5 Ways to Manage Pediatrician Costs

Written by Eric Bricker, M.D., guest writer

Health Harbor

The average pediatrician charges just over $100 for a single visit for which the pediatrician is paid $70 by the typical insurance company. Here are the tricks that tend to make the most difference in cost:

 

  1. Select a pediatrician who performs labs and x-rays in office. Those who don’t often send patients to an independent lab or hospital for these tests which typically receive much higher payments from the insurance company. Also, many benefit plans will simply apply in office labs and x-rays to your office visit co-pay costing you much, much less.
  2. Find a pediatrician group with a 24 hour nurse hotline. Our pediatrician has one that costs $12 per call. Each time my wife is concerned about our daughter and uses the hotline, we frequently are told what to do and save the $70 pediatrician visit.
  3. It is OK to question your pediatrician. Ask yourself how many times you have heard a pediatrician say, “Well, I am pretty sure your daughter just has a cold but let’s run a strep test just in case.” It is OK to ask your pediatrician if a strep test is really necessary. Strep tests can cost you up to $50 and if the physician feels strongly that the test is needed, then he or she will says so and will not be at you for speaking up. Much of medicine is practiced out of habit - habits that cost you money, but do not necessarily contribute to high quality care.
  4. Ask your pediatrician to prescribe you generic medications. Almost all major generics are available now for $4 a month.
  5. Practice asking your pediatrician “How much will this cost me” every time a new treatment is recommended. While the pediatrician will likely not know the exact answer, the question will alert the pediatrician to the fact that cost is important to you and will often trigger a conversation about lower cost alternatives.

At the end of the day, having a pediatrician is one of the single most important steps you can take to protect your child and save you money as a pediatrician’s cost is one fifth the cost of a low level emergency room visit. If you cannot afford health insurance for your child, be sure to check out your state’s childcare program as new legislation helps many more children qualify for coverage.

This is one in a series of HealthHarbor articles contributed by Dr. Eric Bricker. Dr. Bricker is the Chief Medical Officer of Compass Professional Health Services, whose mission is to 'to enable consumers and employers to receive and purchase higher value healthcare.' Compass can be found online at www.compassphs.com.