Why is Doctors Feel They Charge You Whatever They Want After You Already Paid
Thread should read "why is it Doctors Feel They Can Charge You Whatever They Want After You Already Paid" sorry.
I live in New York...
I went to go see an orthopedic surgeon about a month ago. I'm just short of having insurance threw work (I haven't worked tehre long enough) and I make too much to receive any type of medicaid.
I was told over the phone an office visit is $75.00 for new patients if you've never been there and patients who have a fracture are allowed to set up a payment plan.
Ok, so I go in the next day, they charge my credit card $75 and I'm on my way. The doctor tells me if I still have pain and swelling in a week (still do 3-4 weeks later) to come back because it may be a stress or a hairline fracture. Well I can't really afford the office visits at $75 a pop and bone scans and MRI's so i figured I'd wait to my insurance goes through for work to back if I have problems.
I think I'm done with it... Nope, today I get a bill for $45.00! The bill says the office visit is 120.00 and they gave me credit for the $75 payment leaving me with a balance of $45.00. WTF!!! What the hell!! I'm so mad! I was told the office visit was $75! I was charged $75 at the time of the visit! Now a month later they want to tell me the office visit was $120.00?
Only in this industry can they do whatever they want in terms of billing! If I got my oil changed and they told me on the phone it was $75 and I paid $75 at the time of the appointment and got a bill for $120.00 giving me credit for the $75.00 payment it would never fly. If it was a regular practice by the garage charging the oil to tell people one price and then bill like this they would have already been investigated by the NY attorney generals office and probably fined heavily for such a shady move!
Re: Why is Doctors Feel They Charge You Whatever They Want After You Already Paid
Soooooo...what did the office rep say when you called to tell them you were quoted $75 for the visit, paid it in full on the date of service, then just received the bill for the additional amount? It may just be a clerical error on their billing service's part. You may have been given a discount because you are uninsured, and the billing service didn't get the memo. sheesh.
Oh yeah....the mechanic changing your oil....or the pizza guy who forgot they had a special running....or the sales person at the clothing store could make the same clerical error. You'd bring it to their attention on the assumption it was an honest mistake, right?
Re: Why is Doctors Feel They Charge You Whatever They Want After You Already Paid
I'll find out tomorrow...
The person who handles my account is not in.
Forgive me for venting! sheesh.
It is the first thing that goes through my head when I get a bill is that it is a shady situation. I'm sorry I don't think it is that people are unprofessional and not able to their their jobs... Sending a bill out incorrectly!
As far as a "clerical error" it's pretty sad that a person who is a professional - medical biller - will make such a mistake, especially when on the paper they deal with that left the office that went with the doctor, that a copy went to me, and the original went back to the office from the doctor that said $75 paid on it. Did you know that? Did you know it was a $75 office visit with no discounts someone would need a memo about? So why give me an attitude? sheesh.
The sad part is these clerical errors never happen happen (at least for me) at the garage or the pizza shop! ...but happen all the time in medical billing! I've never once paid a garage $x for a service, even if it was discounted, and then get a bill later for $x after I've already paid for service. These professionals should be ashamed! sheesh. That's the problem with NYS! These doctors just bill bill bill and if the states covering it on medicaid, they wouldn't have even questioned it, just paid it. ...we wonder why the state is broke! BTW, charging one price for an office visit and then charging me another price later and billing me a balance is NOTHING like a pizza guy forgetting about a special they are running. sheesh. Maybe in your mind, but something tells me, over how much you had a make a point that it was am simple mistake, you are in teh medial billing field.
An honest mistake? Yea probably. I still don't think it was all that innocent, maybe a lot of carelessness.
Re: Why is Doctors Feel They Charge You Whatever They Want After You Already Paid
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Quoting
wingman
I'll find out tomorrow...
The person who handles my account is not in.
Forgive me for venting! sheesh.
It is the first thing that goes through my head when I get a bill is that it is a shady situation. I'm sorry I don't think it is that people are unprofessional and not able to their their jobs... Sending a bill out incorrectly!
As far as a "clerical error" it's pretty sad that a person who is a professional - medical biller - will make such a mistake, especially when on the paper they deal with that left the office that went with the doctor, that a copy went to me, and the original went back to the office from the doctor that said $75 paid on it. Did you know that? Did you know it was a $75 office visit with no discounts someone would need a memo about? So why give me an attitude? sheesh.
The sad part is these clerical errors never happen happen (at least for me) at the garage or the pizza shop! ...but happen all the time in medical billing! I've never once paid a garage $x for a service, even if it was discounted, and then get a bill later for $x after I've already paid for service. These professionals should be ashamed! sheesh. That's the problem with NYS! These doctors just bill bill bill and if the states covering it on medicaid, they wouldn't have even questioned it, just paid it. ...we wonder why the state is broke! BTW, charging one price for an office visit and then charging me another price later and billing me a balance is NOTHING like a pizza guy forgetting about a special they are running. sheesh. Maybe in your mind, but something tells me, over how much you had a make a point that it was am simple mistake, you are in teh medial billing field.
An honest mistake? Yea probably. I still don't think it was all that innocent, maybe a lot of carelessness.
What attitude?!!? :confused: Medical billers, like any other professional, are human and do make mistakes. Most likely, the medical biller is off site. They may have received an encounter form with the wrong visit code checked off, or as I said earlier, you got a cash discount you may not remember being told about (just my own speculation). Again, it was probably a clerical error. I think "happens all the time" with medical and never with any other business is an overstatement.
If you do not hear from the office by noon-ish tomorrow, call them again and get the name of the person you speak to. Calmly explain your situation and the fact that you paid the full amount on the date of service.
BTW...don't count on your new insurance picking up the cost of your MRI. Your injury will be considered a pre-existing condition.
Re: Why is Doctors Feel They Charge You Whatever They Want After You Already Paid
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lealea1005
BTW...don't count on your new insurance picking up the cost of your MRI. Your injury will be considered a pre-existing condition.
We'll see about about that. ;) Actually, I'll put money on it.
Re: Why is Doctors Feel They Charge You Whatever They Want After You Already Paid
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Quoting
wingman
We'll see about about that. ;) Actually, I'll put money on it.
not to start an argument but why do you believe a new insurance company will have to pick up a pre-existing condition?
Re: Why is Doctors Feel They Charge You Whatever They Want After You Already Paid
I didn't say "have to" but I was dignosed with a contusion, it should have healed. I have every right to go back to the doctor weeks after (it should have healed) and say I swollen painful leg... New claim no? It may or may not be a fracture but at this tine it's not contusion. It would have healed by now.
If it was a hairline fracture, it was diagnosed as a contusion it's a new claim if the hairline fracture (hopefully not) got worse and is visible on x ray now its considered a new fracture because there is no way of proving it's an old fracture not detectable on x ray and not a new fracture/injury... ...and something else I wasn't listening.
Sorry if I don't make much sense I've been drinking...
...but the most important reason it will be covered, is the because the insurance company themselves told me it WILL BE covered! Think of me like a truck. Preventive maintenance... It's cheaper for them to pay for a mri or bone scan to make sure I'm ok and pay if there is not a hairline/stress fracture and treat one if there is rather than gamble and not cover it until/IF I have a hairline/stress fracture not heal and pretty much break all the though one day (that they tell me can happen if it not treated, rare, but it can happen). If that happened I was diagnosed with a contusion and even if I had a hairline/stress fracture they would not be able to prove it and it would be treated as new injury. So I guess they'd rather pay for an mri/bone scan than gamble a big bill based down the road (I guess they play what if) based on what the doctor told them. Crazy, but I guess it makes sense. Better to pay for for an mri to make sure everything is ok and treat it if it is not than pay for the worst case scenario in the "worst case" that they cannot prove is pre existing (again that's just my my guess why they pay for it, mixed in with some of what they told me).
Re: Why is Doctors Feel They Charge You Whatever They Want After You Already Paid
So... you get mad at the Doctor for being misleading about his billing practice, and then tell all of us you are going to lie to get your insurance to pay for a preexisting condition, thus committing insurance fraud? You don't see the hypocrisy?
Re: Why is Doctors Feel They Charge You Whatever They Want After You Already Paid
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I didn't say "have to" but I was dignosed with a contusion, it should have healed. I have every right to go back to the doctor weeks after (it should have healed) and say I swollen painful leg... New claim no? It may or may not be a fracture but at this tine it's not contusion. It would have healed by now.
The severity of a contusion varies greatly, as does the healing time for each individual. It could take months.
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If it was a hairline fracture, it was diagnosed as a contusion it's a new claim if the hairline fracture (hopefully not) got worse and is visible on x ray now its considered a new fracture because there is no way of proving it's an old fracture not detectable on x ray and not a new fracture/injury... ...and something else I wasn't listening.
Don't know where you got (or who gave you) this information, but it's incorrect.
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Sorry if I don't make much sense I've been drinking...
...but the most important reason it will be covered, is the because the insurance company themselves told me it WILL BE covered!
Got that in writing directly from the insurance company?
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Think of me like a truck. Preventive maintenance... It's cheaper for them to pay for a mri or bone scan to make sure I'm ok and pay if there is not a hairline/stress fracture and treat one if there is rather than gamble and not cover it until/IF I have a hairline/stress fracture not heal and pretty much break all the though one day (that they tell me can happen if it not treated, rare, but it can happen).
Although I think there is logic in the prventive medicine schtik, your case will be viewed differently (by your insurance company) because the MRI was already recommended and you refused it, as well as your follow up visit within the time recommended by the Physician. They do not care about the reason you refused treatment. It will be documented in your medical record they will obtain from the Ortho.
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If that happened I was diagnosed with a contusion and even if I had a hairline/stress fracture they would not be able to prove it and it would be treated as new injury.
No, sorry, it won't. Again, it's all documented in your medical record.
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So I guess they'd rather pay for an mri/bone scan than gamble a big bill based down the road (I guess they play what if) based on what the doctor told them. Crazy, but I guess it makes sense. Better to pay for for an mri to make sure everything is ok and treat it if it is not than pay for the worst case scenario in the "worst case" that they cannot prove is pre existing (again that's just my my guess why they pay for it, mixed in with some of what they told me).
Depending upon which insurance plan you choose, the Physician will be required to call your insurance company for an authorization for the diagnostic imaging. The information, including the fact that you did not obtain the test/return for follow-up when recommended, will be given to them. They will then make their decision for coverage based upon that information. You will not be able to con the insurance company.
PS: Wish I was a bettin' woman. ;):cool:
Re: Why is Doctors Feel They Charge You Whatever They Want After You Already Paid
lealea did a great job explaining but a bit wordy. Let me say it this way:
it will not be considered a "new claim" because it is from the same incident. The new insurance company will state "pre-existing condition" and not be responsible for anything to do with that injury.
Now, if you had continual coverage and could provide a letter of "creditable coverage" and the waiting period for pre-existing conditions could be shortened, or even waived.
Here is a site that explains it:
http://healthinsurance.about.com/od/...creditable.htm
Now, if the new insurance company will willingly pay the claim, they can. Hopefully, for your sake, they did not misunderstand your question and will cover the claim, as you say they would.