View Full Version : I need help, my doctors office is trying to bankrupt me...


cualexander
10-04-04, 08:56 AM
I went in to take an ADD test on 11/12/2003 during my last semester of college because I wanted to get some adderall for my upcoming exams.(I barely was hanging on at this point) During this time and until February of 2004, I was covered under my dad's insurance company that I know for a fact would have covered it at the time, because I asked them before I even went there in the first place. Now it seems that apparently the billing office forgot to file the claim with my old insurance company and I never heard another word back from them about the situation so I had forgotten all about it. So now that I have Blue Cross and it doesn't cover mental health, which I know, and I have paid my services in full thus far this year. Well the other day they sent me this nastly letter in the mail saying my insurance doesn't cover the charges of my appointment from last year!!! And they want me to pay $300 for a 30 minute question and answer session that they call an "ADD Test". Does this not seem like unfair billing practices??? I mean they should have filed it last year, not bill me retroactively like this. I can't go back and file the claim with my old insurance. It just doesn't seem fair to me.

triple*eee
10-24-04, 08:52 PM
If they did not file with the correct insurance, you are not responsible for the bill. Did they have the correct information? There is a 12 month period that they have to file with the insurance, if they didn't then it's no fault of yours.
(you should only be charged for what your insurance wouldn't have covered at the time, if your insurance paid 80% then they should only charge you for the 20%)

Contact your attorny generals office for your state and they can get you in touch with who you need to talk to regarding this issue.

gingagirl
10-25-04, 12:32 AM
I would contact your old insurance company. Tell them that you are being charged for a doctor's visit, but you thought that they had already paid this bill (play dumb). They should be able to look it up to see if a claim was filed. If the claim wasn't filed and you had given the doctor's office the correct insurance info, then it shouldn't be your problem. But insurance companies have so many rules about what they do & don't cover. Maybe they don't cover ADD testing for adults? Your doctor may have tried to file the claim and been denied repeatedly. Still, I would think the doctor's office should have told you if they were having trouble with your insurance.

Tip for dealing with insurance company:

Write down the date, time and person who you spoke to when you call your insurance company
Write down what they tell you and read it back to them to make sure you heard them correctly
If the info you get is favorable to you, send a certified/return receipt letter to the insurance company to "confirm" what you were told over the phone

write exactly what you were told, and be sure to include the date, time & name of the person you spoke to when you called
the reason for doing this is that many times they will claim that they never spoke to you (or what you heard is not what they said) --by sending a certified letter, there will be a record of the call

Hopefully you won't need to play hard ball with the insurance company. The above recommendations are based on what I had to go through for some expensive diabetes supplies/equipment ...hopefully they won't be so difficult over one doctor's visit. :o

cualexander
10-25-04, 01:07 AM
Thanks for the advice! I talked to my doctor and I think he is going to straighten it out for me, even though he wasn't there at the time. He's the only one who can write prescriptions so he basically has a lot of power over the other 5 or so regular counselors at the clinic, but I'll definitely keep those tips in mind if they try to pull anything else over on me.