In the grand scheme of medical bills — a very large and limitless scheme as all but a very fortunate few of us are too aware — one for $1,713 from Novant Health amounts to spit in the ocean.
How’s that, you say?
Well, at the close of the third quarter of fiscal 2025, the laughably classified “not-for-profit” reported $831.6 million in the equally ridiculous classification of “excess revenue.”
Read that back. Slowly.
Yep, $831.6 million in “excess revenue.”
That’s what people who pay that freight might call “profit.”
So how does $1,713, of which $1,539.77 was covered by private insurance, factor into that obscenity?
Because that’s what Novant Health charged for my routine annual physical, preventive care, which at one time was supposed to be free under the Affordable Care Act, plus a flu shot that may or may not work.
None of this is new to anyone who takes the time to read their medical bills, of course. Nor is it unique to Novant. They’re part of the system, not a cause.
The health care system is, to put it politely, a dumpster fire. You know it. I know it. Everyone, with the apparent exception of members of Congress, knows it.
Still, a bill for $1,700 for an annual wellness visit, and a bill for $173.23 to the patient, rates a phone call.
“That’s insane,” said a family friend, an emergency room doctor. “I’d call and question the charges. If that doesn’t work, you can appeal it to the insurance company. And if that doesn’t work, try the (North Carolina) Department of Insurance.”
First, let’s look at the breakdown of charges which included: $742 for a Pcv20 vaccine; $418 for an office/facility visit; $291 for another office visit; $65 to give the shot; $57 for a flu shot; $45 for “admin of soc dtr assess 5-15 M”; $39 for a second vaccine; $34 for a brief emotional or behavioral assessment; and $22 for a blood draw.
PCV-20 would be a pneumococcal vaccine, and the “admin of soc det assess” would be an assessment in areas of social determinants of health. Questions such as: Do you worry about paying for food?
Here’s a news flash for a conglomerate reporting $831.6 million in “excess revenue:” Anybody worried about buying groceries isn’t coming for a $1,700 annual physical.
So here’s how the call went: 17 minutes on hold, which wasn’t terrible considering the circumstances, with canned music, an unnecessary admonishment to call 911 if this was a medical emergency and an unsubtle reminder that “kindness is contagious, a little can go a long way.”
The guess here is that it’s included to prevent callers from blowing their stack at those who answer patient calls all day long.
They don’t set billing policies, but they sure hear about them.
In my case, and I’m confident that customer service reps are both well-trained and well-accustomed to complaints, a pleasant young-sounding woman fielded my call.
Her lucky day.
That extra charge for a facility visit? If you ask the doctor a question, even if you think it’s an update about a chronic condition like an arthritic hip, you’re getting a bill.
“That typically happens if you ask about any concerns outside the annual wellness exam,” the rep said. “Do you recall asking any questions?”
Not that I remember. Learned that lesson a while back when a previous family doc actually said with a straight face that he was doing me a favor by saving me from a separate visit. And here I thought part of the reason for the annual checkup was to see if anything had gotten worse.
Doctors, bless their hearts, aren’t buying graying cuts of meat that have to be cooked today.
And the shots? Well, $742 is what pharmaceutical companies charge for a pneumococcal vaccine, and the $100 to give two shots is basically the provider sticking it to you again, simply because they can.
“I can’t speak for other organizations — I don’t work for a pharmacy, and you’d have to contact them — but I don’t think they charge for that,” the rep replied when asked about going to Walgreens or CVS for a flu shot.
As for contesting the $173.23 not covered by insurance, she said, somebody will get back to you.
“That would pay for two weeks of groceries for my little family,” she said. “I don’t blame you at all.”
Looked at another way, the $1,700 Novant Health billed for an annual wellness exam covers about a half-hour of the $6.94 million — if figured at $3,336.54 per hour — pulled down by CEO Carl Amato in fiscal 2024.
And that flu shot?
It didn’t take. Happy New Year.
Scott Sexton is a columnist for the Winston-Salem Journal.
Sexton: After a ‘wellness exam,’ bill brings heartburn and headaches
