I'm 37 weeks pregnant. I am a stay at home mom and my husband is a government employee and his employer carries our insurance. My deductable is $200 and my out of pocket maximum is $1000. My insurance pays 80% after the deductable is paid until I reach my out of pocket max then they pay 100%.
My OB is a "preferred provider" so my insurance company won't be paying his standard charges, they will negotiate.
At my 2nd prenatal appointment I was given a sheet outlining what I would owe the doctor out of pocket - my $200 deductable plus 20% of all charges totalling over $900, so almost my ENTIRE out of pocket max. will be tied up in these payments I've made to his office.
My concern is that when the bills start rolling in for the birth of this baby from the hospital, anesthesiologist, ect. that I will OWE some of them since he has my money, unless he really quickly submits his claim and marks it paid.
Can he legally make me pay all this BEFORE he even delivers the baby?
2007-02-05 01:47:58 · 7 answers · asked by Basil 3 in Business & Finance ➔ Insurance
He wasn't giving me the cost upfront, he actually requires payment upfront. They set up a payment plan and I've been making monthly payments each month for my entire pregnancy for everything - the office visits and the delivery fees.
I guess I'm getting annoyed because I've made about $600 in payments to him so far, and I've paid my deductable when I had my labwork done so that shouldn't be included in what I owe him upfront AND my insurance will surely negotiate the charges in the end but they are STILL asking for more money at my appointments while I'm feeling as though I should pretty well be paid up with them.
It just doesn't seem right that they can require me to pay for the DELIVERY of the baby upfront.
2007-02-05 02:00:02 · update #1
This is a pretty standard practice.
You can request that the doctor's office call your insurer and see how much of your deductible and coinsurance you've already satisfied, and ask them to adjust your payments accordingly.
When I asked my doctor to do this they did. I hope yours will!
2007-02-05 02:08:10 · answer #1 · answered by Wendy S 4 · 2⤊ 0⤋
He can, and probably will, turn you into a collection agency however, they are listed on your credit report but most companies IGNORE medical bills- because most of them are bogus. Your best bet would be to sit down and type a letter to this Doc explaining that your insurance paid x and you owe x and that he was competent in his care and advise to you. Make a copy of the letter and make sure that you state that you will be sending a copy to the American Medical Association if you do not hear from him in 10 days. Please explain in DETAIL what HE DID WRONG in his visits with you--- he is a well educated intellectual and just stating he did not do anything will cut it. 1. Have you seen another doctor and received a correct diagnosis and proper treatment? If so, do not give him the name but tell him this and what the treatment was. 2. The fact that he "hardly even talked with me and listened carefully" is not a prerequisite unfortunately, for being an MD. They listen only to your symptoms and the facts- and tell you as little as possible until they have an answer----sad but true. 3. If you decide to pay his bill- it is a tax deduction. Good luck in whatever you decide to do but if it was me-- and I do not tolerate incompetence in ANY field- I would get a second opinion and then write the letter to him with the copy to the AMA if he decides not to drop the balance. Good luck to you--- and I hope you are feeling better. PS I just read the advise someone stated about him telling your insurance--- by the insurance statutes- the COPAY is supposed to be paid UP FRONT BEFORE the visit- so the doctor's office already violated the insurance agreement.
2016-05-24 17:56:08 · answer #2 · answered by Heather 4 · 0⤊ 0⤋
yes, but he has to refund any unused amount afterwards.
It's an EXTREMELY common practice here in Houston, where there are tons of people that are very happy to NEVER pay the bill, and then the doctor has to try to sue them to collect . . . and they usually are judgement proof - ie, no way to collect the money. You ALWAYS pay your copay/deductible amount up front.
2007-02-05 01:51:53 · answer #3 · answered by Anonymous 7 · 1⤊ 0⤋
I don't think he is asking you to pay now. I think he was only giving you an idea of how much it will cost you. Call the office to make sure.
2007-02-05 01:54:32 · answer #4 · answered by spot 5 · 1⤊ 0⤋
i believe that, if they state it in their policies, you have the obligation to comply. if you don't agree, check out a different doctor. best of luck to you.
2007-02-05 01:52:14 · answer #5 · answered by Curious in Seattle 6 · 0⤊ 0⤋
yes he can make u pay. any good dr. can/will make payment arrangements.
2007-02-05 01:56:38 · answer #6 · answered by Miki 6 · 0⤊ 0⤋
yes he can although most will let you make arrangements
2007-02-05 01:51:30 · answer #7 · answered by furmanator1957 4 · 1⤊ 0⤋