medical billing issue?

Question

I went to the Dr. and had a ingrown toenail removed. I had to have the same procedure done on the same nail one month later. I was billed for both procedures. I spoke with one of the billing reps from the clinic who told me that they would not charge me for the second nail, since the procedure didn't work. now the clinic is charging me for the second procedure. What can I do about this?

Answer 1

I work in a medical billing office for a group of multi-specialty physicians. If you did not obtain this in writing from the physician or his/her office manager, you will not have much recourse in the matter. You utilized the physician's time and supplies, regardless of the outcome of the procedure, and that makes the bill due and payable by you (or your guardian if you are a minor). Taking this up with the physician will sometimes result in his direction to the biller to write off your charges, because most physicians do not want to 'spend time dealing' with billing issues. They are, of course, PHYSICIANS, not billers. In most states (and with most insurance companies), if the biller has already billed your insurance and your insurance has either paid a portion or applied the services to your Deductible or CO-pay, it is ILLEGAL to write off your 'portion due', regardless of what you were promised. This is considered insurance fraud, and may come back to haunt BOTH you and your physician. If you are a cash patient, an alternative solution would be to explain the miscommunication to the office manager and negotiate a discount on the procedure. Physicians cannot provide services for free and at the same time keep their fee's low, as this is the number ONE reason why so many medical bills are increasingly so HIGH. The more instances when insurance companies and patients avoid or do not pay for services rendered, the more others who 'do pay' end up paying much more. Think about it. You received the services. The physician provided these services at his expense. He or She is entitled to some sort of reimbursement.

Answer 2

I think that you owe the money for both visits. The facilities were used twice, the Dr's time used twice, two different instances of materials being used.
Where did you ever get the idea that treatment had to be successful in order to have to pay? If that were true there would be a lot of dead people who had money coming to them.
A Medical Clinic is a business. Business dictates what I have told you above. If the billing rep said something like that, then it is on you to prove it, by stating the exact time of the call and the biller's name. That way phone records can be accessed. That is what Medical Insurance is for.

Answer 3

Talk to the office manager, see if there's a record of the billing clerk telling you that they wouldn't charge you for the second procedure. If they don't have a record of it, and deny you were told that, you'll have to pay. Sorry!!

Answer 4

If you didn't get a persons name the first time you probably will have to pay. Talk to the Dr himself and tell him what is going on. He has the say so.

Answer 5

You can report the doctor to the medical review board eventually they will straighten things out but if you dont want it to go on your credit youll have to pay it now and get re embursed later.