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In early May, my fingers began feeling uncomfortably sensitive and my wrists hurt. I wasn’t sure if it was carpal tunnel (CTS), a neurologic issue, another muscular problem, or something else entirely. I wanted to fix it, but couldn’t figure out what type of doctor or therapist to see. The least expensive and quickest path to resolution, I thought, would be a telemedicine appointment with One Medical.
I booked it, received a CTS diagnosis, and a treatment plan including NSAIDs, wrist braces, and not using my hands.
Was it incorrectly coded? Insurance issue, as I’d recently joined Obvious Ventures? I had already scheduled a follow-up visit, and had I known about the first visit’s cost, would not have gone back.
I’m still working to decipher it all.
Despite collectively paying a fortune, an individual’s journey to obtain quality, affordable care in the United States is fraught at every step. Consumers’ experience (at least for those with employer-sponsored coverage, or no insurance) in healthcare can be as much financial, if not more, as it is medical. For 32% of Americans unable to cover a $400 expense*, a $520 bill would immediately throw them into debt.
Every year, Americans with employer-sponsored coverage choose their insurance during open enrollment season where they can choose from a host of options. Those without sponsored plans check offerings offered directly from insurance providers, seek coverage options on the exchanges, or neither. Even opting out of health insurance coverage is a choice. Employers can contract with companies like Nayya and Budgie Health that offer plan selection tools.
While this stage doesn’t incur any direct costs, consumers must make critical decisions without all the facts — and the wrong choice can inhibit the healing process and result in higher costs. In this stage, consumers ask two key questions: (1) Who can provide high quality care, and (2) how much will this cost? There is no singular, integrated solution that can help, but there are point solutions:
Billing in the United States is determined by Current Procedural Terminology (CPT) Codes. These codes are based on the reported care provided during the visit. The provider creates a claim that goes through a process called adjudication, where a clearing house determines how much the provider gets paid and how much the consumer and insurer owe. The output of this process is used to generate a bill that the consumer receives. While an estimate should be knowable beforehand based on negotiated contracts, claim adjudication can take weeks — a process difficult for consumers to understand the results of, and often riddled with errors.
