how can i prove i paid co payments to my doctor.?

Question

It was 15 dollars every visit which i paid cash every time. i am getting a bill for $270 for services done during dec 2005. what can i do?
the lady said its also for deductible,but by that time it was met already. at that time i was with bluecross, now i have a different insurance. help!!!

Answer 1

The doctor's office should have a record of how the account was paid per visit.

You should demand the billing office provide you with a complete and detailed listing of your account.

You'll need to reconcile that with your recollection of when you went and how you paid.

If the doctor's office's account record for your account shows that on each visit you paid a $15 cash co-payment, that should sufffice with the insurer.

If the accounting doesn't show that....then you are going to have to take that up with the provider. If you've been paying cash all this time and they don't have a way to prove you did pay cash.....then they have a messed up accounting system.

(There is a slight but entirely possible scenario that the clerk to whom you were paying cash to.....pocketed the money and didn't account for it....it would be very easy to do....especially since you apparently didn't ask for or didn't get receipts...you should explore that with the office accounting supervisor.)

Answer 2

If you are paying cash, you need to retain your receipts. Ask your doctors office personnel for an account summary. Match that summary with your EOB's from the insurance company.

Depending on how your insurance Plan Document reads, there may be a good chance that you received services during the office visit that was not included with the co-pay. This is evident because you incurred some deductible during your office visits. Usually a flat co-pay visit is all inclusive and would not be subject to your deductible. However, diagnostic testing is usually extra and subject to your deductible and regular co-pay%. Also, you stated that "by that time" your deductible was already met. Keep in mind that your insurance company applies deductible and out-of-pocket to claims as they are submitted to the insurance company and not by the date of service. So it's very possible, almost normal, to have deductible calculated to services that are not in chronilogical order. You could very well be responsible for the $270. The only way you'll know is to order, from your insurance companies customer service rep, a claims history reports for the full year. For the lay-person, this is sometimes a difficult task as this request is usually outside the normal responsibilities of the CSR. Ask for the CSR's supervisor if you're not getting satisfaction. If you find a CSR that is good, ask to speak with that person on all your calls. If the CSR is very familiar with your files, they usually can answer your questions with a minimal amount of research in a shorter amout of time. The CSR is being pushed by management to produce a large amout of calls in a short amount of time so don't get offended if they seem abrupt. If you have anymore questions, you can email me. Remember, I can't discuss any specific medical related questions with you unless I have a written release from you.

Answer 3

Receipts are a good place to start.

DECEMBER 2005 services and you're getting billed NOW for the first time??? Ummm. I'd call the insurance company you were covered with at the time and ask for copies of the ORIGINAL Explanation of Benefits (EOBs) - unless the doctor's office was just paid (which I sort of doubt, because BCBS is VERY quick to put things to deductibles - often within 2 weeks of being billed!) they have some nerve billing you a year later. (Or they have VERY bad bookkeeping records!)

The doctor's office has to have some kind of record of what you paid at each visit - like a superbill or something that the doctor marks up so the insurance can be billed. I'd ask them to pull all of them (most places keep them for a year or so) and double check their records.

Answer 4

First I would ask them for a record of all payments made to them. Then I would call my insurance company and ask them for the same. See if you find any discrepancies and make a list. Be sure you understand how your insurance works. It seems to change regularly. You should have receipts for all cash payments or some type of proof. Gather everything. Then I would ask to speak to a supervisor and explain nicely the situation and ask for some help. By this time you will know if your payments were applied wrong, missing, or whatever. If you have trouble, go in person. If one person won't help you, go up the line until someone will take the time. Usually it is a change of insurance or posted improperly. Persevere!

Answer 5

They only way you can prove it is to produce the receipts. You can still call BCBS and ask them to discuss the bill with you. Have your former subscriber number available, the date of service and the doctor who is billing you. They'll discuss it with you and tell you whether or not there are additional charges outside the office visit copay that are applying. Sometimes the charges aren't discovered until months later and many times they have to go back and make corrections. Same thing happened to me where I was told I'd met my deductible and then found out a few claims had been reprocessed that were submitted inaccurately and I'd not actually met my deductible. Also, do you have an out of pocket in addition to deductible that might have applied? (IE: You have a $1000 deductible and then an additional $1000 out of pocket expense where BCBS pays x% until you meet the additonal $1000 out of pocket)

Answer 6

Hi Ruben.

First you can ask the doctors' office to pull their records. Businesses have to keep financial records for so many years for tax purposes.

Second you can ask Blue Cross to provide proof. They are an insurnce company so they may not be willing to work with you.

However since this is a $270 bill more than likely it is for something that was not covered by Blue Cross. Insurance companies are good for billing you after you get rid of them.

Answer 7

Ummm...you didn't get receipts for cash payments??

Your doctor should be sending you a statement of account, anyway. Try to dig them up, if you kept them, and show the balances they themselves were reporting at that time. Without this info...good luck, it's just an argument you probably won't win.

Next time, if you pay cash, get a written receipt!! It only takes two more minutes for them to write it out, and it will save you from headaches like this.

Answer 8

Did you keep your receipts? If so you can prove that you met your deductible/copayments. Gather them together, go back to the doctor, and show them to the billing clerk. If you did not save your receipts, you may be out of luck.

Answer 9

You need to give them copies of the receipts they gave you, every time you paid cash. I'm assuming you don't have them.

That's why you should ALWAYS pay co-pays & deductibles with a check or credit card, so you have your OWN record.

Answer 10

you should have receipts for the cash copayments to back you up. Call BlueCross, they should be able to help you figure this one out since you were with them at the time.