State : Kansas
City : Wichita
Problem
I discussed all of the pros and cons regarding what my healthcare coverage
benefits were. We discussed co-pays, coinsurance and Deductibles. I told
them that the only reason for choosing their office was there "in networks"
status. They confirmed the insurance company's approval for the procedure.
I asked "does that mean they agreed to cover the procedure at the 80% / 20%".
They answered yes but reminded me that some things are not covered by insurance.
We agreed that the items "not covered" by insurance would be billed to me.
We also agreed that I would be responsible for the remaining 20% of the covered procedure.
The actual Dollar amount was not set but the percentages of the cost were.
After we discussed all of the insurance and billing questions, the appointment
was set. In good faith I trusted the information they gave me after getting the
procedure approved with my insurance company. I completely expected to
be billed for item not covered and 20% of those that were. I told them I wanted to
be notified before the procedure if there would be any further cost beyond what we
had already discussed. They told me that the only additional cost would be if
complications required additional services to complete the procedure.
I am being sued by the doctor for 100% of the bill after the insurance company
approved the procedure and later passed it all off to deductible when the doctor
billed the insurance company after the procedure. I asked them to confirm that the
cost would be covered and not subject to the deductible. They told me the
procedure was approved. If I had known I would bare the entire cost, I would not
have used them. Paying 100%, I could have negotiated for a better price and
filed a claim for reimbursement myself.
Did they provide good service, for the procedure Yes.
But in regards to billing, I feel completely mislead.
Their attorney is also the debt collector.
Any advice would be appreciated and should I hire an attorney?

