My Doctor doesn't send bills, what do I do?

Question

My son's pedi. doesn't bill their patients (according to the secretary). Upon my visits they try to get me to pay what they think is due at that time. I said to bill me and I will pay. The secretary said the Dr. doesn't send bills and that I get an EOB from my insurance provider (the document that says "This is not a bill" and says what I "May owe the provider"). I said I want a bill. They have provided a year of service and I switched Dr.'s. I have never received a bill and have only paid the co-pay. The last straw was my final visit where they made me sign a document that said I was fully responsible for the remaining cost of vaccinations for my son that insurance doesn't cover. Is this legal? SHould I send a letter requesting a bill for the balance that I am aware of or just wait for them to take action?

My problem is not my insurance coverage, which I am completely aware of, it is with a Dr. who wants me to pay a legitimate bill but will not produce the bill.

Answer 1

You should probably talk to your insurance company about this and see what should be done, and if you need to file a complaint.

It's unacceptable. They MUST have records of your visits and services rendered, because it's a matter of legal and tax liability, for them, and for you and your own finances. How can you claim these services as deductions on your tax return, or how can you claim these should you ever get into an auto accident? you MUST have access to them, and you should demand copies of those bills.

Answer 2

First thing you need to do is speak with your insurance provider and find out what their arrangement is with that office. Many offices accept X dollars for a service and the rest is written off.
Vaccinations are a whole different ball game - many insurances do not cover certain vaccinations or only cover them at a percentage.
You need to be aware of what your insurance coverage is. Your office will bill your insurance, and then should bill you based on what is the balance of uncovered (not waivered or written off) expenses.
I have never received a single bill from my pediatrician or my primary care doctor - because my insurance covers office visits and vaccinations. I am aware of this so I know the only thing I pay is a copay at the time of the visit.
The road goes both ways - your office should have been more forthcoming explaining the office policy, but you as the insured should be knowledgeable about what your insurance coverage is. The office is not responsible for education on insurance coverage.

Answer 3

Usually the doctor over bills the insurance and makes a deal with them what he will accept. Usually the co pay is all you owe. If the doctor doesn't send bills guess you don't owe him anything...