U.S. CitiesCity-Data Forum Index
Go Back   City-Data Forum > U.S. Forums > New York > Long Island
 [Register]
Please register to participate in our discussions with 1.5 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
Jump to a detailed profile or search
site with Google Custom Search

Search Forums  (Advanced)
Business Search - 14 Million verified businesses
Search for:  near: 
 
Old 02-22-2012, 01:53 PM
 
165 posts, read 274,504 times
Reputation: 50
Default North Shore Urgent Care in Nesconset -Beware

Both my husband and I used this facility. Before going we called to ask if they accepted our insurance and was informed that they do. Went, paid $25 co -pay and now we just received $75 bills telling us that they are not in our network. Nothing the insurance company will do or they will do. Just beware and make sure you ask if they are In Network. We will take the blame and just pay the bill.
Reply With Quote Quick reply to this message

 
Old 02-22-2012, 01:54 PM
 
7,262 posts, read 7,521,641 times
Reputation: 2851
Quote:
Originally Posted by mrsstats View Post
Both my husband and I used this facility. Before going we called to ask if they accepted our insurance and was informed that they do. Went, paid $25 co -pay and now we just received $75 bills telling us that they are not in our network. Nothing the insurance company will do or they will do. Just beware and make sure you ask if they are In Network. We will take the blame and just pay the bill.

They scammed us too, never again.
Reply With Quote Quick reply to this message
 
Old 02-22-2012, 02:13 PM
 
1,962 posts, read 1,874,626 times
Reputation: 742
Quote:
Originally Posted by mrsstats View Post
Both my husband and I used this facility. Before going we called to ask if they accepted our insurance and was informed that they do. Went, paid $25 co -pay and now we just received $75 bills telling us that they are not in our network. Nothing the insurance company will do or they will do. Just beware and make sure you ask if they are In Network. We will take the blame and just pay the bill.
Always check on your insurance company website first.
Reply With Quote Quick reply to this message
 
Old 02-22-2012, 02:40 PM
 
Location: Nassau, Long Island, NY
15,738 posts, read 16,300,679 times
Reputation: 6388
Quote:
Originally Posted by mrsstats View Post
Both my husband and I used this facility. Before going we called to ask if they accepted our insurance and was informed that they do. Went, paid $25 co -pay and now we just received $75 bills telling us that they are not in our network. Nothing the insurance company will do or they will do. Just beware and make sure you ask if they are In Network. We will take the blame and just pay the bill.
You don't have to.

Get a printout of what your insurance company paid. For example, if you have Aetna you can do it yourself online.

Make a copy of the copay that was accepted (either credit card printout or copy of check).

Send the bill right back to the office in the envelope they gave you with a letter that says, "Here is what my insurance company pays you according to your contract with them. I am not responsible for anything more than a copayment, which has been paid. Your own office accepted the copayment and assured me on the phone before I used your services that they would."

You shouldn't get another bill. (Note: I have done this before and never had a challenge.)
Reply With Quote Quick reply to this message
 
Old 02-22-2012, 07:16 PM
 
653 posts, read 1,073,268 times
Reputation: 237
There is a difference between accepting your insurance and being "in network".
Reply With Quote Quick reply to this message
 
Old 02-23-2012, 06:12 AM
 
165 posts, read 274,504 times
Reputation: 50
Quote:
Originally Posted by DawnSells View Post
There is a difference between accepting your insurance and being "in network".
Yes there is and that is why I said to beware & make sure you ask the question correctly.
Reply With Quote Quick reply to this message
 
Old 02-23-2012, 07:45 AM
 
857 posts, read 963,907 times
Reputation: 450
It's common at most hospital emergency rooms and urgent care places. The facility may accept your insurance however a doctor working in the facility may not be in your network and thus the separate charge. The insurance company usually send you a check to cover the cost of out of network.
Reply With Quote Quick reply to this message
 
Old 02-23-2012, 09:36 AM
 
1,962 posts, read 1,874,626 times
Reputation: 742
Quote:
Originally Posted by nycbrooklyn View Post
It's common at most hospital emergency rooms and urgent care places. The facility may accept your insurance however a doctor working in the facility may not be in your network and thus the separate charge. The insurance company usually send you a check to cover the cost of out of network.
Assuming you have out of network coverage in your plan... else you are hosed.

I think that any group office all doctors that are in P.C. together should take the same insurance plans.

I had this issue when my wife had surgery and 3 of the 4 doctors in the group took our insurance but 1 didnt. Of course this is the 1 that was on-call for my wife post-surgery when she needed to go back to the ER.

I had to fight and argue to get them to take what my out of network coverage paid. Basically, it came down to... Look you know my insurance, my wife's doctor is on vacation and this other doctor was covering his service for him. Its not my fault someone assigned him to cover my wife.
Reply With Quote Quick reply to this message
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.

Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.


Reply
Please update this thread with any new information or opinions. This open thread is still read by thousands of people, so we encourage all additional points of view.

Quick Reply
Message:



Over $84,000 in prizes was already given out to active posters on our forum and additional giveaways are planned!

Go Back   City-Data Forum > U.S. Forums > New York > Long Island

All times are GMT -6.

2005-2014, Advameg, Inc.

City-Data.com - Archive 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25 - Top