Question:
Anyone else had a problem with Sleep Dr ..
Sending you a 4500.00 bill after insurance who he is a provider for has paid him his contracted amount? — Sarah H. (posted on July 13, 2003)
July 13, 2003
Hi Sarah, I didn't have that problem with my Sleep Dr, but I did with the
Anesthesiologist. I called the insurance co and spoke with a claims
administrator. She explained their agreement with the Doctor. He got his
set amount, they tell him what my co-pay is and the rest is excluded. If he
is "in plan", he can not charge you for what was excluded by the
insurance company. He can only charge you your co-pay or allowed amount
under the plan (The Insurance Co can tell you how much that is.) I called
the Anest. office and read them the riot act, they determined 24hrs later
that their excess billing to me was an oversight. My cost was only $199 not
the $2600 they tried to collect initially.
— M B.
July 13, 2003
Years ago, I had this problem with some of my son's insurance claims. He
had had numerous procedures and surgeries. I was being billed by many
different hospital departments, when I only had a hospital admission
co-pay. The hospital billing department said that it was my responsibility
to work it out with my insurance company and my insurance company said that
the hospital would have to resubmit the bills. I was getting no where. I
was definitely the middle man and I knew that I did not owe the hospital
anything. So, I used three way calling. I got both customer service reps on
the phone and let them discuss it and within 3 minutes, my bill was written
off as it should have been. I would highly recommend this approach. Forget,
the back and forth and go between problems!! Shelley
— Shelley.
July 13, 2003
if you went to a preferred provider, there is usually a certain amount that
the doc 'writes off'(if his fees are above the "usual and
customary") as part of taking your insurance. you should only have to
pay your co-pay/deductable. call your insurance company and tell them what
is going on and THEY will take care of it. i had this happen and when i
called the ins co. they said not to contact the doc that they would take
care of it. don't pay just because you got a bill, especially if you
think it is a mistake. also, if you had a referral (for a hmo) make sure
he got the referral otherwise it is possible that it was paid at a
different rate. hope this helps, call your ins co. ;)
— Keri P.
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