get a little ahead; then get a bigger behind

[twirl]

cuss word %$#$   I posted this and hit a key and all disappeared........
we are ahead this month - being in the hospital I did not spend as much money - I get a notice saying I owe my doc $2000 for a sleep study he had me do - his office sent a referral - now my insurance will not pay it - they say I did not have a referral - could not have had it done without a refferal - my doc of 12 years will not see me until I pay the full amount - he is also my husband's and one of my daughter's doc - never a problem before - I need a follow up visit after surgery last week - his office stated pay the full amount and see the doctor - I have always had insurance and now I have medicare after being on dialysis for over 18 months - I called the doc a while back and gave them the new number for my insurance and they have filed everything else correctly but this sleep study -  my social worker was checking up on this for me two weeks before I went into surgery and she did not have time to do anything until now but she knows how many bone bucks we all have or do not have ( in my case) she volunteered to look into this for me - now we have to battle the insurance company and the social worker says I do not have a chance - I will have to pay - sounds like someone in the doctor's office made a mistake to me

[kimcanada]

THAT SUCKS!!!!!

I hate it when people don't believe you... I mean really, why would you have takin that study if you thought you would have had to pay $2000

I hope you get it all cleared up and fast

[Sunny]

Aren't they supposed to check for insurance coverage for a procedure first before going ahead with it?
Sounds like their mistake, I doubt you would have gone ahead with a sleep study if it weren't covered.
However, if they are threatening you by saying they will not treat you, what choices do you have?
Ask them if they are willing to negotiate the amount and explain you are low on finaces. Then get on a payment plan.
I hope something works out for you.

[David13]

It truly can be a frustrating tribulation to deal with insurance companies and doctors' offices, especially when they won't listen or try in any way to help sort out the problem.  Don't give in if you know you are right.

[oleboy]

Ask them if they will lower it to the amount your insurance would have paid, which will be a big savings if you have to pay it?

[flip]

I would contact Medicare and probably a lawyer too. If your state is like mine, you can qualify for free legal aid. I would probably contact the administrator of your medical facility. Remember " the squeeky wheel gets the grease"

[paddbear0000]

Threaten them with a lawyer! I've found that just threatening to sue someone is VERY effective. If that doesn't work, start seeing a new doctor.

[Ang]

hey  twirl,

a  thought  for  future  reference,  when  you  submit  paperwork  to  any  body,get  them  to  stamp  the  paperwork  with  the  name  of  whoever  and  photocopy  it  for  you,file  it  at  home, when  a  disagreement  occurs  ,shove  it  in  their  face  ,"stick  this  where  the  sun  don't  shine"
hope  this  little  hiccup  fixes  itself  rea;l  soon

[Jill D.]

I feel your pain - I've been fighting rounds w/Medicare on a premium payment that I paid in January that they say they never received (even tho my bank statement showed they cashed it!) It has been nearly impossible to find someone to help me - and all I need is the name and fax # of someone I can fax the #!@& bank statement to so I can prove I paid!!!! I was bounced back and forth between Medicare and Social Security - even spent time @ my local SS office and they couldn't do anything! Then, I received a letter in early May saying they had dropped me for "nonpayment"!!!!!!! (after I had made yet another premium payment - which they did receive)
I think I finally got through to someone last week that is taking care of it...after much persistence, bitching, crying, blahblah. He actually gave me his name and a direct phone number (which is golden when working w/these people).

Yeah, it SUCKS  when someone else messes up and you did nothing wrong but are expected to pay. 

[twirl]

now the doc's office does not want to discuss anything with me - I am not their patient now

[kimcanada]

Call the Better Business Bureau... what crap... oh so ethical

[donnia]

What a jerk!!!  I think the doctor did you a favor.... I wouldn't want him!!!

[Sluff]

My method of resolving this issue would end with three meals and a cot. 

[Robby712]

Right now I am battling with Medicare/United Health Care over a $800 ambulance ride.  I pay my medicare premium every month and get the UHC through my job.  Neither one is willing to pay the bill even though I'm fully insured.

Sometimes I think we would all be better off unemployed and uninsured.

[Sunny]

Being unemployed and uninsured works  if you don't own your home or have any assets.
If you own a home, they put a lien on it. If you have any assets, they will take them. The result is that you are stuck
paying contested medical bills and they know it. Then they stick you with the "going" rate and not the "insurance" rate.
The best bet if you cannot get a medical bills covered by insurance but do have assets is to negotiate an amount
and get on a payment plan. If you don't, there goes your assets. Sad but true fact.

[Robby712]

Hoping we get some serious medical/insurance reform after the upcoming election.

The system as it stands is set up to screw those that have just barely enough to make the payments and also leave important, and in some cases life or death decisions in the hands of the insurance docs who get paid to turn down as many claims as possible.

My first transplant almost wasn't covered because insurance said they didn't cover them.  We had to dig out the book, find the page that said they were covered on, and direct an insurance agent over the phone to said page and paragraph before they would agree to it. 

Disgusting.

[twirl]

so today my husband was told that the bill was paid to the sleep doctor instead of my family doc and
I owe two copays
when I go there and take out my checkbook I am told we have an over pay
so I don't pay
well, the office denies that
so I'm saying if I had a visit and refused to pay, your office would not let me make another appointment
PAYMENT AT TIME OF SERVICE
the women in the office were rude
it is not my job to make sure the office does what they should
I know next to nothing about insurance
the office is explaining the situation to the doctor and he will decide if I can still see him again

[jbeany]

twirl, honey, I know this was a serious rant, and I hope the stupid doctor gets his head out of his a** soon. . ..

but every time I read the title of this post, I keep getting the impression that you were complaining about regaining some weight. . . . 

[okarol]

LOL I have the same twisted vision as jbeany...

only I am picturing a small head  on a person with a BIG butt 

[twirl]

my behind is bigger than my head
the latest
the doctor's office knows my insurance paid the wrong doctor but I still may not be allowed back to the doctor - they have had to go to too much paper work to get this settled
that primary doctor does not ever come to the hospital to visit his patients
so I am still in limbo

[monrein]

I suggest butting him. Or head-butting him if you prefer.

[kitkatz]

Send pics of the ass whupping you give these dumb doctors for screwing with you!

[twirl]

my insurance paid the wrong doctor two months after my sleep test
they have everything in order now
my doc will not see me b/c his office thinks I just blew them off
I went to see my doctor every week for 4 months
and never once was anything said
so I thought it must be okay
so I went to a new doctor Monday
and I do not like her as much
but time will tell
the doc may let me come back after a time
I guess I am in detention or time out
I will not go back

[okarol]

I wouldn't either.