Encounter with a Procedure

Kevin has a procedure scheduled next Thursday at a Cincinnati hospital.

"Procedure" is medical code for something more than nothing and less than everything. It usually includes pain, at least discomfort, waiting around and large co-pays.

Procedures come with co-pays that rival the down payment we put on our first house. Be prepared to front it before you even get to sign in at the desk. Kevin's had a year and a half of "procedures" now and I can see the bad economy having an impact already. Used to be enough to just sign that, yes, we would pay the co-pay. Then they wanted a piece of the co-pay up front as well as a signature indicating we would be forking over the remainder. Now they want the entire co-pay before the receptionist will give him a welcome.

At least they still take checks. I think the next move is going to be cash only. Maybe they'll gather the staff at the end of the work day and tip out everyone from the day's collection of cash co-pays.

Before you get to that point, though, you have to have several office visits to determine if you do, indeed, need a procedure and just which procedure you're going to get. This may involve an encounter.

Encounters have an exponentially higher price tag than office visits or appointments. You won't feel in in your office visit/encounter co-pay since that is set in stone by your insurance carrier. It'll slide in somewhere in the fine print of your procedure. In fact, if you have an encounter instead of an appointment, it's almost a guarantee that a procedure will follow, with a large co-pay and there will be some portion of it which is indefineably not covered by your insurance carrier.

I can guarantee you that Kevin's gastroenterologist bills for "encounters." Anyplace where the medical assistants, receptionists AND doctors are garbed in color coordinated medical attire will most certainly have encounters. Having the doctor show up wearing black trimmed in hot pink piping was a dead-on assurance that an encounter was in the making.

Should you miss your encounter with less than 24 hours notice, death being exempted, you will be billed for your insurance co-pay. Nevermind that the office can cancel on you at any time in the process, even after you've spent 30 minutes sitting in the waiting room.

Once your encounter has morphed into the inevitable procedure, your window for withdrawal shrinks dramatically. You have to give 7 DAYS notice to cancel or change your appointment or pay a $250 dollar cancellation fee.

Kevin's procedure was scheduled during yesterday's encounter which means he had about 2 hours in the freebie range to change his mind before the 7 day countdown began.

Of course when the low end of your intestines is mostly closed and you're living in pain and nausea, it's a pretty good call that you're going to show up. Assuming, of course, the week long wait for the procedure doesn't end with you able to play the get-out-of-jail-free card of being dead.