Medical Bills

skuhl - 12:43pm Jun 29, 2005 EST

I hope that everyone will learn from this discussion. I recently received a medical bill from a physician for services rendered that my insurance did not fully cover. Suffice to say it was a LARGE bill. Shortly after receiving the services, I started receiving statements from my insurance company with "REJECTED" on many of the charges related to the service I had received. Being concerned, I contacted my insurance company. They told me that the reason that the charges were being rejected was because my primary care physician had not obtained proper authorization for the referring physician's procedures. As a result, the charges were not going to be paid by the insurance company, because proper procedure had not been followed by the PCP. I was told by my insurance company that I WAS NOT RESPONSIBLE FOR THOSE CHARGES, and to notify them of any bill for those charges I might receive. I was, needless to say, very relieved to hear that.

That was last October.

Last week, I received a bill from the referring physician's office, of the whole amount not covered by the insurance. AND, the bill stated that the amount was OVER 90 DAYS PAST DUE. This was the first bill I had ever received.

I immediately contacted my insurance company, who said again, that I was not responsible for those charges and that it was not my responsibility to obtain authorizations for procedures, it was my PCP's. They are sending me a statement to attach to the bill and return to the doctor's office that explains why I can't be billed for these charges.

The point of all of this is this: DON'T automatically pay a medical bill until you research it with your insurance company. The referring doctor's office does not know that I was aware that I didn't have to pay this bill, yet they are trying to bill me and get me to pay it so that they don't lose money because of their mistake. How many people simply would have looked at that bill, saw the over 90 days past due and went ahead and paid it so they didn't have a problem with the doctor's office or their credit report? The Majority, I can tell you. Don't do it - make sure the bills you get are completely accurate - and the ONLY way to know is by calling your insurance company whenever you get a bill. If you pay a bill and your insurance company has a payment in the mail to the doctor's office, do you think you will get the refund of what you overpaid back? I've NEVER seen that happen.

PAY attention to your medical bills - it could save you a lot of money in the long run!!!!