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  1. #1
    Join Date
    Jun 2011
    Posts
    2

    Default Doctor Won't Fix a Billing Error

    My question involves collection proceedings in the State of: Florida

    I went to visit my former GP because I was having a lot of hypothyroid symptoms and the endo said I needed a referral from my GP. I called him and said I had gained a bit of weight, was very tired, didn't feel right, etc. and needed an appointment. At the appointment I asked for a medical referral to an endo. I also told him I was having some sinus problems and started a new medication and was given an inhaler by an allergy doctor. I told him the inhaler was for my lungs clearing out due to quitting smoking and was making me jittery and I didn't like it and asked him if I needed it. He said no. So I left with a referrall, antibiotics for my sinuses and instructions to not use the inhaler.

    I went to the endo, found out I was hypothyroid, among other problems and have been treated for that ever since.

    Well my insurance denied the claim because apparently he wrote weight management and asthma. I don't have asthma, I never had asthma. He wrote in his notes I had asthma since age 5. It's just false. My insurance is calling that a pre-existing condition and not paying.

    Their is no record of the referall in my office visit notes. Billing has been nothing but nasty to me and is sending me to collections. I called my doctor and tried to get it fixed and they keep saying but that's not what the notes say. I sent them my referall from my endo that he WROTE on that day. Still no help, still not fixing it.

    I'm so irritated with them. How can they send me a huge bill, and expect me to pay for their mistake? The visit was last year, 2010. What can I do to fix this with them being so uncooperative? Also, he send me to a podiatrist in his own practice because he said I had "bone spurs." Went to the doctor, didn't have bone spurs according to him, or anything wrong and my insurance got a $600 bill for that.

    What can I do?

  2. #2
    Join Date
    Sep 2005
    Location
    Behind a Desk
    Posts
    98,846

    Default Re: Doctor Won't Fix a Billing Error

    The insurance denied what claim? You're being billed by which doctor?

    It's difficult to believe that they denied diagnosis and treatment of hypothyroidism based upon an alleged prior diagnosis of asthma, and even if your weight issues go beyond the hypothyroidism, being treated for hypothyroidism is different from being given general weight management treatment.

  3. #3
    Join Date
    Jun 2011
    Posts
    2

    Default Re: Doctor Won't Fix a Billing Error

    I know! It's crazy. My GP put the wrong billing codes in the insurance claim, the insurance denied it, and they won't fix the codes. He also says his notes say I had asthma since I was 5 and not mention of a referral to an endo, however I was referred and the insurance paid the endo, but not the GP who made the mistake.

  4. #4
    Join Date
    Oct 2006
    Location
    supratentorial region
    Posts
    818

    Default Re: Doctor Won't Fix a Billing Error

    IF your PCP did not diagnose you with hypothyroid, then he cannot bill for that diagnosis code.

    There is no diangosis code for "I stopped smoking and the allergy Doctor gave me an inhaler to clear out my lungs". Since he has to prove by documentation that he addressed that complaint, and you were prescribed an inhaler, it's coded as asthma. Otherwise the inhaler is inappropriate.

    Have the endo send you a copy of the referral that you can then send to the insurance company.

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