Wifes obgyn

[cinchhorn]

Long story short, wife needs some work done by obgyn and the office manager tells her our insurance covers it. 2 months later we get a bill for 1300 on the procedure. The insurance company says the doctor coded it wrong and therefore will not pay now. Now the doctor has agreed to settle for 650. I refuse to pay for someone's mistakes. I guess I will try to explain to the doctor that we have yet to have kids and my wife really likes her, so it would be beneficial for her to keep the patient happy and eat the amount. Thoughts, ideas, or suggestions?

 

[cmvUT75]

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[tbone]

we had a similar issue a while back. Doctors office was very apologetic and resubmitted right away. if its really a coding issue your doctor is out of line not to resubmit.

 

[MaduroUTMB]

Knowing nothing about this situation, I would submit that insurance companies are about a half step above mail-in rebate companies. I am being generous with the half step.

 

[Wild Bill]

Agree with Maduro. Ask the Dr's office to resubmit.

 

[NCAAFBALLROX]

What if the 'incorrect coding' was when the doc office staff 'coded it wrong' when you asked if it would be covered & THEN when they sent off the 'right' code, the 'right' one was NOT payable?

If that were the case, I would 100% expect the doc's office to suck it up.

You should also ask what the "code" is that won't be covered... are we talking a totally voluntary thing in comparison to the work / procedure / examination of a special variety that she had done?

 

[cinchhorn]

Thanks for the replies, we're headed to the doctors office on Thursday to get her birth control, then we'll "discuss" the situation. I now know that the procedure was not covered at all and I still stand firm that I'm not paying a dime for their mistake. Now if I could get Countrywide to stop harassing me over a late payment that was never late. Thanks again.

 

[gecko]

Is your point that you were misled by a coding error by the OBGYN into thinking the procedure would be covered in full...?

Assuming this is a procedure that your wife needed, I think your OBGYN's offer to meet you half way is fair.

 

[cinchhorn]

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