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Can my doctor bill me more than a year later because he improperly billed the insurance and they won't pay?

Discuss Lap Band Surgery

Can my doctor bill me more than a year later because he improperly billed the insurance and they won't pay?

Postby birk » Mon Nov 07, 2011 8:33 pm

I saw my doctor 8/22/08 and at that time I had double insurance coverage. My doctor billed the first insurance which paid, and then later withdrew the payment because I dropped them that same day (to avoid billing issues with a surgery that was only covered by the second insurance). Then 10/2/08 my mother (and mind you I am not a minor) goes into the doctors office and they try and get her to pay my office visit bill, which is of course ridiculous. She calls me while in the office and I explain to them the insurance situation had changed and to please bill what is now my only but was then my secondary insurance. I also told them at that time to please not ask my parents for money for my account as they are not responsible. They said thank you very much for the info and they would file with the other insurance. Then 9/3/09 I go into see my doctor and have a nice visit pay my copay every thing is fine. THE NEXT DAY I get a call from my father saying that I owe the doctor some money, while I am on the phone with him, my doctors office calls and tells me I owe for the visit in 8/09. I ask them why they did not tell me while I was in the office the day before and they said that it was " too far down on the screen" and they did not see it. I ask them why I was not ever notified for more than a year that my insurance company was not billed and there fore did not pay on the claim. They said they never got that information to the billing person. They also told me that it was too late to file the claim and that if I wanted the insurance to pay it I would need to file and insurance appeal and I would have to get a copy of my records and send it to them and all of these other steps (the bill is only 73 dollars hardly seems worth the effort). I told them I would like to speak to their billing person (who also happens to be the doctor that owns the practice not my doc). I was told he does not speak to patients about billing issues, THEN WHY DOES HE DO THE BILLING!!!! They told me I could make an appointment (and take off work mind you) to see the doctor to discuss billing in the office, but that he would not call me. I told them that it could be resolved over the phone if it was explained to me why this bill should eb mine and not theirs.Anyway I told them if they wanted me to pay I would need to speak with a billing person and told them again do not ask my family for repayment of my bills and hung up. Then today my dad takes little sister goes to the doc for a sore throat and cough and they ask him again for the money. Mind you they have not let me speak to anyone about billing and I have still never received a bill. I called back up to the and told them not to ask my parents for my money again explaining how this is actually a violation of patient doctor confidentiality since I am not a minor and my parents my not have know i was visiting the doctor at all. I told them again I did not think I should have to pay for their mistake or communication error or whatever, and I still needed to speak with a billing person. I also offered a concession of paying half, because I did not inform them the day of that I was dropping insurance #1, however I told them I wanted a n itemized bill for my appointment that day (which literally consisted of a weigh in, my final one before lap-band surgery) Please tell me
1) Am I being unreasonable?
2) Should I file some kind of violation of patient confidentiality report on them for repeatedly asking my parents for money?
3)How should I handle this bill?

Thanks for your responses

Kandi
birk
 
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Can my doctor bill me more than a year later because he improperly billed the insurance and they won't pay?

Postby george » Mon Nov 07, 2011 8:36 pm

If the Dr. is in network with the insurance company that's responsible for the bill, just call them. They should call the Drs. office and get it straight. In the mean time find a new Dr.
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Can my doctor bill me more than a year later because he improperly billed the insurance and they won't pay?

Postby renne » Mon Nov 07, 2011 8:43 pm

If the Dr. is in network with the insurance company that's responsible for the bill, just call them. They should call the Drs. office and get it straight. In the mean time find a new Dr.
you're being reasonable. They've violated privacy issues. I'd file a lawsuit in small claims against the doctor and watch the matter resolved faster than you can blink an eyelid.
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Can my doctor bill me more than a year later because he improperly billed the insurance and they won't pay?

Postby chizkia » Mon Nov 07, 2011 8:54 pm

1. Yes
2. No
3. Pay
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Can my doctor bill me more than a year later because he improperly billed the insurance and they won't pay?

Postby holmes » Mon Nov 07, 2011 9:04 pm

Remind them of the HIPAA law. But honestly I dont think you can do anything about them asking your parents for money because they did not release any information about your visit, such as your reason why you were there, what was done, or your diagnosis. But just remind them of that and tell them that you do not want them to speak to anyone but you about your account/visits with them.

You would need to file an appeal with your insurance.
Even though you told them to bill what was your 2ndry ins as your primary because it was switched, or whatever it was, you should have atleast called to check on it and make sure it was done, you never know in any office, things can fall through the crack, misunderstandings, or simply billing errors. If you do not appeal it with your insurance, you will be held responsible for the bill, unless the doctors office will admit to the mistake and write it off or discount it for you.
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Can my doctor bill me more than a year later because he improperly billed the insurance and they won't pay?

Postby harris » Mon Nov 07, 2011 9:15 pm

My question is did they send you bills or only call you and your parents for payment? For this matter to be around 1 year and not resolved is odd to me. When the 1st company denied due to you cancelling, you still should have gotten a bill from the doctors office showing denied and then you could have called the secondary to handle or call them to submit for payment.

Unless your parents have on record in their office that they would be held responsible, they should NEVER ask them for payment. When you went into the office, most of the time, they ask for your insurance info which I am guessing, you showed both, plus on the bottom you have to sign that if insurance denys YOU will be held responsible. I am guessing the 2nd appointment you signed the form again and put down your insurance info. They do this since many people change insurance all the time so they want the most current.

There is one last option and that even though you are not a minor, are you on your parents health insurance?? If so, then they bill them and your parents would find out, since you are listed under their policy and could conceivably expect them to pay. But if this policy is under your name only, then they had no right to bill or harass them.

good luck
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Can my doctor bill me more than a year later because he improperly billed the insurance and they won't pay?

Postby gerrald » Mon Nov 07, 2011 9:17 pm

Absolutely, they can bill you for this.

1. yes. you're being unreasonable. They did the best they could, with the information YOU gave them, which was not accurate (your fault they didn't bill the right company the first time).
2. Assuming you're over 18, AND your parents NEVER signed a financial responsibility form for you (if they had, legally the doctor CAN collect from them for your bill!), there's no "penalty" to them for violation of patient confidentiality - and if you suffered no financial loss, no lawyer will take the case.
3. Pay it.
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