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Old 09-19-2010, 05:40 AM
 
689 posts, read 1,059,547 times
Reputation: 768

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Wow, I didn't realize there were responses to my thread until today. Thanks so much for everyone who has jumped in to help!

First let me give a summary,

Went to my in-network PPO doctor for an annual physical with my new insurance card. I have already met my annual deductable.

I was charged after my co-pay over $300 for tests then later another $300+ for the doctor visit.

That meant that this month, after I paying $800 out of my paycheck for my premiums I owed $600 in bills AFTER meeting my annual deductable for a physical with my IN-NETWORK doctor. So if in my post I seemed like I had an attitude I think it was well justified. For those who don't agree well, I need to take what your taking!

Anyhow, figured out what happened.

The doctor first filed using my old insurance company card. (i got a bill)

Then the doctor filed using the correct insurance but missed one digit on my account number.

(I got another bill)

Then I called my doctor and the lab and gave them the number. I am not sure how this error happend since they got the number off a photocopy they took of my card.

This time some stuff was paid but some tests were not)

I called the insurance company and then my doctor to find out why, my doctors office said she filed some as diagnostic and some as routine but the lab filed them all as routine to my insurance company so my insurance rejected a couple of the tests altogether.

Then I discoverd that my doctors office didn't file my office visit with my insurance and had billed me for the whole amount.

So after fixing everyone elses mistakes it turns out that in the end I am going to owe about $100. PHEW!!
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Old 09-19-2010, 08:30 AM
 
Location: NJ
12,631 posts, read 22,581,050 times
Reputation: 11538
That was going to be a suggestion I gave, to make sure they did not bill wrong or billed the right insurance because we've had that happen. Our ear, nose, throat is going to stop taking our insurance in November because they are having issues getting paid. We currently owe them about $500+ which I'm not sure what will happen if we will eventually owe it or not. The gal I spoke to the other day said we won't owe it because it's an insurance issue.

Glad you got it straightened out

Quote:
Originally Posted by Sky1 View Post
Wow, I didn't realize there were responses to my thread until today. Thanks so much for everyone who has jumped in to help!

First let me give a summary,

Went to my in-network PPO doctor for an annual physical with my new insurance card. I have already met my annual deductable.

I was charged after my co-pay over $300 for tests then later another $300+ for the doctor visit.

That meant that this month, after I paying $800 out of my paycheck for my premiums I owed $600 in bills AFTER meeting my annual deductable for a physical with my IN-NETWORK doctor. So if in my post I seemed like I had an attitude I think it was well justified. For those who don't agree well, I need to take what your taking!

Anyhow, figured out what happened.

The doctor first filed using my old insurance company card. (i got a bill)

Then the doctor filed using the correct insurance but missed one digit on my account number.

(I got another bill)

Then I called my doctor and the lab and gave them the number. I am not sure how this error happend since they got the number off a photocopy they took of my card.

This time some stuff was paid but some tests were not)

I called the insurance company and then my doctor to find out why, my doctors office said she filed some as diagnostic and some as routine but the lab filed them all as routine to my insurance company so my insurance rejected a couple of the tests altogether.

Then I discoverd that my doctors office didn't file my office visit with my insurance and had billed me for the whole amount.

So after fixing everyone elses mistakes it turns out that in the end I am going to owe about $100. PHEW!!
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Old 09-20-2010, 12:45 AM
 
Location: Victoria TX
42,662 posts, read 76,440,288 times
Reputation: 36232
I have a similar issue with my doctor.

I went to my doctor with a couple of symptons, and he prescribed a number of lab tests, for which I'm being billed a $231 copay. However, it turned out that all the symptoms I described were recognized side effects to the medication I was already taking, which he had prescribed. And my Rx was changed and the symptoms ceased. All the lab tests came back negative.

When I got the bill, I called his office and asked them to query the doctor, and see if he agreed that he should have first ruled out side effects to the medication, before ordering the tests. They said they would, and get back to me. They never called, and sent me the same bill the next month. Again, I called, and they said they'd call back. This has been going on now for 5 months.

In this case, the doctor has all the lab facilities in his own clinic, and all lab work is being billed by the doctor's office. Medicare is paying $766 of the total bill of $997, leaving me with a copay of $231, which is not a large amount of money, but I don't feel, as a matter of principle, that that the tests were justified. There is, of course, the question of conflict of interest, but I'm not raising that. He is sending me to his own lab, without first ruling out other causes for the symptoms.

All I want is for the billing office to show the bill to the doctor, explain my position, and call me back with a reply. If the doctor says yes, I have to pay, then i'll pay, but I just want him to hear my concern and make an honorable and professional judgment. But I get no response to my calls, and keep getting billed. I told the billing office last month that I thought I had a legitimate protest, and I didn't want my bill turned over to a collection agency, and they assured me that it would not be.

Last edited by jtur88; 09-20-2010 at 12:57 AM..
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Old 09-21-2010, 07:21 AM
 
Location: NJ
12,631 posts, read 22,581,050 times
Reputation: 11538
Quote:
Originally Posted by jtur88 View Post
I have a similar issue with my doctor.

I went to my doctor with a couple of symptons, and he prescribed a number of lab tests, for which I'm being billed a $231 copay. However, it turned out that all the symptoms I described were recognized side effects to the medication I was already taking, which he had prescribed. And my Rx was changed and the symptoms ceased. All the lab tests came back negative.

When I got the bill, I called his office and asked them to query the doctor, and see if he agreed that he should have first ruled out side effects to the medication, before ordering the tests. They said they would, and get back to me. They never called, and sent me the same bill the next month. Again, I called, and they said they'd call back. This has been going on now for 5 months.

In this case, the doctor has all the lab facilities in his own clinic, and all lab work is being billed by the doctor's office. Medicare is paying $766 of the total bill of $997, leaving me with a copay of $231, which is not a large amount of money, but I don't feel, as a matter of principle, that that the tests were justified. There is, of course, the question of conflict of interest, but I'm not raising that. He is sending me to his own lab, without first ruling out other causes for the symptoms.

All I want is for the billing office to show the bill to the doctor, explain my position, and call me back with a reply. If the doctor says yes, I have to pay, then i'll pay, but I just want him to hear my concern and make an honorable and professional judgment. But I get no response to my calls, and keep getting billed. I told the billing office last month that I thought I had a legitimate protest, and I didn't want my bill turned over to a collection agency, and they assured me that it would not be.
You're better off spending the copay & making an appointment with the Dr himself.

With hub; he sees an ENT who charged for a scope which we're positive he did not do because he was still "cooking" after radiation & chemo. He was never scoped during treatment.
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Old 09-21-2010, 09:41 AM
 
Location: Victoria TX
42,662 posts, read 76,440,288 times
Reputation: 36232
Quote:
Originally Posted by Roselvr View Post
You're better off spending the copay & making an appointment with the Dr himself.
.
Why? If I've already paid the copay, what is the point of seeing the Dr himself, and being charged for another $200 office call? I intend to find another doctor, who doesn't automatically railroad all his patients through his own labs.
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Old 09-21-2010, 03:05 PM
 
Location: NJ
12,631 posts, read 22,581,050 times
Reputation: 11538
Quote:
Originally Posted by jtur88 View Post
Why? If I've already paid the copay, what is the point of seeing the Dr himself, and being charged for another $200 office call? I intend to find another doctor, who doesn't automatically railroad all his patients through his own labs.
An office visit costs you $200?

Write a letter and fax it then. That usually gets action because its in writing.
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