Hi Rose76,

I completely agree with you. It's crazy, isn't it? Nowhere else are you expected to prepay with no breakdown of the costs, and then not actually get a receipt. I am having trouble wrapping my head around it.

And, I still haven't gotten that receipt! I need to follow-up with them, but it's painful to keep nagging for it.

This was a fairly minor, in-office surgery. Here's how it's played out.

1. Before the surgery, the doctor's office told me that I had $770 left to meet my deductible, and that they preferred to collect that money before the surgery. No breakdown of costs, no receipt. Just a request for a large sum of money before we could proceed.

I double checked with my insurance company before paying b/c my plan doesn't have copays, and (for normal visits) usually requires the doctors to bill insurance before they bill me, but insurance said that this is happening more and more, and that they had no control. So, I paid.

2. Had the procedure. No talk of finances at all (other than the payment from #1, which I did right before going in to see the doctor).

3. Got a bill from the pathologist. Paid online, assuming I could request or generate a receipt that way. The system said that I would have a receipt emailed to me, but none came. Called to get a receipt. Had to call again 2 weeks later. I now have the receipt! Success.

4. Got the bill from the doctor's office. Confusion, because it didn't show the $770 that I had already paid as a line item (although the balance due reflected it). Called the doctor's office to check the amount (and had to leave a message, b/c nobody answers the phone there). Got an email verifying the correct amount, and paid online. No receipt, again.

Emailed back and forth. She told me to try the online system.. I couldn't figure out how to generate a receipt from it. She told me that she'd have it generate a receipt for me, but that was literally just one page that said, "you've paid $52" - no breakdown of what was paid, and no mention of the $770! Emailed again... and that's when she told me she'd send me the receipt, but was working from home (just before the holidays). So far, I have not received anything, and need to contact again.

3. On my insurance website, I can see that the anesthesiology team put through a bill, and that I'll owe more money. I haven't received a bill yet from them, which is causing me some stress. I don't think I have any contact info for them (I might, I need to go through my paperwork, but I'm not sure). I'm guessing there will be a whole other bunch of hoops to jump through to get the receipt for that.

Everything about this seems so unnecessarily difficult and complicated and screwed up to me. Same thing with some of the shenanigans that I've dealt with trying to get out-of-network insurance reimbursement for therapy, just craziness and having to re-submit every other claim.

It seems that the system is pretty dysfunctional to me... I really wish we could get some actual work done in *fixing* it. I'd volunteer to be on a panel (my day job is in user-experience, so I think I'd have some good insights ).

It just *pains* me.... and as I said, this was a fairly simple procedure. I shudder to think of what it's like trying to deal with a major health crisis that involves hospitalization.

Back to the receipts... aren't there actual laws on the books about credit card receipts (i.e. not showing the full number)? I'd love to see a law for medical receipts as well, as you said, that any time you make a payment to a medical provider, they're required to give you a proper invoice and receipt that can be used for tax purposes or HSA reimbursements. And if they don't, there should be a fine that gets paid back to the patient!

Thanks!