Medical billing issue

Wed Apr 13, 2011 11:37 am

I saw an ENT a couple months ago to have my throat examined. The doctor first looked at my throat with a light and her eyes, and then decided to examine it with a camera. This was all done in the office. A few weeks later I received a bill for $245 for the camera exam which, unbeknownst to me, is considered a "procedure" and not covered by my insurance. My insurance (a PPO) sucks in that I have a large yearly deductible. I know this so I avoid anything which isn't covered. In my mind, the problem was a lack of disclosure by the doctor when the exam transitioned to a "procedure".

I've talked to their billing agent for about an hour, but she's possibly the biggest bitch I've ever met and just repeats that it's my responsibility to pay. When I state that I wasn't properly informed that a "procedure" was going to take place, she said I should have asked. My requests to negotiate the charge have fallen on deaf ears.

So what the f*ck can I do? I don't feel like having my credit score affected, but this isn't a charge I feel I should pay on principle. I'm planning to call my insurance company and explain the situation to see if they can do anything, but they'll probably say it's out of their hands.
Me: I'm gonna drink a Boon Geuze.
SWMBO: You're a booze goon.
PhillyBrewer
 
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Re: Medical billing issue

Wed Apr 13, 2011 11:41 am

Perhaps speak with the Dr. that did the "procedure". Maybe she can clear it up for the insurance people. Just a thought, and it's worth a try. The worst thing she can do is say no.
Gotta love insurance. Fuckers :twisted:
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snowcapt
 
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Location: Alexandria, MN

Re: Medical billing issue

Wed Apr 13, 2011 11:49 am

It's not an issue or fault with the insurance company. It's the fact that the doctor's office didn't inform me that they were going to do something in the exam that was considered a "procedure" and something that was potentially not covered by insurance. I asked the receptionist "What if I charged $500 for allowing you to examine me and then billed you for it? That's a charge you wouldn't have been aware of, right?" She said she didn't want to talk hypotheticals.
Me: I'm gonna drink a Boon Geuze.
SWMBO: You're a booze goon.
PhillyBrewer
 
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Joined: Tue Mar 02, 2010 8:11 am

Re: Medical billing issue

Wed Apr 13, 2011 1:37 pm

I see. You should send the Dr. a bill, that'll get them thinking. Or just file sexual harrassment against her! :shock: Pretty bogus situation. I hope it works out, but we already know what the outcome will be. She f-ed ya and ya didnt even get a kiss.
Oh yeah, how's the throat?
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snowcapt
 
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Location: Alexandria, MN

Re: Medical billing issue

Wed Apr 13, 2011 2:20 pm

Throat's fine, no thanks to the doctor. I've been having tonsil issues for a while and currently have tonsil stones. So much fun removing sh*t from my crypts a couple times a week!
Me: I'm gonna drink a Boon Geuze.
SWMBO: You're a booze goon.
PhillyBrewer
 
Posts: 345
Joined: Tue Mar 02, 2010 8:11 am

Re: Medical billing issue

Wed Apr 13, 2011 2:49 pm

Wow, that is a f-ing nightmare. I had my tonsils removed when I was about 10. I didnt read it all the way through, but is there a cure for that? It looks like the ultimate nuisance. "Hold on, I have to dislodge a stone from my tonsil crypt" That really sucks, man. I hope you are able to get that remedied- the billing and the stones.
:jnj
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snowcapt
 
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Location: Alexandria, MN

Re: Medical billing issue

Wed Apr 13, 2011 3:31 pm

No worries. I'm getting hitched in November and plan on getting a tonsillectomy as soon as I'm on her insurance (which is great).

I'm kind of concluding that I'm basically f*cked as far as having to pay for the "procedure". I have lastworditis (my mom's creation) so I'm trying to figure out how I can have the last word after having to pay the $245. All I can come up with is writing dozens of negative reviews on as many doctor reviews sites as I can find.
Me: I'm gonna drink a Boon Geuze.
SWMBO: You're a booze goon.
PhillyBrewer
 
Posts: 345
Joined: Tue Mar 02, 2010 8:11 am

Re: Medical billing issue

Wed Apr 13, 2011 4:49 pm

thats the problem with seeing a specialist. any primary care md could have looked in your throat and told you the same thing without the scope and for 1/5 the office visit. the ent feels that she has to "be sure" that more serious but less likely things arent going on further down in your throat and is practicing defensive medicine since she is the specialist. i agree that you got screwed but she probably has no idea that your insurance doesnt cover that procedure(it probably would have covered this 2 years ago). there are multiple levels of fault here- insurance companies cutting coverage/defensive medicine practices by mds/lawyers driving the whole cycle/not enough hours in the day to go check and see if every "procedure" is covered for every insurance on each patient and then go have 15 minute discussion about whether or not to procede.
if you called and asked me for a refund i'd give it to you or at least discount it.
positiverpr
 
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