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trianglejohn

How to fight with Dr's office over insurance claim?

trianglejohn
14 years ago

In a nutshell: I went to the Dr for a routine physical. From the appointment to take blood samples and the appointment to get the results my health insurance changed. Though co-workers were able to be recognized by the new provider, I was not. I paid the fee out of pocket and filed a claim myself. The claim was denied. I fought with the insurance company and got it paid (only partially) but they sent the check to the doctors office instead of to me! The doctors office wants to keep the check because they said they discounted my visit because I was paying myself instead of using insurance.

Their accountant won't return my calls. I've been calling since July and have gotten nowhere.

I keep explaining that the right thing to do is to send me the money or charge it back onto my credit card. That giving me the money is cheaper than keeping it because to keep it is to admit that I was covered by insurance which means that I am only liable for the $25 co-pay - and if you subtract that co-pay from what I've already paid they would have to return more money to me than what the insurance sent them.

I know I need another doctor - even though I like the doctor but I can't do business with these people. What I want to know is where do you turn for help in this sort of situation. The state Medical Board doesn't get involved with payment issues, only doctor misconduct. The insurance company wants nothing to do with it. I would love to go sit at their front door with protest sign but I can't afford the time off work.

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