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Old 01-30-2019, 07:02 PM
 
4 posts, read 1,808 times
Reputation: 10

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I took my daughter to the dr yesterday and they told me my last claim was denied. They have had problems sending in my claims almost every time. I always have to call my insurance and get them to approve it right there so I can see the dr. I had my insurance on the phone, and the office manager refused to send it in again and said I had to pay cash or i wouldn’t be seen. I told her I would pay, but I wanted it sent in because I also pay for insurance and they need to pay for the claim. (I had to see the dr my child was extremely sick. She tested positive for the flu.) She finally said she would fax it over. I even got her a direct # so it could be approved immediately. Before I left I called back the same lady at my insurance and she said she still hadn’t received it. I then asked for a copy of the claim myself so I could send it in. Now all of a sudden there are 4 unpaid claims between my 2 daughters. Dating back over a year ago. I emailed all of them to my insurance company. They called me back. They said they would cover 2 of them, 1 was out of the 1 yr required time limit for claims, but if they could show they at least tried to submit it, they would cover that too. The last one has already been paid. They sent me a copy of the EOB and it showed full payment. The drs office decided to fax them in today. Since I had taken care of it yesterday, my insurance company actually called the dr’s office to explain. She wouldn’t even listen to him! She screamed at him that they didn’t pay and that I would just have to pay cash as she hung up on him. He was researching while I was on the phone with him and found that both of my daughters went to the dr on that day and they paid both of them with the same check. At the drs office 1 is showing paid, the other isn’t. But she wouldn’t let him send her proof. Between that and the claim they never sent that is over a year old, I just don’t feel like I should be the one having to pay! What do I do since the drs office is so unreasonable?!?
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Old 01-30-2019, 07:07 PM
 
Location: Denver CO
21,991 posts, read 13,042,464 times
Reputation: 34008
Quote:
Originally Posted by JMMitch8819 View Post
What do I do since the drs office is so unreasonable?!?
find a new doctor. It seems like they are the ones creating most of the problem here
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Old 01-30-2019, 07:46 PM
 
4 posts, read 1,808 times
Reputation: 10
Agreed! But I don’t want to have to pay this bill again and I don’t want it on my credit
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Old 01-31-2019, 12:08 AM
 
Location: New Braunfels, TX
6,504 posts, read 9,508,168 times
Reputation: 6809
Quote:
Originally Posted by JMMitch8819 View Post
Agreed! But I don’t want to have to pay this bill again and I don’t want it on my credit
Contest the bill. Get the insurance to send you a copy of the canceled check, and if they turn it in for collections, let them know you intend to sue the c*** out of them for fraud. I'd also call the State Licensing agency - see what relief they might be able to provide.
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Old 01-31-2019, 02:36 AM
 
4 posts, read 1,808 times
Reputation: 10
I may have to! The insurance company cannot send me the copy of the check, I tried that, and she hung up on him when he was trying to send it to her! I’ve been working on my credit so hard! Brought it up 127 points in the last 9 months. I just don’t want it to hit my credit... but on the principle of the matter, I don’t want to pay either!
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Old 01-31-2019, 08:28 AM
 
Location: New Braunfels, TX
6,504 posts, read 9,508,168 times
Reputation: 6809
Yeah - find yourself another doctor, and put THAT one on full social media blast!
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Old 01-31-2019, 08:32 AM
 
Location: Bedford
609 posts, read 839,886 times
Reputation: 750
If keeping your credit score in tact is that important and you don't see a quick solution before it gets to that point, you could always pay the bill in the mean time and still contest the issue. I know that's a not a reasonable option for everyone, but it's an option.
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Old 01-31-2019, 08:39 AM
 
1,430 posts, read 565,533 times
Reputation: 4631
Is there someone else at that doctor's office you could talk to? Maybe even formally document your issues to the office manager or doctor.

And yes, go somewhere else.
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Old 01-31-2019, 10:12 AM
 
4 posts, read 1,808 times
Reputation: 10
Problem is the office manager and the dr are married. My insurance company is faxing over all of the proof this morning. They also covered the claim that is over a year old. So as long as she can read, they shouldn’t be able to ask me for any money or come after me at all for this anymore. I’ll keep y’all updated as to what she says next. If they try and bill me now, I’m reporting them for medical fraud. Because they would obviously be trying to collect on that bill twice
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Old 01-31-2019, 04:56 PM
 
964 posts, read 544,880 times
Reputation: 2332
Here's what you need to do -- I am an appeals supervisor at an insurance company. Get copies of all four of the EOBs reflecting payment from your insurance company. Send copies via certified mail to the providers office and remit any patient responsibility. Then find a new doctor.

My daughter went to a pediatrician's office we'll call Kid Cash Pediatrics. While the doctor was great, his wife that did the billing was a nightmare to deal with.
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