The guest’s symptoms suggested a urine infection, one of my favorite diseases. They’re miserable but respond quickly to antibiotics. This looked like a good visit. I quoted my fee.
“Oh… I didn’t realize it would be so much.”
This happens. I remember guests from the Four Seasons where room rates start at $600 who didn’t want to pay half that. In any case, once I mention the fee, I consider it tacky to refuse someone who complains. I quoted a lower fee. That was OK.
It was a good visit. I tested her urine, announced she had an infection, and handed over her medicine. She was grateful. As I left, she indicated my invoice.
“Can I submit this to my insurance?”
“You have travel insurance?”
“I think so. They made us buy something for this trip.”
It was too late to ask why, if she had insurance, she had objected to my fee. But this also happens. In every developed country except Russia and China, if you need a doctor you don’t first decide if you can afford it, so foreign tourists often pay little attention to insurance.