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Docs Are Demanding More From Patients

Doctor Bills

I just had a doctor overcharge me (twice) and keep the extra money until I figured out what happened.

First, I was charged a $40 co-pay for the consultation before a minor surgery.

The next week I was billed another $40 to pay for part of the surgery the doctor’s office said was not covered by my insurance company.

Then I hear from my health insurance company. It says my co-pay was $30 and it covered all but $30 of the additional cost.

Needless to say, I called the doctor’s billing rep.

She said the doctor overcharged me on the co-pay for the first visit and kept a $10 credit on my account. Yes, on purpose. Yes, without telling me.

The second bill was a mistake, but once again the $10 overpayment was credited to my account without any notice and without asking if I’d like a refund.

Twenty bucks might not seem like much, but this practice screams rip off.

If I hadn’t called them out on it, I’d have paid $80 and had a credit of $20 on my account that’s worthless since I don’t plan on seeing that dermatologist ever again.

It seems I’m not alone.

The Wall Street Journal says an optometrist asked Atlanta attorney Michael Gurion to pay $70 for an exam and contact lenses.

But months later, when Mr. Gurion received an explanation of his benefits from his insurance company, it said he should have paid no more than $25.

What was the doctor doing with the difference?

Holding it as a credit toward future services without telling Mr. Gurion, who wasn’t a regular patient and didn’t intend to return.

The Journal suggests this is part of a trend in which physicians are no longer waiting to be paid by insurers before they try to collect more than just co-pays from patients.

If they’re ultimately paid too much, the extra is not refunded — it’s credited to a patient’s account.

I’m sympathetic to doctors who have bills to pay, too.

But as a patient you’ve got to know your co-pay before going to the doctor’s office and question any request to pay more until your insurance comes through.

Comments (7)
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7 Existing Comments
  1. Zircon-212 said:
    on August 24th at 06:14 pm

    Fret not! This will all be taken care of when our government takes over the entire health care system. BHO et al will run it with military like precision and cost effectiveness of a bailed out Wall St. bank.

  2. willam hopkins said:
    on August 24th at 07:34 pm

    When you’re already being screwed by the private insurers by overbilling, you might as well trust the federal government. Due to Vetertan’s lobbies, the VA system is improving. So, there is the potential for better and much fairer pricing for health care. Until then, I’m buying prostrate drugs from Canada at 60% of what my US Blue Cross charges me on the American market. Compare US drug costs on Canadian sites and see how we’re being screwed.

  3. marc said:
    on August 25th at 02:48 am

    Anyone actually happy with the current healthcare “system” today in the U.S., either has unlimited resources with money to burn, or has never needed medical attention.
    Where does it say in the Constitution that BIG INSURANCE has some god given right to exploit us for the maximum profit possible.
    Government is the only entity powerful enough to break the strangle hold insurance companies have on all of us.
    Talk about “Government Rationing” makes me laugh…as if every private insurance company today isn’t absolutely committed to standing between the patient and the care they need.

  4. Growing Unscrupulous Doctor Billing said:
    on August 25th at 02:04 pm

    This is a HUGE growing problem.

    Doctors have become very unscrupulous and bold in their billing practices. They demand double payments, they bill for things not even performed, and far worse. The most despicable is when they malpractice on you and demand payment for the mapractice!

    When you dispute it, they threaten to hurt your credit rating and essentially extort you into paying their overcharges. Good credit is more important than ever and doctors know it.

    File a dispute with your insurance co. Many doctors won’t refund until the insurance co gets involved or it goes to small claims court. Report them to the medical board.

    There needs to be consumer protection from medical billing practices. Doctors should not be able to cheat people and then stick it on your good credit if you don’t pay the wrongful charges. There should be a separate way to handle medical bills when it comes to credit bureaus. Also, doctors know people will often pay the overcharge so embarrassing medical info won’t go on their credit report (it’s supposed to be masked but often isn’t.)

    Psychologically it’s hard to deal with such situations because we’re taught that doctors are honorable and we trust them with our lives. However, those days of the trusted white coat are over. Doctors are businesspeople. And a bad economy pushes people to do unethical things.

  5. mm said:
    on August 25th at 02:27 pm

    As a patient myself and also directly working in the medical billing side at the same time, i can honestly say that both are the victims of this “mafia” network called the US insurance companies.

    The truth is that the insurance plans and administration rules are so complex, perhaps intentionally so, that most brainiacs will have trouble figuring these out, much less the average Joe on the street… (err…the procedure is covered with a 20% copay, but only up to an annual benefit maximum of $ XXX, and covered only if you do it at location A, B, C, but not covered if done at location D, and only if you use all in-network providers, but also subject to deductible, which patient has only met part of, but will not be covered if it is a pre-existing condition, and will not be covered at all if precertification procedure is not met, etc, etc………..)

    On top of that, they throw in the all mighty self-protective disclaimer – whatever insurance rep quotes you on the phone or on the website is not a guarantee of accuracy nor of actual payment. WTH?? If the insurance people don’t stand by what they say, who the heck else is the patient or the doc supposed to turn to for accurate information? You don’t think patients have to accurately know how much they’ll be out before they opt for a kind of treatment? And don’t you think docs need to know if they’ll get paid before they do a procedure?

    In all normal everyday biz transactions, we are able to see the price tag at the store before buying something. For non-tangible products like services, we get a reasonble quote for services in writing, make a deposit, before we enter into a deal with them and before they start work.

    On the flip side, docs should have a reasonable guarantee that they’ll get paid BEFORE they dole out their services ( I’m talking about non-emergency situations). But the truth is that everyday, the docs do their work without knowing if they will get paid, and have to wait till they send a bill to the insurance company and wait, wait, wait to see if the check comes through. And often, it will get held for this, that technicality.

    Have you been able to walk out of a salon after a haircut and tell them you’ll pay them later? It is like Wimpy saying “I’ll gladly pay you Tuesday for a hamburger today.” Would you be willing to work on those terms, ever?

    I have accumulated a 3 inch stack of papers in just 5 months for the MD office I do accounting work for – ALL DENIED CLAIMS. Work/surgery has already been done and cannot be recovered. Unlike the auto biz, it’s not like you can re-possess the device our doc has implanted in the patient.

    And you wonder why, we too, switched to an office policy of taking “Deposits” up front. Rather than “trust” the insurance mafia (proven to not be worth the trust), we would rather take matters in our hand. The difference from this story is that, if we are overpaid, we do issue a refund check as soon as we can. People should be forewarned however, that negotiating back and forth with the insurance, IPA, etc. can take up to 3, 6, even 9 months before the case is completely closed.

  6. Medical Mafia said:
    on August 27th at 02:34 pm

    Oh, please.

    I too have been fleeced by dishonest doctors and it had nothing to do with the complexity of insurance billing.

    In my instance, it was fee for service, no insurance involved.

    Doctors always like to blame everything on insurance companies, but the fact is even doctors who don’t take insurance are equally dishonest and exploitative (and don’t offer any better quality of service as one would think.)

    Agree with the other comment that it is scary and difficult to accept that doctors are underhanded because we trust them with our lives. But the sooner people wake up to the new reality in medicine, the better off we all will be. Doctors themselves know it. If you know any doctors personally, they will tell you the medical field has changed and is filled with charlatan doctors. Even the supposed “best doctors.”

    The real “mafia” is the medical profession. They are worse than insurance companies because insurance co.’s make no pretense about being anything but a business.

  7. It couldn't be any worse than the current mess said:
    on August 28th at 06:32 pm

    There should be national health care. Health care can’t get any worse. Even the “best” doctors and hospitals in the most affluent cities are an absolute disaster. There is no such thing as quality medical care anymore because the medical profession is not accountable or transparent. Those who cling to the status quo are just creatures of habit who subscribe to the devil you know is better than the devil you don’t know philosophy. Meanwhile, Medi-care functions rather well and that’s nationalized health care.