My insurance company is billed by my Dr and they pay a portion of the claim that is a predetermined amount for that type of service.I pay a small portion per visit.And as a discount the Dr office is to "writeoff" a portion.I found they were not deducting the write off from my balance,by carefully reviewing my records.When confronted, the secretary admitted that she knew she was suppose to she just didnt know how much.And admitted she does not deduct the write off from any of the patients balances.These patients are owed that discounted service for seeing an in network provider and I would assume is part of the offices contract with the Ins.co. I feel the financials should be audited, some how.I dont know who to call or if I should call...Is this write off only at the dr offices discretion?If anyone knows who to call in Illinois it would be great!
2007-01-19 13:28:23 · 4 answers · asked by justthinkin 1 in Politics & Government ➔ Law & Ethics
She has already corrected my bill only because I showed her my explanation of benefits....It is the other patients I am afraid are being ripped off!This office has a very high amount of disabled patients...who may be putting out more than they need to because of her.
2007-01-19 14:41:31 · update #1
If this lady knows that she is suppose to be deducting this amount and is not doing so,she is violating the contract terms of their agreement with the insurance company they are providing services for and chances are they are not only doing this with your insurance company,they are doing it with the other insurance companies they have agreements with.
The biggest problem comes when she tries to collect that money and that is truly Fraud.
This secretary needs to learn how to read those insurance papers that come with the payments,this is her job and failure to take care of her job puts her boss in jeopardy.
Wait and see if you get a statement for that amount that should have been written off and along with that you need your EOB's (Explanation of Benefits) showing where she is charging for what should be written off and with that you need to send it to your insurance company with an explanation of what is going on.
Keep in mind that once you do this your current Dr will probably not want to see you in his office again so be prepared.
Good Luck and you ARE doing the right thing!
2007-01-19 14:08:53 · answer #1 · answered by Just Q 6 · 0⤊ 0⤋
Try the site below on this legal matter, make sure to change the location/state in which you reside. The last site is an affordable way to get access to your Legal Rights and work with a TOP Law Firm in your State. Watch the online movie presentation. Hope this helps.
2007-01-19 14:06:10 · answer #2 · answered by citronge69 4 · 0⤊ 0⤋
Try going to the website below to file a complaint with the State of Illinois Insurance Department.
http://www.idfpr.com/DOI/Default2.asp
2007-01-19 13:50:05 · answer #3 · answered by HowFuzzyWuzee 6 · 0⤊ 0⤋
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2016-10-15 11:35:04 · answer #4 · answered by xie 4 · 0⤊ 0⤋