Watch your doctors office billing and co-pay charges

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MEDICO

Middlesboro, KY

#1 Aug 29, 2009
A new fraud has emerged through your local doctors office billing office.

If you have a procedure that requires a follow up, particularly a minor surgical procedure that requires a post-procedure visit, you ARE NOT REQUIRED TO PAY ANOTHER CO-PAY PAYMENT. This is included in the procedure price initially billed by your doctor. Local doctors are instruction their insurance billing clerks, but mainly their business office managers, to try to collect another co-pay when you come back in for you follow up visit for your procedure. THIS IS ILLEGAL, but, we never check, because of the complicated nature of the medical insurance field.

It's simple to check out though, just call the 800 number on your card, call the pre-approval extension, have you bill handy, and they'll gladly tell you what you are supposed to do. Very simple.

Then, call your doctors office, talk to the insurance biller, and tell them. If they don't correct it, tell them simply and matter of factly, "I AM REPORTING YOU TO THE INSURANCE COMPANY, THE STATE INSURANCE COMMISSION, AND ALSO FOR INSURANCE FRAUD". This will let them know you know the truth.

When I hear of this, I went back to my last issue that relates to this, and guess what,,,,,I paid 3 co-pays that I didn't have to. I got my ammunition, and called the office. They first balked, both the insurance billing clerk, but mainly the office manager. Then, I asked them for the number of the state insurance fraud hotline, which by law, they are required to have on hand and give you if you request it. When I asked for that, she said she would mail me a check. I told her, "No, I'll be in at 2pm to get the check. If it's not ready, then I'll call the insurance fraud hotline from YOUR phone"!

Guess what,,,,,,I got my check.

And one other thing, if the business office manager threatens you with having to find another doctor, let her know that's a violation as well. It is!!!!
grammar and spelling

Kennett, MO

#2 Aug 29, 2009
If you're going to give random advise how about spell and grammar checking your information first. You pretty much lose credability when you can't even type a few paragraphs.. fyi copay means copayment so when you say copay payment it makes no sense!
sick patient

London, KY

#3 Aug 29, 2009
MEDICO wrote:
A new fraud has emerged through your local doctors office billing office.
If you have a procedure that requires a follow up, particularly a minor surgical procedure that requires a post-procedure visit, you ARE NOT REQUIRED TO PAY ANOTHER CO-PAY PAYMENT. This is included in the procedure price initially billed by your doctor. Local doctors are instruction their insurance billing clerks, but mainly their business office managers, to try to collect another co-pay when you come back in for you follow up visit for your procedure. THIS IS ILLEGAL, but, we never check, because of the complicated nature of the medical insurance field.
It's simple to check out though, just call the 800 number on your card, call the pre-approval extension, have you bill handy, and they'll gladly tell you what you are supposed to do. Very simple.
Then, call your doctors office, talk to the insurance biller, and tell them. If they don't correct it, tell them simply and matter of factly, "I AM REPORTING YOU TO THE INSURANCE COMPANY, THE STATE INSURANCE COMMISSION, AND ALSO FOR INSURANCE FRAUD". This will let them know you know the truth.
When I hear of this, I went back to my last issue that relates to this, and guess what,,,,,I paid 3 co-pays that I didn't have to. I got my ammunition, and called the office. They first balked, both the insurance billing clerk, but mainly the office manager. Then, I asked them for the number of the state insurance fraud hotline, which by law, they are required to have on hand and give you if you request it. When I asked for that, she said she would mail me a check. I told her, "No, I'll be in at 2pm to get the check. If it's not ready, then I'll call the insurance fraud hotline from YOUR phone"!
Guess what,,,,,,I got my check.
And one other thing, if the business office manager threatens you with having to find another doctor, let her know that's a violation as well. It is!!!!
My doctor ALWAYS tells me to come back in 2 weeks for a follow up. Always have a copay again and then the nurse asks why I am being seen.
Get real

Middlesboro, KY

#4 Aug 30, 2009
grammar and spelling wrote:
If you're going to give random advise how about spell and grammar checking your information first. You pretty much lose credability when you can't even type a few paragraphs.. fyi copay means copayment so when you say copay payment it makes no sense!
Guess you can't see the forest for the trees.

I understood the content of the post, didn't you? Could you not get past the intent of the posting, or do you just read them for spelling and grammar mistakes.

This type of fraud is rampant in our local medical offices, especially in the specialist's offices. These doctors try to grab every dollar they can from both our insurance companies and the patients.

Call your insurance fraud hotline, every company has one. Tell them what is going on.

Call you insurance benefits section too. Tell them what happens, and see what they say. I believe you'll be surprised. And don't be afraid to turn in your doctors office staff. It's the office managers that initiate this practice, and the insurance billing clerk is the one that initiates it.

Read your bill when the doctor gives it to you. See what is checked off. Don't ask the doctor what it means, he'll (she'll) just give you some medical jargon as an answer, if they answer you at all. Wait till you get out to the window, and ask the clerk, you'll hear a different answer.

The average GP doctor's office sees over 150 patients a day, and if they hook half of them for an extra "co-pay" of $25, that's an extra $1875 bucks a day for them. For five days a week, that's $9375 in extra slush money, and for the month, and extra $37,500.00 in their pockets, or, an extra $450,000.00 a year that their making, out of YOUR pockets, that you don't have to pay.

Read your bill, call you insurance company.
med office billing clerk

Corbin, KY

#5 Aug 31, 2009
Oh sure...once again it's the billing clerks and the doctors fault. We're SUCH money grubbing pigs, aren't we? It always cracks me up that noone ever wonders why insurance companies have these HUGE skyscrapers in the cities and their CEO's make these HUGE bonuses every year! Do local physicians and billing clerks have these things? I don't think so! Last time I checked the people getting rich in the medical field were insurance companies and drug companies and a low percentage of plastic surgeons maybe in Hollywood! Get off it people! Your doctor is definitely NOT getting rich off collecting a $15 or $25 copay from you! His/her poor billing clerk is probably rebilling your insurance for the umpteenth time trying to collect what your insurance SHOULD have paid months ago for that procedure they preapproved you for and haven't paid for yet! Oh and when is the last time you ever actually read your EOB ( that's Explanation Of Benefits for the insurance illiterate out there which, the insurance company is banking on is most of us!)? I'll bet on your last doctor visit the poor doctor had to write off almost as much as the insurance company paid! Go ahead...READ IT! It's right there in black and white if you don't believe me! Most doctors are forced to participate in these shoddy insurance plans that your employers pay for because they can't afford the good plans and the doctors, as providers on these plans, have to write off nearly all their profits so, yes, we ask to collect our measly $15 or $25 copays! So sorry...our staff has to eat too! I don't know what "real world" get real lives in but, it ain't a doctor's office and that's for sure! Wonder what you'll do when you have to do without medical care in this country?
DUMB

Madisonville, KY

#6 Aug 31, 2009
med office billing clerk wrote:
Oh sure...once again it's the billing clerks and the doctors fault. We're SUCH money grubbing pigs, aren't we? It always cracks me up that noone ever wonders why insurance companies have these HUGE skyscrapers in the cities and their CEO's make these HUGE bonuses every year! Do local physicians and billing clerks have these things? I don't think so! Last time I checked the people getting rich in the medical field were insurance companies and drug companies and a low percentage of plastic surgeons maybe in Hollywood! Get off it people! Your doctor is definitely NOT getting rich off collecting a $15 or $25 copay from you! His/her poor billing clerk is probably rebilling your insurance for the umpteenth time trying to collect what your insurance SHOULD have paid months ago for that procedure they preapproved you for and haven't paid for yet! Oh and when is the last time you ever actually read your EOB ( that's Explanation Of Benefits for the insurance illiterate out there which, the insurance company is banking on is most of us!)? I'll bet on your last doctor visit the poor doctor had to write off almost as much as the insurance company paid! Go ahead...READ IT! It's right there in black and white if you don't believe me! Most doctors are forced to participate in these shoddy insurance plans that your employers pay for because they can't afford the good plans and the doctors, as providers on these plans, have to write off nearly all their profits so, yes, we ask to collect our measly $15 or $25 copays! So sorry...our staff has to eat too! I don't know what "real world" get real lives in but, it ain't a doctor's office and that's for sure! Wonder what you'll do when you have to do without medical care in this country?
I guess the doctor is not the one telling you to pay whatever I used to work at a doctors office and we always messed up peoples bills and never fixed it unless the person called so get off your high horse
mobc

Corbin, KY

#7 Aug 31, 2009
well, I don't know what DUMB doctor's office you worked for but, ours does sort out misbillings which every doctor's office has. We go through a credit report as well as a debit report every few months and if someone has a credit over $25 we go through their account and send back their refund. It's called common courtesy and honesty! I've also received checks back from my own doctor's and from the hospital before so, if patient's are not receiving overpayments back then they must not be paying enough on their copayments in the first place or their insurance isn't paying what they should. Period. It's people like you complainers who give doctors a bad name and make it nearly impossible for them to work and treat patients is all I'm saying! We do the best job we can in an already crumbling system and then we have people calling us thieves! Who do you want running your doctor's office? President O'Bama? Think about it people!
then quit

Middlesboro, KY

#8 Sep 1, 2009
Doctors office staff follows the wishes of the so called healers so they can make all they can in the shortest amount of time. There isn't one medical professional within 250 miles of here that didn't choose to be a physician for any reason except to make lots of money, then they whine and complain because they have to work to do it.

And there is an office manager or insurance billing clerk that doesn't literally break the law daily with their billing and collecting practices trying to please their everloving doctors by making them an extra $25 or $30 bucks from every patient.

Get on line and find out how many of our so called "Holy Healers" have had to go to drug rehab because they were stealing their own office's drugs, or taking a swig of gin or vodka between patients,,,,cause they were stressed at the office and home. Poor pittiful them.

Who do you want running your doctors office? you ask, well, anyone but the people running them now.

The problem with healthcare is the doctors and medical administrators, right along side of the insurance companies.

From my experience, I received an insurance EOB, or Explaination of Benefits, letter about an office visit, lab work, and diagnosis for an illness. The office had billed MY insurance for this. I quickly called he office, and talked to some "dingy" sounding woman that just literally said, "My Bad, I'll fix it".

Guess what, one of her friends had no insurance, came to the doctor, and she worked it out with the others in the office, and billed my insurance. The good news,,,,,,,they're all gone now, FIRED. But how many other times has this happened, and, the worse part,,,,,,where are they working now, which doctor.
lilliput

London, KY

#9 Sep 1, 2009
dentist do it also.
Teacher man

Paris, KY

#10 Sep 1, 2009
grammar and spelling wrote:
If you're going to give random advise how about spell and grammar checking your information first. You pretty much lose credability when you can't even type a few paragraphs.. fyi copay means copayment so when you say copay payment it makes no sense!
please refer to the seventh word in the above post. If you are going to give ADVICE on spelling and grammar, please learn it yourself, Idiot!!!!!
Funny

London, KY

#11 Sep 1, 2009
grammar and spelling wrote:
If you're going to give random advise how about spell and grammar checking your information first. You pretty much lose credability when you can't even type a few paragraphs.. fyi copay means copayment so when you say copay payment it makes no sense!
Here's another one for you....
Look how this person spelled the word "credability".
Here is the correct spelling of that word, "credibility".
Way to go...."grammar and spelling"!!

Since: May 09

Middlesboro, KY

#12 Sep 1, 2009
To clarify what Medico was saying. There are certain procedures that are done that when you return you should not be charged for an Office Visit or have a copay collect. Example: if your provider removes a mole and has to put stitches in, when you return to have the stitches removed you should not be charged for an office visit or have to pay a copay. But if you come in for Bronchitis, treated for it and your provider says to come back in 2 weeks for a follow up then you can be charged for an office visit. If you get hurt and have to go to the ER for stitches, then go to your family doctor to have them removed you can be charged for an office visit and pay your copay. Just because your provider wants you to come back for a follow up does not mean you have to go, if you are better call the office at least the day before you visit cancel your appointment and be kind enough to leave a message for your provider letting them know you are better. Most providers want to make sure you are doing better and there isnt a treatment failure. If you feel you doctor or doctor's staff are ripping you off, find another you have that right to go where ever you want. And you also need to remember that providers and their staff are people too, and people do sometimes make honest mistakes...its not like anyone here hasnt and you expect to be forgiven. You also need to realize most providers do not truely get a day off, they are on call alot or doing message from home or from vacation.
Right above

Middlesboro, KY

#13 Sep 2, 2009
The above post is correct, in that some procedures have follow ups that are not to be billed, such as minor surgical procedures, and even they are different. You need to check with your insurance company, not your doctors office.
lmao

Corbin, KY

#14 Sep 2, 2009
HEY EVERYONE-i eat glue!!
anonymous

Corbin, KY

#16 Sep 2, 2009
So you had a bad experience with your doctor's office staff and now ALL doctor's are horrible people that are only after one thing? Your money? and all doctors are taking drinks of vodka between patients and herding them in like cattle and don't give a crap about anyone? Well, all I can say is I hope you never need me as your physician! I wouldn't want a patient with your attitude! Every profession has a crab apple or two in the barrel! Truth is most of the problems with medical care stem from the big insurance companies and drug companies but, if you want to believe it's the money grubbing doctors, nurses and office staff then so be it! Next time you need a procedure, save yourself a lot of time, hassle and money and just do it yourself! Should be fairly simple! I'm sure with your medical expertise and knowledge, you'll be able to do some self exploratory surgery and place your own dang sutures! I'm sure the drug companies will be more than happy to sell you some antibiotics to heal up all the nasty infection you'll cause yourself too! You can probably google the procedure and find out exactly the tools you'll need and I'm sure some ex-con wouldn't mind doing the cutting or drilling. Best of luck! I guess this is what the world is coming to! Nice and cheap medicine! Hassle free! hahahahahahahaha!
Amanda

Baltimore, MD

#17 Sep 29, 2009
The annoying part is for the truly honest offices. We try to do what's best for the patient AND our doctor meanwhile the insurance companies are SO darned vague. They can't even give us exact figures to quote our patients yet they expect us to collect an "estimated copay" from the patient. Then the patient blames us when they were overcharged or when they get an additional bill. It's sad. Then the patients who call us and don't even know what their own insurance is...pathetic.
anonymous

Corbin, KY

#18 Sep 29, 2009
Amanda! I agree! I'm in the health care field too (it sounds like you're a frustrated health care worker too!!! I hope I'm not assuming too much!!!) I think we all need to get together and form some sort of support group! LOL It's getting old getting blamed for everyone's problem, isn't it? Since when is it our responsibility to find out what Mrs Smith's health insurance pays for through Mrs Smith's employer? Shouldn't Mrs Smith have read her insurance booklet provided for her by her employer and insurance company through which she's provided this insurance? Shouldn't she expect to know at least the basics like what sort of copay she should expect to pay and what is covered under the basic healthcare? Goodness! Oh and let's not forget that when you do receive a bill from our office oh...yes, we expect you to actually PAY that! Ugh! People and their healthcare! They want the best! They want it quick! and they want it free! That's my America...we just don't know how to pay for it! haha!
Tina

Knoxville, TN

#19 Jun 11, 2012
I had this co-pay experience 2x in the past month. I went to my regular MD for an issue and saw the practitioner who took tests and put me on antibiotics to see if it helped and said to come back after antibiotics were finished to test to see if antibiotics worked, which to me is a follow up.. well they asked for another co-pay. They referred me to a Specialist who did the same thing.. I paid the $50 for my visit, he sent me for tests and scheduled me to come back for him to read the results, I was asked again to pay $50. In both instances I told them I did not have it because this is a follow up and should not be charged, I was told it is considered an appointment and my insurance requires a co-pay each time I see the specialist. I called my insurance and they said it's whatever they mark on their billing sheet.. if they mark it as an appointment then that's what it is.. What is going on.. I'm a sure people with an issue don't have $50 and $30 to just pull out each time they walk in for a follow up appointment just for results !! Not to mention the balance they will owe on the tests the same doctor just sent them for.. What is going on ??
Spelling

United States

#20 Jun 20, 2012
grammar and spelling wrote:
If you're going to give random advise how about spell and grammar checking your information first. You pretty much lose credability when you can't even type a few paragraphs.. fyi copay means copayment so when you say copay payment it makes no sense!
Before judging someone for their spelling, how about looking up how to spell credibility???
Anonymous

Johnston, RI

#21 Jul 13, 2012
grammar and spelling wrote:
If you're going to give random advise how about spell and grammar checking your information first. You pretty much lose credability when you can't even type a few paragraphs.. fyi copay means copayment so when you say copay payment it makes no sense!
YOU SPELLED "ADVICE" WRONG.
YOU SPELLED "CREDIBILITY WRONG" AS WELL.
YOU FORGOT THE COMMA AFTER THE WORD "ADVICE".
YOU SHOULD MAYBE GO BACK AND REVIEW YOUR EIGHTH GRADE GRAMMAR BOOK. LOL

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