I’m pretty frustrated about this but here is the story.
In the summer of 2000 Mrs. Z needed some wisdom teeth out and after searching through our provider directory we went to a Oral Surgeon. Our first trip there was a complet wash as after calling our insurance they insisted that we had no coverage. I couldn’t use thier phone and I didn’t have a cel but when I got home I confirmed that I did indeed have coverage for me and my wife and for some dumb reason we went back to the same oral surgeon.
Everything goes fine. I pay my co-pay, they know we have insurance bla bla bla.
We never return to this oral surgoen.
3 years later I get a letter from them saying I owe $600.
WTF?!?!?
So I call my insurnace and they look up the old claim and assure me that it was paid at the insurance negotiated rate.
I call them and tell them this.
They respond. Ok we’ll look into it.
6 weeks later another letter demanding payment of $600 or it will be turned over to a collection agency.
Again I call my insurance and they fax me a copy of the payment to the doctor. I send this to Dr. office and they say they’ll look into it but they don’t have a record of getting the check. It does look like I have to pay another co-pay of $55. I tell her to send me a bill for $55 dollars and I’ll pay it.
Now it’s two months later and guess what I got yesterday?
A letter from the dentist saying the claim was denied and I have to pay $600 now or it will be turned over to a collection agency.
(insert primal scream of rage here)
Logic doesn’t seem to be working here. What would happen if it was turned over to a collection agency? Could I sue them? I doubt the collection agency will be swayed by faxes from my insurance company. This is just so frustrating and it really hits my personal buttons, so any suggestions?
Inform your insurance company that the dentist is attempting to commit insurance fraud by billing you for claims that were already paid. They’ll sic so many lawyers on them so fast it will hurt more than a root canal.
In the mean time, inform your insurance company and the dentist in writing that you are disputing the bill. If you do get a letter from a collections agency, inform them in writing, too.
Yes, send a letter, with copies of your evidence to the dentist and cc (carbon copy) to your insurance provider, the Better Business Bureau, the secretary of states office, and whom ever else you can think of to scare the crap out of them. Including a lawyer, if you know one.
Make SURE you detail in your letter how MUCH this is Distressing you!! Heck, your losing SLEEP over this, HOW can this be happening???!! You may lose your job/marriage/mental sanity, if this keeps up.
They will correct themselves, if you alarm them enough into actually doing their damn homework.
I second sending a copy to the insurance company, along with sending a copy of the insurance company’s letter to the dentist saying the bill was paid.
Also, if the bill goes into collections, it will end up on your credit report. Since bad credit history can jeapordize your ability to get a home loan, or, in some cases, even a job, you may have grounds for a lawsuit should the occasion arise. You might want to point this out in your letter.
I did a piece of paper from the insurance company saying it was paid. I did send a copy to the office of the dentist. It’s just that a lot of time seems to pass then the dentist’s accounts payable seems to reset and go back to saying the claim was denied.
Ok I talked to the insurance company and they issued a new check to the OS on 12/2/03. It seems that the first check was never cashed so it must have been lost between the insurance and the oral surgeon.
So I called the surgeon and they don’t have the check yet but they are waiting for it. Of course I asked why a new statement went out on 12/15 and they didn’t even know that they had sent me a letter.
I’m sure I’ve got another month or two dealing with this but I’m keeping a file.