Advice Needed: Getting double billed for medical treatments

[KC Jones]

It's a small deal - just some $20 co-pays, but it's the principal of it.

We have receipts for our co-payments from 3 visits with a specialist associated with a children's hospital. For two of the visits we have the physicians group still sending letters requesting we pay them. For the third visit we have the associated hospital requesting a payment.

My wife is very confused and none of the office workers she's spoken to have been able to satisfactorily explain why we need to pay these and what happened to the money we already paid. As far as we can tell it seems the two groups both want a full co-pay for each visit, and it just matters who charged us at the time of the visit for which one is coming after us now.

They don't seem to be taking 'we already paid and here's a copy of the receipt' as a reason to stop pestering us. Any advice? I could write a cease and desist letter, but these aren't collection agencies (yet). I also don't want any of this on a credit report. Can they really both be charging us for the same visit and be rightfully owed a full co-pay?

What to do?

[Pneuma]

It's a small deal - just some $20 co-pays, but it's the principal of it.

We have receipts for our co-payments from 3 visits with a specialist associated with a children's hospital. For two of the visits we have the physicians group still sending letters requesting we pay them. For the third visit we have the associated hospital requesting a payment.

My wife is very confused and none of the office workers she's spoken to have been able to satisfactorily explain why we need to pay these and what happened to the money we already paid. As far as we can tell it seems the two groups both want a full co-pay for each visit, and it just matters who charged us at the time of the visit for which one is coming after us now.

They don't seem to be taking 'we already paid and here's a copy of the receipt' as a reason to stop pestering us. Any advice? I could write a cease and desist letter, but these aren't collection agencies (yet). I also don't want any of this on a credit report. Can they really both be charging us for the same visit and be rightfully owed a full co-pay?

What to do?

I would call myself. No offense to your wife, but people generally take men more seriously...I would ask to speak directly to a supervisor.

[Bob Dole]

Contact your insurance provider and let them deal with it.

[Simplex3]

Contact your insurance provider and let them deal with it.
They may not, but if they will this works well with very little effort.

Another option is to call them and mention that if they don't get it straightened out you're going to report it to your state's insurance commissioner. It makes it that much more effective when you know the commissioner's name and use it.

The only way they both get to ding you on the copay is if you went to see both of them for separate appointments. If you showed up at the doc's office, visited with the doc, then left, the hospital doesn't have a leg to stand on.

My mom consults for physician's offices and hospitals on upping their profits and says this type of s**t is pretty common practice when a place is struggling or when they decide they just don't make enough money.

[DenverChief]

Antifreeze

























First IN! :loser:

[KC Jones]

They may not, but if they will this works well with very little effort.

Another option is to call them and mention that if they don't get it straightened out you're going to report it to your state's insurance commissioner. It makes it that much more effective when you know the commissioner's name and use it.

The only way they both get to ding you on the copay is if you went to see both of them for separate appointments. If you showed up at the doc's office, visited with the doc, then left, the hospital doesn't have a leg to stand on.

My mom consults for physician's offices and hospitals on upping their profits and says this type of s**t is pretty common practice when a place is struggling or when they decide they just don't make enough money.

Thanks. It's a weird situation where we went to the Children's hospital urology office, but the surgeons have a separate management group. Probably so they can do exactly this and make more money.

[patteeu]

Contact your insurance provider and let them deal with it.

This is the first step, for sure. Your insurance provider can help you to understand whether or not your policy requires you to pay one co-pay or two co-pays per visit. I've never heard of a policy that would require two co-pays for a single visit so I'm pretty confident that won't be the case, but I doubt that there's a rule against writing the policy that way so it's worth checking.

Chances are, after you talk to your insurance provider and let them know that you have receipts for paying your co-pay, this will all be easily handled. I wouldn't sweat it too much at this point. Mistakes happen between the insured, the provider, and the insurance company all the time and once everyone gets on the same page, they are usually pretty easy to clear up. But for those who haven't dealt with it much, it can be confusing.

BTW, you probably received some kind of explanation of benefits disclosure from your insurance company that describes what was paid on your behalf and how much you should be on the hook for.

[Shaid]

Contact your insurance provider and let them deal with it.

I work for an insurance company, they'll easily be able to tell you what copays you actually owe and what you don't. If a providers office is double-billing you than you should ask them to call the office and straighten it out. At the very least they will be able to provide you with an Explanation of Benefits(sheet of paper that shows what you owe, what the insurance company paid, and what the provider needs to write off) and you can simply show that to the doctors office and they will have to follow it.