Question

Hi, Does anyone think DMG pediatrics charges a lot for visits? I keep getting bills for $250 $478 just seems a lot. I know this all depends on contacted amount and what the insurance plans is. But I feel like I haven’t paid this much ever. We have good insurance BCBS PPO, does anyone go to a different office that may be cheaper? As in the doctors charges are lesser so if the doctor charges $300 a visit as compared to $500 a visit. Thank you.  

Answer 1

We have the same insurance as you and go to Naperville Pediatrics. We dont pay anything for well visits and only 15 for sick visits. I love the doctors at Naperville Pediatrics too.  

Comments

@diddle there are only two doctors there Rubin and Lawande we love them both. I am a first time mom and my son had issues gaining weight at the beginning and they both were so helpful plus they have a hotline you can call anytime and one of the doctors will call you right back, I have call at 9pm cause I was concerned about my son and rubin called me back within 5 mins. Plus they really listen to you and answer all your questions.  

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@diddle I would be pissed if someone told me that when it came to the health of my son. I have dmg for myself but would not use them as a pediatrician I have heard to many horror stories with them. I own my own daycare.  

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@diddle I've had to call DMG pediatrics a couple of times after hours over the years. I always received a return phone call within 5-10 minutes. One time was after 11 at night! We love our DMG pediatricians - Dr. Gruzalski and Dr. Cooling are wonderful!  

Answer 2

That’s a lot! Is it just sick visits ? Any labs ? Out recent well baby check with shots was over 600 bucks -

Comments

@diddle that seems like a lot - of course it’s the new year and you probably need to meet your deductible

Answer 3

I don’t use DMG- but if it’s a preventative visit, you shouldn’t be paying anything if they’re contracted with your insurance. They should not be charging you anything over what the agreed amount is with your insurance.  

Comments

@thorn98096 I was going to say the same thing. Our pediatrician is with Dreyer, but we’ve never had to pay for a well visit!  

Answer 4

A regular visit is a $20 co-pay for us.  

Comments

Is that what you’re having to pay?  

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No matter what whenever we visit the pediatrician it’s $20 Well checks are 100% covered

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@estimable we have a BCBS HMO and pay $20 per visit for regular doctor visits out of DMG. We’ve had a number of health issues in the past year and have been very happy with what we have to pay out of pocket.  

Answer 5

Depends on what type of visit you a talking about. Well visit vs. sick visit. price is very different

Comments

That’s extremely high for a sick visit. Even if they are adding breathing treatments that may increase a level. It still should not be over $270 ish. Ever

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Well, that right there is shady. They are doing an influenza test which most people think is going to cost roughly 13-20 depending on your insurance and they did a dna probe. If they didn’t tell him and have him sign a form stating that he was ok with that, I would fight it. Tell them you were unaware of the type of influenza test being run and you would have taken the regular test that shows the same results. They are just trying to upcharge you. Sorry for this pain in the *ss

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What is the dna probe compared to influenza test?  

Answer 6

Is your medical plan is a High deductible health plan (Hsa) ?  

Comments

@diddle most Hsa plans have high rates.  

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@diddle as other plans just have co pays only. but in a HSA plan there is no copay . your plan does not pay until you meet your deductible. Only annual wellness is covered 100%

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@diddle a HMO plan can he HSA compatible and a PPO plan can be HSA compatible

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@diddle yes

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@tailwind13 those can have an HRA not an HSA

Answer 7

So is that your portion or what they bill the insurance ? Is that just the office or other charges ? Breathing treatment, blood draw etc.? New patient vs established pt? I would ask for an itemize bill & compare it to the EOB from your insurance.  

Answer 8

Yep. Every visit was $94 when we were PPO. Now that we are HMO it’s just $25. They were already in our network so it was a no brainer for us

Comments

@diddle best thing we ever did. Every single doctor (except one) was already in the networks. Combine that with using our FSA and we are saving thousands. I was scared to go HMO at first but I wish I did it sooner

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@diddle depends on your employer. Mine doesn’t

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@diddle I believe it’s based on the company they use, idk for sure

Answer 9

You might want to make sure you’re seeing specific doctors in your insurance. Mine is covered with specific doctors within DMG and only comes to $5 copay and usually never have a charge for anything otherwise it’s $20-$60 depending on xrays or whatever else

Answer 10

This does seem high. I’m an insurance broker. BCBSs contracted rates usually warrant a 40-60% discount. Sounds like maybe you aren’t being charge for just an office visit rather it may include other charges, tests?  

Comments

@diddle yes good idea. They can tell you what charges were billed. Also, keep in mind that if you saw a specialist, the charges will be higher.  

Answer 11

I was frustrated with amounts like that as well with my BCBS PPO during all my OB appointments throughout my pregnancy. In August I switched to BCBS HMO and have not had a bill since, even with the delivery of my child.  

Answer 12

That may be what they charge but the negotiated rate (even before you meet your deductible) should be lower! That seems very high. Maybe confirm they’re still in network with the new calendar year? And call their billing to see what’s up. Then your insurance. I’ve found CDH to charge slightly more for services so maybe DMG just is more expensive in general? Still seems high, though.  

Comments

@diddle central DuPage hospital. they dr appts always seem higher than others. So I think some places just do Bill more.  

Answer 13

This is why ALL medical institutions should be transparent with the cost of services. We need to shop around at our will. There is going to be a huge uproar once this becomes a law. I'm a nurse, and I am very happy about this. A visit to any doctor, sick or not sick, should cost no more than 100 bucks. End of story. It's a 15-minute visit. Insurance gets involved. It's 500 bucks but bcbs only make you pay 300. Wow! What a discount! Even a 20 or 30 dollar co-pay and insurance pay the rest. Still a rip-off. No wonder insurance seems unaffordable! If we all paid a cash rate for regular visits. It wouldn't be so dang high. Leave the insurance for hospital visits.  

Answer 14

I love DMG and my family has may health concerns that require specialized doctors. Everyone says PPO is the way to go when having such medical problems but we love DMG doctor so much we went to HMO with them as our group

Comments

@girard where do you go for your family? Looking for peds, pediatric psychiatrist, and regular doctor for check ups for myself. Thanks

Answer 15

We paid more at drs for ppo. We switched to hmo and it’s been so much cheaper

Comments

@diddle ours is cheaper. We also love dmg because of all the specialities. The immediate care on the weekends is a huge plus.  

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@diddle yes definitely. I have a ton of friends who have to go through all these hoops to go to ents or anything like thst. With dmg they just refer through their mychart

Answer 16

I use kane county health services. So much cheaper for everything. Check out your county health services

Answer 17

If this is an insurance through work or if you shopped with a health insurance rep I would recommend contacting the rep to see if they can help you negotiate. We pay for our insurance through our business and our rep is WONDERFUL for saving time and money.  

Answer 18

My insurance company sent me a letter directing me to use a different office away from DuPage Medical. No explanation other than DPM out .  

Answer 19

Make sure what is in network and out of network with your insurance company. We found out the hard way. Some is just a 10-20 difference in what they cover and sometimes more.