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| *Ostroff, Fair and Company>>>Insurance |
WHAT IF YOU DO NOT PAY CO INSURANCE AND CO PAYMENT TO YOUR DOCTOR< becuase HE DID NOT EVEN LISTENED TO ME? |
mY DOC. hardly even talked with me and listened carefully what I was talking. He charged me $255 for that visit. Another time when I had to follow up he charged me the same amount aprroximately. My insurance is paying most amount, but still I have to pay the co insurance and co pays. Everything adds up to about $100 (exluding te payment from insurance). I think it is not worth to pay this guy (DOC) this amount, since he did not do anything. My question is that what happens if I do not pay the remaining amount to him? I would like to clarify that my insurance paid 80% of the cost. I am talking about the remaining 20 % that I have to pay. You've received some good advice, but I wanted to add a few details to clarify. 1) There is no statute that I'm aware of requiring a physician or other health care provider to collect your co-pay before services are rendered. However, most providers do this because people tend to leave as soon as the visit is over. There are some providers that bill the patient for the co-pay. All the law says is that a provider is able to collect the co-pay from the patient. 2) Quality of care complaints against a health care provider should be sent to: a) the board of practitioner licensing in the state where the practice is located and b) to your insurance company (but only if it's a participating provider). Some states (such as mine) provide the insurance commissioner's office with limited investigative authority in this area. Contact them to see if this is an option for you. 3) If a patient fails to pay his or her co-pay, a health care provider can and will forward this to a collection agency. Further refusal to pay the bill will result in a report to the credit bureaus as an "unpaid debt." Further, the collection agency may resort to remedies such as court ordered fee garnishment or liens against your home to ensure the debt is paid. Interest and attorney's fees will be added to what you owe. 4) I can assure you, medical bills reported as outstanding debts on a credit report ARE NOT ignored by potential lenders. Depending on the size of the loan, most creditors will require a written explanation; documentation proving you don't owe the debt; and proof that you're trying to clear this from your history. Some will not grant the loan until your loan history is cleared of the debt, regardless of its validity. I understand you feel your doctor didn't interact with you; this lead to the perception that he didn't do anything for you. However, many doctors have poor "bedside manners" -- in other words, they do not interact well on a personal level. This doesn't mean he didn't do anything for you. He still listened to you, assessed your condition and progress, and decided on what to do next. So while you left his office feeling as if nothing was accomplished, this is probably not the case. I would suggest you send him a cordial letter explaining how he made you feel and asking him to call you to explain exactly what it is that he did (silently) during your visit. As others have suggested, you also have every right to seek care from another doctor. I hope this helps. Source(s): 16+ years insurance industry experience; 9+ years insurance law experience bring it up with him and lodge a complaint. All health professionals must follow a professional code of conduct. If you feel he is not fufilling his role, then report him to your insurance company because they are always looking for doctors that rort the system. But you must be realistic also with your expectations. You have to pay this amount because you recieved the service. You can always shop around and look for a different doctor who will pay more attention to you but any previous money due has to be paid. If you do not complain before you leave the office, you will have a hard time getting the bill cancelled. He will send you to a collection agency and it will be a bad mark on your credit. It's your choice. If you took a doctors time, it really doesn't matter if you didn't like the result. Your only choice is to never see him again -- you don't really have the option of not paying for a service you received. He could legally go after you for the amount, place a mark on your credit and turn it over to a collection agency. He could also inform your insurance since most require that you actually pay the copay. He can, and probably will, turn you into a collection agency however, they are listed on your credit report but most companies IGNORE medical bills- because most of them are bogus. Your best bet would be to sit down and type a letter to this Doc explaining that your insurance paid x and you owe x and that he was competent in his care and advise to you. Make a copy of the letter and make sure that you state that you will be sending a copy to the American Medical Association if you do not hear from him in 10 days. Please explain in DETAIL what HE DID WRONG in his visits with you--- he is a well educated intellectual and just stating he did not do anything will cut it. 1. Have you seen another doctor and received a correct diagnosis and proper treatment? If so, do not give him the name but tell him this and what the treatment was. 2. The fact that he "hardly even talked with me and listened carefully" is not a prerequisite unfortunately, for being an MD. They listen only to your symptoms and the facts- and tell you as little as possible until they have an answer----sad but true. 3. If you decide to pay his bill- it is a tax deduction. Good luck in whatever you decide to do but if it was me-- and I do not tolerate incompetence in ANY field- I would get a second opinion and then write the letter to him with the copy to the AMA if he decides not to drop the balance. Good luck to you--- and I hope you are feeling better. PS I just read the advise someone stated about him telling your insurance--- by the insurance statutes- the COPAY is supposed to be paid UP FRONT BEFORE the visit- so the doctor's office already violated the insurance agreement. |
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