I Just Got The Bill from My Daughter's Visit to the Pediatrician, Is This Reasonable?

My son has eczema and I'll tell you what we do. It's what the pediatric dermatologist and I worked out.

1. Bathe in warm water every day. In the bath water put some colloidal oatmeal and a healthy squirt of unscented baby oil. The oatmeal soothes the skin and the baby oil coats it, sealing in the moisture from the bath.

2. Use very little mild soap to wash.

3. Immediately after bath, towel off and rub Aquaphor or vaseline into the skin - all of the skin. You want to do it while the skin is still damp.

4. If the child is scratching and breaking open the skin, put on some Neosporin Plus. The Neosporin will help heal the wound and kill the germs in there. The pLus part has a numbing agent in it.

5. Regular old Benadryl. It'll help calm the itch down. Ask your pharmacist or call the doc for the correct dosage.

As for the steroid creams, they're a short term fix and can make your child irritable. Just fair warning. I'm laughing a little about the supplements - when I asked the pedi dermatologist she looked at me like I was crazy and said supplements wouldn't do any bit of good.

Depending on how your insurance works, you should only be paying the amount the insurance provider would have paid under their contract if you're paying off your deductible. Also, the bill is related to the Date of Service, NOT the date they submitted. If you were seen last year, the visit should still count under last year.

IMHO $231 to see a NP seems rather excessive. Have you asked for the breakdown of that bill?

And personally, I'd ask for a referral to go see an allergist for allergy testing. If you're still having problems with the eczema, get a referral to see a pedi dermatologist. The best part? They have SAMPLES. Ask for them before going out and buying them to make sure they work!

It is very common for a first visit to a new office to be much more than a regular visit charge. That is usually because they spend more time with you, taking history, learning about your issues and illnesses, and answering questions. I have always had doctors charge me more for the very first visit than they have for subsequent ones. It was not because she was an allergy specialist, but the doctor might be and that could make a difference.

Medical care costs in this country are completely out of control, but hopefully (cross your fingers) it will get better in time.

I'm so sorry you have to pay anything at all. It's not a concept i fully understand. I have lived in Canada my whole life and have never paid a cent for any health care. I would be so scared to get sick living in the states. i hear stories about parents with cancer, who say if it ever comes back they will just let it takes it's course or else they would force the family into bankruptcy. to me this is unimaginable. People complain about long wait times here, but from experience if there is an issue that will affect your ability to survive you are quickly bumped to the top of the list (ie. after my dad's second heart attack he waited about a week for his angiogram and was in the ICU until that point.-very well cared for) I understand there is a lot of resistance about health care in the states but i don't really know why. so yes i think $230 is too high. anything over $0 is too high. also my brother had excema VERY badly growing up. other than the topical steroids he used Watkin's Red clover salve. it was the most effective.

Because of the state of health care in America, costs like these are inflated. It's just how it works and it's a little ridiculous, but it's not the doctor's fault - they frequently don't have a ton of control over billing, it is heavily influenced by insurance companies. Did she have any tests? Is it itemized? I only had to pay a $500 deductible for my labor and delivery, but I did get to see an itemized bill and I was amazed at some of the line items on it. 3 dollars for a pill - 50 bucks for this 2 second test - 75 bucks for a catheter - more money every time someone changed my IV. It is a little ridiculous. If the bill isn't itemized, I would request that, if only from curiosity.

As a side note, our pediatrician's office is participating in some kind of study about early childhood intervention. So every time we are there we have to fill out a 6-10 question questionaire about our son's "milestone" skills and how we, as parents, perceive them. It's no big deal - but in big letters, on top of the form it says that if we are not insured we will have to pay 25 dollars to FILL OUT THE FORM! We are insured, so we don't mind, but if I wasn't, you can bet I'd refuse.

That depends on how the visit was coded and if this NP works for a doctor who is a specialist. It should not matter when they submitted the first bill, it is based on the date of service. If the date of service was last year and you deductible had been met then what you pay should be based on that...

To answer the question, reasonable? Not really. Surprising? Not really.

It sounds reasonable to me, but if the service occured during your previous year then it should not be subject to the deductible for this new calendar year. I would call the billing desk at the pediatrician's office and/or your insurance company and get that straightened out.

Sounds right for a dr visit in my area. Dr's visits are average about $250.00.

I also have a deductible plan and pay out of pocket until it's met, but I get the negotiated rate. Check with your insurance, you shouldn't have to pay the dr's bill for their cash price. If my Dr charges $250, the negotiated rate is about $108 and that is applied to my deductible and what I have to pay. Specialists are about the same here $250.

Also, try Mustela Bath oil for the eczema, it's awesome for flare ups. http://www.mustelausa.com/stelatopia_bath_oil.html

That's quite reasonable for a specialist.

I would try taking her to a dermatologist, however.

All the best.