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Old 04-27-2011, 02:55 PM
 
4 posts, read 9,313 times
Reputation: 19
Default What can I do if a doctors office refuses to fill out insurance forms?

First off I live in North Carolina.

This past year I had changed health insurance. Well my insurance company needs a form filled out by the doctors office stating when I was seen, what I was diagnoised with, what medication and symptoms of any visit between certain dates. There were only 2 visits. I have been fighting with this doctors office since Feb 2010 to get this form filled out. The office manager told me she had faxed the papers in then she said she didn't but mailed the form (not signed) and my medical forms for those 2 visits. The insurance company never received either. So I went and got copies of the papers and of course they were not signed and faxed them in myself. The insurance company received those but could not accept them without the form itself being filled out and signed. So I called again and she says that did not make since and said she was going to call her self. She said the insurance company has all the forms and all they need is for her to fax over the signed paper (not filled out), but they would have to call her back with a fax number. This did not sound right so I called the insurance company myself again and they did not have any of the papers she mailed and still needed the form filled out and signed. The office manager says she refuses to fill out the papers, says she doesn't have time. I then called to talk to the doctor and was told that neither doctors were in today. Does anyone know what I could do to get these papers filled out?

Last edited by mrsmojo01; 04-27-2011 at 03:37 PM..
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Old 04-27-2011, 03:31 PM
 
Location: Somewhere.
1,362 posts, read 1,468,426 times
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I had a similar issue (and am still having issues but thats a different story). It was with a hospital though and it took filling a BBB complaint to get them to work with my insurance company. I actually was on a 3 way call with the hospital and my insurance and had the hospital HANG up on me and then wouldn't answer calls from my number.

Maybe your doctor is on there and you can file a complaint against them? If not look into filing a complaint with the NC dept. of insurance. Maybe just call/and or give the doctor a written threat stating if its not taken care of within 30 days you'll take action?

I can't tell you how frustrating its been to deal with these morons and now I'm fighting a collection agency for a bill my insurance paid long before it supposedly even went into collections. I'm afraid its only going to get worse because of the new health care law unless something is done to give patients protection and not the insurance. I hope you get this straightened out soon.
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Old 04-27-2011, 07:35 PM
 
5,150 posts, read 2,760,314 times
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If the doctor is important to you write him/her a letter asking them to look into it for you. He might not know. If the doctor is indifferent as is the staff then I'd be concerned with my health care choice.
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Old 04-28-2011, 10:17 AM
 
167 posts, read 131,907 times
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Quote:
Originally Posted by mrsmojo01 View Post
First off I live in North Carolina.

This past year I had changed health insurance. Well my insurance company needs a form filled out by the doctors office stating when I was seen, what I was diagnoised with, what medication and symptoms of any visit between certain dates. There were only 2 visits. I have been fighting with this doctors office since Feb 2010 to get this form filled out. The office manager told me she had faxed the papers in then she said she didn't but mailed the form (not signed) and my medical forms for those 2 visits. The insurance company never received either. So I went and got copies of the papers and of course they were not signed and faxed them in myself. The insurance company received those but could not accept them without the form itself being filled out and signed. So I called again and she says that did not make since and said she was going to call her self. She said the insurance company has all the forms and all they need is for her to fax over the signed paper (not filled out), but they would have to call her back with a fax number. This did not sound right so I called the insurance company myself again and they did not have any of the papers she mailed and still needed the form filled out and signed. The office manager says she refuses to fill out the papers, says she doesn't have time. I then called to talk to the doctor and was told that neither doctors were in today. Does anyone know what I could do to get these papers filled out?
this is when having a lawyer as a friend is perfect. have him send a friendly letter on his letter head requesting the same thing you are asking. WATCH WHAT HAPPENS???

I had a counselor outright lie to me and say that she is no longer a part of the insurance plan I'm enrolled in. I searched and searched and found out that she was still in network. She just didn't want to fill out the paper work anymore . She was trying to get me to pay until her contract was in fact over.

Sent a letter on my friends letter head asking for her to file with the insurance and it was taken care of immediately.
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Old 05-02-2011, 04:22 PM
 
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Update...I finally got the form signed...I had to go to the office and refuse to leave until it was done. I also took my phone and recorded the conversation...yes I did inform her that it was being recorded...they even threatened to call the police if I did not leave...I never was able to talk to the doctors themselves...they are cowards...I called to talk to the doctor 3 times and either he never received the messages or he chose not to call me back...I still call them cowards...I will never go back to Carley Family Practice...they are incompetent.
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Old 05-03-2011, 07:59 AM
 
Location: Somewhere.
1,362 posts, read 1,468,426 times
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Congrats! Way to stick to your guns. Its an extremely sad day in this country though when you have to go to such measures to get something so stupid taken care of.
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Old 05-03-2011, 08:58 AM
 
Location: Containment Area, NC
12,150 posts, read 7,295,413 times
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Quote:
Originally Posted by saucystargazer View Post
Congrats! Way to stick to your guns. Its an extremely sad day in this country though when you have to go to such measures to get something so stupid taken care of.
Agreed! I've had a hard time getting a form filled out by my doc's office. It's really frustrating, isn't it?

I'm glad you finally got it done, OP!

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Old 05-03-2011, 04:59 PM
 
Location: in a house
3,530 posts, read 8,904,144 times
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Quote:
Originally Posted by mrsmojo01 View Post
Update...I finally got the form signed...I had to go to the office and refuse to leave until it was done. I also took my phone and recorded the conversation...yes I did inform her that it was being recorded...they even threatened to call the police if I did not leave...I never was able to talk to the doctors themselves...they are cowards...I called to talk to the doctor 3 times and either he never received the messages or he chose not to call me back...I still call them cowards...I will never go back to Carley Family Practice...they are incompetent.
but in the 1st post you said they wouldn't fill out the forms (a courtesy, by the way, because they really aren't required to complete insurance forms for people) not that the doc wouldn't sign it. It simply doesn't make sense, unless you had another issue with the office. And for a claim to be open for more than 3-6mo., it might be difficult to get reimbursed....
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Old 09-17-2011, 07:00 PM
 
4 posts, read 9,313 times
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It was a form that was sent to them from the insurance company. Its a form that they have agreed to fill out if the insurance company wants it. It is part of the contract they have with the insurance company. Its not a form I gave them to fill out. So in order to be in the insurance network they have to fill out these papers its something that the insurance company and the doctors office agreed to do. But its me that suffers when it doesn't get done. Well all has been completed and I am no longer going to Carley Family Practice. I have a new doctor and they are great. I do not have to fight to have anything done. Very happy with them.
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