Medical Bill BS

Discussion in 'The Okie Corral' started by matt4shadow, Feb 21, 2010.

  1. matt4shadow

    matt4shadow

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    I am asking around to get some knowledge, no one seems to know what will happen.
    I thought the men and women of GlockTalk would be able to help me out.

    Here is the deal:
    I had a baby over three years ago. During labor, my wife recieved an epideral.

    Hospital bills came and went and we paid them all.....so we thought.
    Five months ago we recieved a letter from a lawyer seeking payment for the epideral procedure.
    We contacted our insurance carrier at the time and they pulled everything from that timeframe. They told us that the Docter never filed claim with them. She said it would have been paid if so. It was past the 2 year claim mark.

    Recently, we had an epideral on my son's labor and paid 150 bucks for it.


    This doctor wants 750 plus 500 in interest and expense.

    We go to court on March 9th

    My arguement would be that we were to pay that doctor for a service. Part of that service was for him to file with my insurance company. If he never did that, I find it believable that he never billed me. I honored all other debt from the hospital. I don't believe that I should have to pay that amount.

    Do I have a chance?
     
  2. PicardMD

    PicardMD Make It So!!

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    The doctor should eat the bill on this if indeed his office failed to file for insurance claim and you can prove that the insurance company would have paid the bill had it been filed (lots of "if's" here).

    Problem is, tracking paperwork will be a nightmare, and I would not take the insurance company's word on this without seeing what paperwork the doctor's office has. Some insurance companies are notorious for playing the "we never received the claim" card.

    In any case, your lability ceiling regardless of what happens should be the negociated rate between the insurance company and your doctor at the time based on the terms of your insurance at the time.

    Most doctor's office would have written this off.
     

  3. Carrys

    Carrys Inquisitive

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    I would get something from my insurance company stating that they did not receive a bill from the doc.

    And why aren't they in court with you?
     
  4. Wolfgang

    Wolfgang Millennium Member

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    could it be that he/she/wife signed a form assigning insurance to the Dr. and it also states he/she/wife is responsible for the balance?

    Ever read what you sign?
     
  5. Hef

    Hef Stop Obammunism

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    Talk to a lawyer. Medical billing fights can get ugly.
     
  6. matt4shadow

    matt4shadow

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    Sure do, There was a form stating that we would take financial responsibilty follow by some wording that could be interpeted in many ways.

    Also, your wife is in a ton of pain. Nurses shove paperwork in front of her, not exactly the time to read the fine print.
     
  7. Davegrave

    Davegrave Dapper Dan

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    Wolfgangs quote was directed at Carrys, not you. :tongueout:
     
  8. Wolfgang

    Wolfgang Millennium Member

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    my comment wasn't directed to you; reread carrys.

    I sympathize with you. Hope you get it fixed without paying what they are asking!
     
    Last edited: Feb 21, 2010
  9. Wolfgang

    Wolfgang Millennium Member

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    thank you:wavey:
     
  10. Carrys

    Carrys Inquisitive

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    Since it was "directed" to me, I'll answer.


    Yes I do. And because of that, I'm not the one having troubles.






    Could it be that you're wrong here?

    Just maybe?


    Thought so.
     
  11. Hawker Man

    Hawker Man

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    My wife had a sleep study done and the doctors office did not bill the insurance company in the time allowed by the insurance company. When they finally billed the insurance company it was denied. The doctors office then billed me, not for the amount the insurance company would have paid but for the amount a person walking in off the street with no insurance would have to pay. I was on and off the phone for about a month trying to figure this all out. When I finally "got it" and explained to the doctors office it was their incompetence that caused them to not get paid, they relented.
    Good luck
    Tom
     
  12. Hawker Man

    Hawker Man

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    The doctors office agrees/contracts with the insurance company to be bound by a set of rules, that includes on time billing. I keep up my end by paying premiums, the insurance company keeps up their end by paying the doctor, the doctor keeps up his end by providing a service to me and promptly billing the insurance company. If someone drops the ball it is their fault and I should not have to pay for treatment twice because of the doctor offices incompetence.
    If the doctor billed the insurance company on time and was not paid then I would be responsible for the bill and the insurance company and I would go around.

    Tom
     
  13. shavedape

    shavedape

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    A lawyer would cost more than what they owe on the bill. Ask me how I know. They don't need a lawyer for this, they need to fight it out in court themselves. In fact, it might not even make it to court if they rattle enough cages. I had a similar problem 2 years after having surgery, had a new job and new insurance also. One detailed and calm phone conversation with someone at the old insurance company where I pointed out that since it was a charge from back then when I was covered meant that they were still liable to cover it. It was totally NOT my problem that it wasn't billed in a timely fashion. Also mentioned I didn't want to take this to the state Insurance Commissioners office, but I would be happy to oblige if necessary. That fixed the problem right there.

    The OP's insurance company is jerking him around with BS about a 3 year cut off, blah blah blah. Insurance companies are legalized extortion and these guys are scam artists. They're bullies just trying to see what they can get away with. They know a certain percentage of people will give up the fight and pay the bill, that's how they play the game. I say play the game right back and remind them this isn't "touch" football but rather a full contact sport.
     
  14. Wolfgang

    Wolfgang Millennium Member

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    Wrong about what?

    He doesn't owe the $$$$?

    They didn't sign a form stating they were responsible?

    Not much else to be wrong about since they are the only issues.

    Maybe you have a solution, since you must be right?
     
  15. IndyGunFreak

    IndyGunFreak

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    I went through this sort of thing about 4yrs ago... My insurance company didn't authorize an anesthesiologist. The Surgeon because of the nature of the surgery(brain surgery) required one. Went around for a bit, and they were great paying all of my bills(quite a few) except that one, which came to the tune of around $1800, I received it around 8mo after the surgery. Called the insurance company, the dr, etc.. was Pretty sure I was gonna be left holding the ball, but then about 2-3mo later, I got a letter in the mail showing I owed the anesthesiologist a $49, and that the insurance had covered the rest.... Paid the $49 and that was that. I probably didn't owe the $49, as it should have been covered by my policy, but at that point, $49 wasn't worth fighting over.

    IGF
     
  16. matt4shadow

    matt4shadow

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    Thanks, but if it was directed towards me I would not have gotten agry about it. I hope my reply did not reflex this.:embarassed:
     
  17. matt4shadow

    matt4shadow

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    Your killing me with that avatar, I sell Pepsi for a living!
     
  18. Wolfgang

    Wolfgang Millennium Member

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    You are good---I hope you can come to an agreement with Dr office on the bill. :cool:
     
  19. zoyter2

    zoyter2 Yeah, so what?

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    Why would they go to court? They are not involved.

    Good luck. The problem is that YOU/whoever is responsible for the bill, NOT for filing, NOT for billing, NOT for straightening out a problem.

    If you/whoever owed this money, then they WILL be required to pay. Interest, etc is negotiable, but I would advise settling this before court time.

    I, unfortunately have experience with this exact problem. The anesthesiologist is probably in no way connected to the doctor. The doctor probably has no idea about their billing.

    I had the doctor (mine put the wrong code for "non-invasive surgery" thus the anesthesia was NOT covered), the anesthesiologist, and the insurance company on the phone with a conference call. The doctor admitted HE made a mistake in the billing, the anesthesiologist, verified the amount, the insurance company said there would be a check sent 0800 the next morning. I wrapped up the phone call (recorded, with permission) with a question to each involved...."are you satisfied?". Each answered "Yes".

    The check didn't go out until 2 days later, and the anesthesiologist added $135 interest and $200 collection fees.

    The judge ordered me to pay. "The bill is YOUR responsibility, not anyone elses" was his comment.

    Bear in mind that judges don't have to know any law to make a ruling, and common sense is a rare commodity at any job, and in my experience, even more rare in the judicial system. The appeal would have cost me more than the bill, so I paid.

    Good luck with YOUR situation.
     
  20. Eyescream

    Eyescream hates you

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    It's remarkable to me just how ****ing stupid the office staff at a doctor's office is. It's like they sit around and find new and creative ways to **** everything up.