romanojg

I'd be talking to your insurance company about that. I have two ins. comp. and they send me a statement with what was charged and what if any the docotor is allowed to charge me. That just doesn't sound right.

vivoaks

That sounds ridiculous! I've never heard of such a thing! I'd raise a stink if it was me. Anything to make a buck....

arimuse

All this is too true. I worked as a 3rd party medical biller (medical bill collection angency - these people buy bills that arent being pd and then collect what they can and keep it.) Most issues in billing happen because a HCFA is mis -coded. There are a gajillion ins cos and they all have different "rules" , and different "rules" within each co depending on the plan you're on. The only absolute is: these HCFAs, (health forms, ) are all the same across the board (used in the USA, dont know about outside the country) and every ins co/ dr has to use them for billing.
They are computer generated by people inputting info from your medical charts for your dr services - usu at your dr/hospital office.. Even a paper form feed issue, where a code is out of alignment will kick the bill out of the system and a computer at your ins co will deny payment because it isnt reading the form properly.
Where I worked, we found this issue(misprinted paper) for billing BC/BS ins coming from a hospital in MD. We reprinted hundreds of HCFAs and refiled the claims and made 40K on that one issue from one hospital.
Its really a terrible thing to get sick in this country. I dont carry ins now, and I wont go to a Dr. Period. You have to really hunt to find a Dr who is really a Dr and not a money machine. They are out there but you really really have to look for them. I absolutely have nothing good to say about ins cos at all.
For your own well being, if you have ins, learn everything you can about your plan, and if there is a grey area call and get clarification in writing. Also, every insurer sends you a copy of what happened every visit you have. Keep these copies, even just in a shoebox under a bed. If there is a question on who pd what and what is owed you can send a COPY (always a copy, not the original - you'd be suprised how many times you end up needing the same piece of paper) of the date/ service in question and usually that will end any calls to you about payment - if you've paid your part, or didnt owe.
and, yes 3rd party medical billers can sometimes even help you by getting some paperwork issues fixed, but you must understand how your ins plan works. Ins plans range from top of the line - if the medical office doesnt bill properly in a time range the bill will be denied in full by the ins co and you owe nothing to garbage plans where if the medical office doesnt bill properly in a time range the ins co denies payment and YOU OWE the whole bill.
Its all about being proactive for you and your family. sharet

debbieoh

SOunds weird never heard of such a thing. call your insurance and see what they say. sounds like a way to double dip to me.

amandasgramma

When i worked for a doctor, 100 yrs ago, Medicare did an audit.........we had to prove with the appointment book each visit. If you didn't have 2 appointments set up, then you shouldn't be charged for 2. Talk to the billing SUPERVISOR and if that doesn't work, tell the doctor why you're changing doctors.

Years ago I had a dentist that guaranteed the fillings. Three months later 1 fell out --- he billed my insurance co. for a filling for a different tooth. HAH -- nailed him! I reported him.....Feds stepped in (must have had other complaints) and he got nailed for Medicare fraud, too. He lost his license.

So I stand by my first comment, if you didn't have two appointments, they can't charge for 2.

writerwomen

More common then you'd like to believe- I'm tired of going in with the kids or myself and getting a shrug and nothing to be found then getting a bill for what was acording to them was nothing- funny if I charged customers for doing nothing I'd be out of business- and there definatly wouldn't be an isurance kick out

writerwomen

Gotta add to that- some years ago I worked with a dentist with great ethics. He was telling us one day that at a poker night of dentists one decided to brag about how he was scamming insurance companies with the knowledge and a cut for his patients. Funny thing the other dentists didn't think it was funny they turned him in first thing the next morning. All 5 of them testified against him.

sammy89

that dont sound right, never heard about that.I think is time for a new doctor.

arizonagirl

Everyone should always check their EOB's. The first pain management office that I went to over charged me for over $700. When I called their business office about this, they tried to play dumb and say that they would have to research it. I advised them that they were aware that this was going on and that I was not going to wait 6 to 8 weeks for a refund. I let them know that I have medical billing and collections experience and know that when the insurance company issues them their check that they also get a copy of the same EOB that I get. I advised them that they had 1 week to get my refund to me our I would notify my insurance company of fraud. They got my refund to me very quickly and I took my business to another office.

p.s EOB means explanation of benefits

dogpursemaker

Oh my goodness! I knew I REALLY liked my pediatrician, not only for his unsurpassed "bedside manner" with my kiddos, but for his honesty and ethics. I rarely take only one child into the office with me. If I am there due to an ill child, he ALWAYS checks ears, throat and lungs on any siblings that are there with me, and inquires about any that are not present. I pay ONE co-pay-for the sick child that had the appt. I do not ask for him to check, he just does. At the end of the visit, (no matter the reason we were there-illness or check-up), he always asks if I have any questions about anything else. Yes, I have asked questions about a different child (infrequently), no extra charge. If I have to come back for a re-check on ears, throat or whatever-no co-pay-it's just a re-check to make sure things are on track.
My PCP is pretty much the same way. I can give her a list, and she handles it all for one co-pay.
As for the well baby check, my ped always checked the umbilical stump. I guess all doctors don't care so much about their patients. Sad.
On the flip side of that, my insurance was billed by the hospital for my newborn daughter's circumcision. I notified the insurance company that I had delivered a girl, and had not had her circumcised, and they said basically, oh well, it's already paid for. :hunf: