Guidewell Emergency Doctors Shady billing practices for customers who pay out of pocket. Winter Park FL

I came here after accidentally removing a tick from my groin area - I couldn't see the tick bite site on my own and wanted to make sure that the tick head wasn't embedded. I would have asked my boyfriend to do it but he was out of town, so I came here and asked for a visual inspection of the tick bite to make sure the head was gone. I also brought the tick body with me in case they could tell at a glance what type of tick it was, because Lyme disease is a risk for some types of ticks but not others.

I explained all of that to the front desk.  The front desk staff saw that my insurance wouldn’t cover what they usually charge for this type of visit because my deductible wasn’t met yet. So they quoted me a price for an “out of pocket office visit” and asked me if I wanted to proceed with that instead of using my insurance. I said yes even though it was at the upper limit of what I was willing to pay. I was worried that the tick head might still be embedded - worried enough to pay $160ish for a fast answer instead of waiting for my boyfriend to get back from his trip. I agreed to the price she gave me and I paid in full while I was there. Front desk said the price might be higher later if we need other tests like pathology reports or MRIs (I knew that we didn’t need that though - I really only needed a visual inspection of the tick bite site).

During my visit the doctor inspected my tick bite with the flashlight on her cell phone. She confirmed the tick was gone, so that was a relief. But when she looked at the adult tick body, she told me it was a "beetle" even though it obvious even without magnification that the tick body had 8 leg stumps. Beetles are a type of insect, and insects only have 6 legs. She gave a specific species name of beetle and asked me to google it on my phone - it brought up an array of beetle pictures that looked nothing like the tick I had brought with me. In response I told her that the pictures don't look like mine at all, plus mine clearly had 8 leg stumps and insects only have 6 legs. She left the room, looked at it again, and came back half an hour later with the blindingly obvious concession that it "might" be a tick. Still, she sent me home with a piece of paper entitled "Insect Bites" even though ticks are arachnids, not insects.

I went home and did google image searches - found several "brown dog tick" images that looked exactly like mine from multiple angles.

Overall, I went home feeling like I had payed too much for a doctor that doesn't know what a tick looks like. But I was also relieved that the tick was gone, so I didn’t write a bad review or dispute the cost I had agreed to. Just moved on. 

3 months later, I got a second bill for the same visit - for a completely unexpected amount that effectively TRIPLED the total cost of my visit. It brought the total cost to $500. That's ridiculous, considering the only thing of value that I got there was a visual inspection of my tick bite site with a cell phone flashlight. If I had known in advance that they wanted $500 to 1) look at a tick bite near my groin with a cell phone flashlight, and then 2) incorrectly identify what had bit me - then I would have said no to the visit, and I would have asked my boyfriend to look at it for free a few days later.

So one of three things happened - either the doctor ordered additional tests that I didn’t authorize - or maybe they decided to charge for that inexperienced misidentification process as an extra service without asking me if I was OK with paying extra for it - or maybe their front desk gave me completely misleading information about how much the total cost would be for someone who is paying out of pocket.

Either way, I am very unhappy with how this was handled. I called to talk to someone in their billing department. Instead of listening to me, she only repeatedly explained what they "usually" charge for office visits and told me to stop talking. To my situation it isn't relevant what they "usually" charge, because the front desk made it sound like they were making an exception to their usual prices for a cash customers. When your front desk gives your customer a price up front, and the customer uses that price to make a decision about whether or not to proceed with the visit, then it doesn’t matter what you "usually" charge - the only price that matters is the one that I said yes to.