Cost for CDE visit

Has anyone paid for a visit with. Certified Diabetes Educator out of pocket, without insurance? I have health insurance, but this CDE is not in network, so I’ll have to pay out of pocket. It’ll be full price, unless I get a discount. I was going to call today about it, but got tied up and couldn’t. I’m just curious. I’ve seen this CDE before, but was covered by insurance then and never noticed anything other than my co-pay. I realize rates may vary from region to region and facility.

Hi @HighHopes . Your best bet might be to pull up your insurance plan online and check their out of network cost.

Thanks for the tip. Sadly, I get zero credit for out of network costs. They pay nothing, unless it’s an emergency visit. I don’t even get credit towards my deductible! It seems so unfair.

I had been a patient at this facility for many years when I had to switch due to insurance. While the new place was okay, I found I didn’t do as well as years previous, so I returned to my old facility and have seen an improvement. I hope it will continue, especially after meeting with my old CDE, who’s T1. I’m just hoping the visit charge will be closer to $300. as opposed to $800.

Hi Dee @HighHopes! We don’t have insurance. I have discovered that providers will give you as cash discount from the rates that they normally charge the insurance companies. I would call and ask.

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I’m going to give it a try. I did that with the last doctor visit, but the physician charge wasn’t reduced. I hope they’ll be of help. Thanks.

I think they have to give you an estimate thanks to the “No Surprises Act” that was enacted January 1, 2022. Schedule the appointment for at least three days in the future then ask them for a “Good Faith Estimate”.

This is a Medicare document but its for people paying cash. https://www.cms.gov/files/document/nosurpriseactfactsheet-whats-good-faith-estimate508c.pdf

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Thanks a lot. This is helpful. I don’t get Medicare, but still it’s helpful. I left a message, will call back tomorrow for sure.