Insurance says the doctor didn't bill correctly and the doctor says talk to the insurance company. Now what?

Question

We went to an Ob/Gyn who did an annual exam and now the insurance company won't pay for the visit and says the doctor billed everything wrong. The doctor says take it up with the insurance company. The insurance company says take it up with the doctors office. And we just keep getting bills for $2000 for an annual exam! What do we do? We can't afford that at all. We are just students. Is there someone out there that can help fix this? Is there a service like the Better Business Bureau for medical practices?

Answer 1

One thing you ahve to realize is that your doctor bills the insurance company as a courtesy to you. They do not have to do that, and it costs them money to bill.

That being said, if they screw it up, they need to make it right.

Ask them to resubmit the bill. You might want to find out from the insurance company exactly what the problem was, so that they don't resubmit it with the same error. It may be something as simple as a typo that they need to correct, or they may need to send copies of medical records with the bill.

$2000! That must have been one heck of an exam.

Good luck.

Answer 2

Your insurance company should intervene on your behalf....
If what you are saying is correct, that you just had a run of the mill annual exam, this could be fraudulent billing. If all else fails, each state has a insurance commissioner that handles complaints such as this. Get a supervisor at the insurance company and tell them if they do not help you resolve this matter, you will call the commissioner's office and file a complaint..Also: Document, Document, Document.

http://personalinsure.about.com/cs/statecommisioners/a/blcommissioners.htm

Answer 3

I've had the same problem. What you need to do is stop talking to them and put everything in writing. Send the doctor's office copies of all your correspondence with the insurance company and vice versa and, of course, keep copies of all the correspondence yourself. It took me nearly two years but it was finally sorted out without me having to pay anything (in my case it turned out that the doctors office tried to bill the insurance company twice for the same procedure but there were such bureaucratic morons on both sides that it took me nearly two years to figure out what was happening).

Answer 4

#a million attraction the declare via your medical coverage co. you ought to try this to evade being in charge for the billing, as there's a time decrease-off with submitting it. The attraction technique will the two be at the back of the reason of advantages assertion you rec'd or call their 800 quantity to ask with regard to the technique, yet appeals ought to be in writing. Then easily seek advice from Dr.'s workplace honestly coverage person, additionally talkt o a supervisor at coverage customer help. See if that person could take a call from the Dr.'s coverage person and get them to communicate to a minimum of one yet another to straighten out declare.

Answer 5

Just keep calling and B ing until the Dr bills it correctly. That is the only way the insurance company will pay.

NOTE: ALWAYS ASK SPECIFICALLY FOR AND GET PRECERTIFICATION FROM THE DOCTOR BEFORE ANY MEDICAL PROCEDURE!!!
ALSO WHEN THEY ASK YOU TO FILL OUT THE FINANCIAL RESPONSIBILITY FORM MAKE A NOTE THAT YOU WILL NOT BE RESPONSIBLE FOR CHARGES THAT EXCEED THE PRECERTIFICATION UNLESS PREAPPROVED IN WRITING.

Answer 6

1 ask dr to resubmit
2. going round with the insurance company generally does little good
3. If your plan is through employer or school see if they have a benefits administrator for help
4. good luck