Monday, January 31, 2011
Help Me Howard: Dr's Billing Twice
Here is a question for you? Your insurance company pays the doctor then the doctor turns around and says they didnt pay enough. I want you to pay more can they do that well its why one woman called Help me Howard with Patrick Fraser.
WSVN -- It's tough to beat having two adoreable little boys, but if you are lucky enough to have them you also know it can be tough to keep up with them.
Melissa Falco-Diaz: "He's 13 months. It's a bad thing because once he starts walking I have two of them running around."
Dillon and Sebastian are healthy and happy, Melissa is the one with the headache.
Melissa Falco-Diaz: "Then in October of this year I get a bill from a collection agency."
The bill said Melissa and her husband owed the doctors who helped deliver Dillon $1,487 confusing them since they have insurance, so Melissa called the hospital.
Melissa Falco-Diaz: "They stated that my insurance had in fact paid, but that they didn't pay enough."
Melissa then got in touch with their insurance company.
Melissa Falco-Diaz: "When I called my insurance, they said that they had paid and that's what they were going to pay. So basically I thought I was caught between the two."
Melissa had never been contacted by the doctors office they just turned it straight over to the collection agency who tried to guilt her into paying.
Melissa Falco-Diaz: "They said well don't you feel this doctor and these people who performed these services they only paid this amount don't you feel they're owed more?"
Melissa's insurance company told her she did not have to pay them anymore money the collection agency said if you dont it can ruin your credit.
Melissa Falco-Diaz: "In all honesty I don't mind paying a bill that I owe but I don't know if I owe it truly owe it because I thought my insurance had covered it."
She is being told you dont have to pay, you have to pay. Remember what Melissa said about being stuck in the middle.
Melissa Falco-Diaz: "It's been very frustrating. I just want to know whether I really owe this. Whether I need to pay it. If I need to pay it and ultimately, I just don't want this on my credit report and I just want to know if I am responsible for this."
Well Howard her insurance paid the doctors say they didnt pay enough the patient is stuck in the middle.
Howard Finkelstein: "What happened in this case is whats called balance billing in other words, the provider wants more money than they get from the insurance company and that practice is prohibited in Florida its also illegal to turn the patient over to a collection agency for a debt that is not theirs."
Good news for Melissa, I called South Miami Hospital. They checked into it and a few days later told me Melissa did not have to worry about the bill. That the doctors office was now dealing directly with the insurance company to try and get the money they feel they are owed.
The doctors also told the collection agency to stop sending Melissa letters. Howard says if it doesnt work out that well for you take the next steps.
Howard Finkelstein: "If the medical provider will not back off, file a complaint with the department of health lso if they dont call the collection agency off file a complaint with the office of financial regulation you have insurance you dont have to put up with this."
Melissa is glad she is no longer in the middle of a battle between doctors and an insurance company, and wishes in the future they could agree on a fee before they procedure.
Melissa Falco-Diaz: "They have contract with them. They did accept money and whether that's enough or not take it up with my insurance company. That's why I have insurance."
Patrick Fraser: "Now, if you are going for a medical procedure, make sure you know what is covered and make sure the hospital and doctors accept your insurance. Insurance can help cover you, but it can also create alot of headaches for you."
Babied a problem you cant seem to pacify? Want to insure its put to bed? Deliver it to us, we dont have but we legally we can cure some things.