am i responsible to pay?

Question

my husband and i staring seeing a pcyhothepapist for marital problems and the receptionist told us they took our insurace and our only out of pocket expense would be a 15$ co-pay. But she didn't realize my insurance was a different branch of the one they took and it did not cover the full session. so six weeks went by before they realized it and sent us a bill for 800$ what the ins. co. did not cover. It was their fault for not checking what kind of ins. we had and letting us know what our total cost would be before starting sessions so i don't feel it's our responsability. Thier taking us to court now are we responsable or is it their fault?

Answer 1

don't use them anymore

Answer 2

I'm afraid it is YOUR responsibility to ensure your insurance covers this, not the receptionist. I've been stuck with a bill this way too. It's really annoying, but I learned a lesson. Always call your insurance company yourself to determine if treatment is covered.

Even though the receptionist made a mistake (and you can try arguing that with the supplier) you will have signed paperwork stating something like "I understand that I am personally responsible for the billing". Providers will sometimes send a debt to a debt collector even though it is covered by insurance, because the insurance company is slow in paying - and they come after the patient because that's the way contract law works.

There are two contracts - one between you and the medical provider, and another between you and the insurance company. Although the provider and insurance company normally work everything out between themselves, they really don't have to - they don't have a contract with each other.

I'd advise you to pay up. You WILL lose in court, and that will be more expensive.

Answer 3

Two things.
Depending on the Carrier:

1: The Doctor (in this case Therapist [compound word for THE RAPIST - thought I'd add that]) can be bound to only accept what the Insurance Company pays as being "paid in full".

2:The Doctor may be FREE to Bill the Client for ADDITIONAL monies IN ADDITION TO WHAT THE CARRIER PAYS.

Either way, you should have been informed of this BEFORE your sessions started. If this doctor is trying to usurp monies from you AFTER you were informed and comfortable in knowing you were fully covered, REPORT HIM/HER and DO NOT PAY until you have cleared this up with your insurance carrier.

You are, however ultimately responsible for any bills incurred.

Answer 4

I have three answers:

1. If the sessions worked, you should consider yourself very fortunate to have improved the most important relationship in you life and you should pay the $800.

2. If the sessions didn't work, your husband should pay, you're mad at him anyway.

3. If the sessions didn't work and you aren't ready to get rid of the husband, it seems your argument is correct that the psychotherapist's office took upon itself the responsibility that in fact you insurance would cover the costs besides the co-pay and it was there error, and it was reasonable for you to rely upon their expertise in these matters.

More importantly, good luck to both you and your husband in finding the path to resolve you difficulties.

Answer 5

I would say it is their fault.However,would your legal expenses exceed $800 dollars?Unless you have plenty of $$'s and it's just a right/wrong thing,it might not be worth it.I would talk to a lawyer though.He/she might be able to get a judgment in a counter suit for your legal expenses, if the judge sides with you,which has been known to happen a lot. If you get a cool judge that sides with the little guy a lot,you could possibly recover money from them because of the strain on your marriage,which brought you there in the first place.

Answer 6

You are going to end up paying and if it goes to court then you might get the bill for that as well. You should contact your insurance before seeking any medical attention other than urgent care needs to understand your financial responsibilities. It is not the medical office clerks to explain your coverage to you. They forward the outstanding balance of you care to the insurance and the insurance sends the amount that your coverage allows. You are responsible for the difference.

Answer 7

I have no doubt that when you started going to this psychotherapist, you signed something saying that you would be ultimately responsible for payment whether or not you had insurance.

You should have checked with the insurance company yourself.

Sorry I can't give you any better news than this.

Answer 8

I don't know what's legal here, but, I'm with you. They didn't catch it and it's not like you were trying to pull a fast one. Another way to look at is they never really did anything for you, its not like they fixed your car or painted your house. The whole counseling thing is a big racket, they get to charge incredible fees with no accountability whatsoever. I say go to court over it, what have you got to lose?
GB

Answer 9

Office billing is a convienence. You are ultimately responsible. $800.00 seems a bit high for a session.

Answer 10

If you signed a paper which states that if your insurance doesn't pay you have to, then yes. Most hospitals and medical professions do have clients sign the form.

Answer 11

Yes, you are liable. You should have consulted with your insurance company before you started.