What should I do about my medical provider overcharging my health insurance and

1. 53

   saltylimeposted 13 years ago

   What should I do about my medical provider overcharging my health insurance and me as well?
   
   I went to an out of state provider that accepts my insurance. The doctor has a website that states the prices of the treatments as approx. $9k. I did have supplementary treatment beyond the main treatment but these extra charges should add only a small percentage to the final charge. The doctor's office charged my health insurance about $65k and me about $8k as the "uncovered" portion. The cash rate charged to cash paying patients is about $10k. So my health insurance paid them $65k and now they requesting almost as much as if I had not been covered 100% by insurance. I do not know what to do.

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2. 83

   bryteyedgeminiposted 13 years ago

   go on the website, print the page that dicusses procedure costs, call your insurance agent and alert them that you are concerned that they are being defrauded, fax them the web page along with a highlighted copy of your bill, insurance companies take these issues very seriously, then report to the better business bureu, call a lawyer...do not make a payment untill this has been sorted out

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3. 75

   Jillian Barclayposted 13 years ago

   First, you must contact the provider and remind them of the original agreement. If you have an estimate of costs in writing, that would be your back-up. Second, contact your insurance provider and give them the details of the arrangement made with the provider of services. If your state has a Department of Managed care, file a complaint. They will investigate.
   
   Providers will negotiate discounts. You must speak to the actual administrator. Do not waste your time with junior personnel.
   
   If none of these things help, Without knowing the particulars- such as your insurance company and policy coverage, the provider and type of services provided, I can give you nothing but generic advice. I do negotiate discounts with medical services providers. I handle many of these situations on a daily basis. If you would like personalized assistance, please let me know. I will be happy to help.
   
   Do not pay this bill until you are sure it is a legitimate charge.

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