about how I've been doing.
For example, when I first went to see her, she started me on Ketek and said she'd add Bicillin LA the next month. The next month she said I should start a 2nd abx and maybe she'd give me amoxicillin. I said "I thought you were going to give me benzathine pcn?" Then she said, "Oh that's right!" Duh?! Sorry, but I expect a little better for this kind of money.
Forgive me for venting a little. This has always bugged me.
Posts: 449 | From Pasadena, CA, usa | Registered: Aug 2005
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