A Mukwonago family has found that removing a splinter can be considered surgery.
Maddie Prigge got a splinter on her foot over the summer, and they were unable to get it out themselves.
They decided to avoid the high cost of urgent care or the ER, and went to their primary physician at Froedtert’s Westbrook Health Center in Waukesha.
Her dad, Brian Prigge, was expecting a $30 co-pay for a routine doctor’s visit, but instead the bill was $377.49. He then called Call 4 Action for help.
With the co-pay, that cost jumped to more than $400. And that was with health insurance through United Health Care.
If the Prigge family was uninsured, it would have cost $705.
The hospital considered the procedure to remove the splinter a surgery.
“I just casually mentioned to the physician ‘hey this was billed as surgery, do you think that what happened in that room was surgical?’ And her answer was no. She didn't believe it was surgical,” Brian said.
Brian’s physician responded to his complaint saying in an email he tried to “change the name of the procedure,” to change the billing code, but found “there really isn’t an alternative.”
The hospital investigated the complaint and found that because the physician used a scalpel, it was considered surgical. In a final decision letter they called the charges valid.
Froedtert declined an interview for this story, and instead sent us the following statement:
At the request of Mr. Prigge, we reviewed the charges he received for his daughter’s care on July 30, 2018. We shared our findings with him last October. All documentation was deemed appropriate for the care received. The final cost to Mr. Prigge was determined by the care received and his insurance coverage. We have offered him a payment plan if he prefers to pay in installments.
“Let patients know what they are going to be on the hook for when these issues occur,” Brian said. “Had I known that the bill for that office visit was going to be over $400 perhaps I would have taken a different form of treatment.”