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Author Topic: Doctor's Office Billing  (Read 3965 times)
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« on: September 21, 2007, 08:33:27 AM »

I usually never get a bill from my Nephrologist's office.  I get the Explanation of Benefits (EOB) from my insurance company.  They are still primary.  I never see anything from Medicare concerning my Nephrologist's office.

Three months ago all of a sudden I get a bill for like $400.  I examine the bill and discover they are billing my insurance say $500 and are receiving $650.  Hmmmm  So I can see they are either double billing my insurance or billing both insurance and medicare as primary.

The only reason I got a bill was because someone wised up and didn't pay so they were coming after me.

The next time my Nephrologist came in I gave her a "copy" of my billing statement and reminded her that under the law she is responsible for her billing statements and it is a federal offense to screw with Medicare.  A Nephrologist group in the 90's were inadvertently billing medicare and they got millions of dollars in fines and one doc shot himself.

So this week I get a pack of EOB's from my insurance company denying 7 months worth of bills.  I don't blame them since THEY ALREADY PAID THEM!!  I called the Neph's office and demanded to speak with billing and then demanded to come in and see someone face to face (which they would not do).

They billed my insurance company 3 times for April.  My insurance pays within 3 days of billing.  WTF

I basically called them IDIOTS!  Told them someone needed fired!

Then I finally get something from medicare who denied all payments because they were billing them as primary when they are still secondary.  Glad someone at Medicare caught that one.

My insurance usually pays a service date of the first of the month like January 1, February 1..... for the whole month.  So I see where they were billed for January twice but there was a January 12 in there.  Well, because my stupid Neph's office billed them twice they accidentally paid it twice because someone at my insurance accidentally keyed in 12 instead of 1.  So my Neph's office made a cool $450.

If it happens again I'm turning them into Insurance Fraud and Medicare Fraud.


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« Reply #1 on: September 21, 2007, 07:08:35 PM »

Wow.. I wouldn't give them a second chance... they are probably doing it to other people who aren't catching on.

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« Reply #2 on: September 22, 2007, 02:22:27 AM »

How many patients are getting double billed? Someone is looking at early retirement. If it smells fishy it probably is fish.
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