View Single Post
  #4  
Old 04-22-2006, 10:05 AM
Guest
 
Posts: n/a
Default

This info might be useful to some of the US members:

When you have insurance and a doctor accepts that insurance, they are NOT allowed to bill you for the difference between what they charged and what the insurance covered.

I had a previous doctor trying to pull this and my insurance company told me to write them a letter and say "you are not in compliance with your agreement to (insurance company name). When you accept their agreement, you are accepting what charges they have allotted for certain procedures.
You are NOT allowed to bill for patient for the difference in the amount of what you submitted to the insurance and what the insurance covered.
This would make you not in accompliance with your agreement with (insurance company name).
Please adjust your actions accordingly."

I sent this to the doctor and magically, the next bill showed that I had a zero balance.
I didn't know that until the claims person told me this. She also explained that if you have a deductible to meet, then you might have to pay that but they can still only charge you the amount that the insurance company you have allots for that procedure/visit. Example: if you have a $500 deductible, they can still only charge you $295 if that is the amount your insurance allots for what the doctor submitted on the claim.

If you go to the doctor with no insurance, well then he can charge you his full ridiculous price.

I'm guessing that people who just can't afford medical insurance are just suffering with whatever ails them. How sad!

tmont:

I only seen the doctor I had an appt with for 3 or 4 minutes. He came in (never apologized either) and said Dr. $#%@ went over everything with you, did you have any other questions? (the other doctor told me that my MRI showed that I have DDDL5 stuff I already knew from my previous doctor).

I asked him what do we do next.
He said we'll set you up to give you two injections to see if the pain is coming from the facets as well and we'll see what your insurance covers as far as your next options.

That's the amount of time I spent with him after waiting TWO hours. My husband wasn't at work so he could be there with me. Sorta makes you feel like only their time is valuable.

By the time I left the appt, all the girls up front left for lunch. I asked him, "how do I make the appt to come back now" and I was told "the girls are all at lunch now. I will leave a note for the scheduler to call you. If you don't hear from her within a few days, then call her back".
This was a Friday. On Wed., I stopped in and made the appt myself since she never called me.

This is the part that worries me.
Imagine if I have him do my ADR and I have a problem after. I won't be able to get in there to see him. They will put me with another doctor.

I hate that. I went to him because he's supposed to be very good. I don't want to see the other doctor's he has trained to do this. I want to see the teacher....not the students!

Again, thanks for letting me vent.
Maybe if someone else is going through some frustrations too, this will show them that they are not alone and feeling Charlie Brown.
Reply With Quote