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for KHN: At Urgent Care, He Got 5 Stitches and a Big Surprise: A Plastic Surgeon’s Bill for $1,040
josé a. alvarado jr.
Dec 15, 2021
The surprises came fast and hard: a fall that sent his head into the pavement and left him bleeding profusely and in shock, a trip to an urgent care clinic for five stitches and then a $1,039.50 bill.
Keller’s health insurance covered much of the cost of his visit to the CityMD clinic on Manhattan’s Lower East Side. But it didn’t cover the physician who arrived to stitch his forehead ― an out-of-network plastic surgeon with a Park Avenue office.
“The people at CityMD just said [this] sort of thing is covered as part of an emergency procedure,” said Keller, a regular cyclist who’s lived in New York City for three decades. Even in post-accident “delirium,” he said, he asked several times whether the stitches would be covered by his health insurance because it struck him as unusual that a plastic surgeon would do them.
“It really irked me that, it’s this classic thing you hear in this country all the time,” Keller said. “When you do all the right things, ask all the right questions and you’re still hit with a large bill because of some weird technicality that there’s absolutely no way for you to understand when you’re in the moment.”
Photographed for KHN, with words by Rachana Pradhan.At Urgent Care, He Got 5 Stitches and a Big Surprise: A Plastic Surgeon’s Bill for $1,040
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