Insurance issues

[Anna C. 4]

Hi guys,

My hubbie and I are surprised by a medical bill we got yesterday. it's not a big deal, we only have to pay 9 bucks and the rest did the insurance. But I was quite suprised to see that the doctor billed me for a urin pregnancy test which I never inquired nor took. I came for a vaccination which I got and that was it. And as all women will know you don't get shots when you are pregnant because it would harm the baby. I had a TD shot, just regular shot.

I already called the doctor but their office billing person is not to be reached - voicemail only and they don't call back. We called the insurance and they said go to the doctor's office and make that clear.

They also said if they claim they did take a pregnancy test that they will have to prodcue lab reports about it (which they will have to fake since they never got my urin sample). I wonder how far they would go with their fraud on us and the insurance?

Do you have any advise how to handle this situation? We took a closer look to the check out sheet and the doctor herself circled very vaguely (barely visible) a pregnancy test, so it is no mistake, she cheated on me on purpose. What can we do? I honestly don't care about the money, I care about honesty and insurance fraud!!!! I did not expect that doctors cheat on people, this is a completely new concept to me....

Thanks for your input!

Anna

Edited November 7, 2006 by Anna C.

[kitkat1 5]

I've experienced a similar situation. I reported it to the insurance company and let them take it from there.

[Anna C. 4]

Thanks kitkat, but United Healthcare told me to try to resolve the issue with the billing department of my doctor's office. I am so shocked because something like that I only expect from dentists, they are known fraudsters. I will let you know what happens... I guess I will have to appear in the office in person to find out about my "pregnancy test" (hey am I? I wanna know! ) ....

[kitkat1 5]

Well it's nice of you to deal with the billing department but I would tell United Healthcare that it's their responsibility to follow up on potential insurance fraud - not yours!

[Anna C. 4]

Good idea! I had no experience and thought it was normal procedure. I will give them a call!!!!

Thanks for the help!

[perfect 39]

I had the same experience in a different context with a Doctor who is nothing but a con artist. I paid my $15 co-pay and when I got the bill, I had been billed for an exam which never took place to the tune of $150 for me and another $70 for my son - for something she had never done. I'm still fighting it nearly a year later!

[Kathryn41 3,205]

We have had several incidents as well - one, they tried to charge me a rental fee for a piece of physiotherapy equipment that was 4 times the purchase price of the piece and had been returned to them but was still listed as being outstanding - and which was prescribed by my doctor supposedly with no cost to me but covered by insurance. I called the insurance company and advised them of the circumstances, then I also called the medical organization advising them that I had called the insurance company. Both the insurance company and I received a 'corrected' invoice. My husband's dentist charged him for work they hadn't done and we had to fight with the dental company to get them to correct their 'error' - and promptly left them as clients. This past summer I was hospitalized when the right side of my body went numb. Along with the obvious tests for stroke, the doctor ordered CTtscans and heart tests stating I had complained about chest pain which I absolutely had not. We are still fighting this one. And one of my favourites - our insurance coverage will pay up to $40 for chiropractic - but they require you to pay the first $40 - and the chiropractic fee is $35 so basically, no coverage. I have spent so much time on the phone to insurance companies and medical billing offices trying to get things correct that I think they should pay me for doing their jobs.

Edited November 8, 2006 by Kathryn41

[Anna C. 4]

Oh boy, guess I encountered a common problem here. Btw they still didn't call me back. I will try again once today, tomorrow I will be there in person.

I will let them know that I already told the insurance company. Let's see what will happen...

Also I found another thing that doctor totally screwed: I came in for a TD shot (my last shot was 8 years ago, I am clumsy and kinda hurt myself a lot so I thought I need extra protection) and I wanted my second varicella shot (though immigration only asks for one, it won't make you fully immune, you need 2 shots). So she searched for the varicella vaccine which they allegedly had on stock (that is why I made an appointment with them), but there was none. So she wrote me a prescription for it and gave me the number of the health department. I totally forgot about it but yesterday I finally called there. All real BS: the health department shot is not covered by any insurance (but ours pays for shots), so it would be totally stupid to get the shot there (120 bucks). In Germany you can come back in a day and they ordered the shot and you are not charged any extra visit. Grrr but here you are.

Anyway my sister is a doc and when I go home next time she will just give it to me (she can get it for 25 Euros).

Kathryn, your message showed me that playing nice probably will not help! Thanks, I am now prepared better to "encounter" the billing lady.

[samantha_lou 0]

I am so shocked because something like that I only expect from dentists, they are known fraudsters.

Sorry, I had to respond to this comment...no one in the dental office I manage would ever cheat a patient, nor would I ever let that happen!

[Saddle Bronc 124]

Unfortunately, this appears to be almost "b-a-u" with American medical labs/hospitals.

I can remember having a physical at El Camino Hospital in SJ and paying $350 CASH and getting a receipt for it--two months down the road, I got a bill from them for $169 (and no explanation as to what was missing). I tried resolving it (even sending them a copy of the receipt), but they wouldn't even acknowledge the discrepancy.

[Anna C. 4]

@ Samantha: unfortunately I had to deal with two fraudelent dentists in Germany and one in the USA. My health plan in Germany as well as United said it is super common - it is hard to find a good and honest dentist and you are lucky to work with a good dentist. And I am not the only one in my now extended family who was cheated on by a dentist.

@ Cherry: Wow that is really bad, but isn't it illegal to send a bill without stating for what it is???

I walked into the doctor's office today and the responsible worker looked up my file and found no pregnancy test. They will rebill my insurance and me as well (now nothing to pay).