Pain management doc trying to take advantage of me? Need advice..?

I went to my pain management doc (Neurologist) about 30 days ago. He scheduled me to see his nurse today to pick up my Rx refills. I wouldn't be seeing him, just an RN. In order to get certain meds that I have I have to be present and pick up a written Rx. I went back to get them from the nurse they said they want me to pay my 40 dollar co-pay. I told them that I was not seeing my Dr. today, just getting my Rx's from the nurse and they said I'd have to pay it anyway. I refused and told them that i shouldn't have to pay the same amount for a Neuro consult as I would to have an RN hand me my written prescriptions. I have a background in medical billing and insurance and I think this is shady. I called my insurance and they said that if I dont see the Dr. they don't know why the charge would be the same. What should I do? I already emailed the superv. at the clinic, but should I just go ahead and pay it? I will go without my meds until I get a resolution. That means pain.

BUT don't worry.... the doctor will be nice and comfy tonight in his warm bed and his million dollar home! Meanwhile on the side of town I'm DROWNING in medical debt and glued to a heating pad for a lifelong spinal disease. Grrr... I'm sure the 40 bucks will be a detriment to another patient that will be suckered into paying it....
Don't see the doctor suffering too much.

It is not uncommon for chronic pain patients to be seen monthly for their prescription refills. This is neccessary as they are usually Schedule II narcotics and cannot be written for a longer than 30 day supply and the prescription is only good for a short period of time. This normally means the physician writes the prescription while you are in the office.

In my practice, we see every patient every month. We assess the effectiveness of the medication, any side effects and other interventions which might help.

In most cases this is an established patient short or minimal appointment.

I actually don't have a nurse, and my partner or myself see every patient. It is time consuming but the patients deserve it, and we often catch the need for changes in the plan, where we thought a simple refill might be in order.

Follow up and discuss this with the physician, if they won't discuss it with you, take the refill (so you aren't in pain, and start the process of finding a new physician.

do not pay and notify your insurance company of possible fraud for charging you- tell the office to bill the insurance after you notify the insurance of the possible scam.
Find another doc ASAP

It seems pretty common for specialists to charge very high "consultation" fees, and not too unusual for a doc to charge a consultation fee for opening your record, and looking it over for a minute or two before writing a prescription. I am not defending this practice, but it does seems to be the usual way of doing business. For a recent x-ray at a hospital, I received a $150 charge for a radiologist to look at the x-ray and write two sentences describing the injury. There were also fees for the x-ray itself, fees for the hospital facility, and fees for the x-ray tech. A $150 fee for several minutes of work seems extremely high, but the doc probably has payments to make for the country club and Mercedes. If i were you, I would just pay the bill and find another doctor that has rational billing rules and fully discloses fees up front.

I would pay the fee so you can get your meds and dispute the fee later. Then I would find another doctor ASAP. I have never been to a doctor that would charge me a fee I was disputing. If there was any doubt about whether or not I owed a copay, the doctor's office has always said that they would look into it and bill me if I have to pay a copay according to what my insurance requires. I've also had a credit at one of my doctor's offices because I paid a copay when I didn't have to. If you were just getting refills of meds, the doctor shouldn't have to consult you or look at anything in your file other than what type of med he needs to give you. I also wonder why he couldn't just call it in to the pharmacy for you- they check ID if you are given a controlled substance. You obviously aren't comfortable with this doctor so you should find another one.

Not sure why you didn't get your refill RX at time of neuro visit?
Was the neuro visit $40 too? or actually more like $60 or 80..
http://www.carpal-tunnel-symptoms.com