Author Topic: Screwed by out of network insurance charges?  (Read 1973 times)

P938LVR

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Screwed by out of network insurance charges?
« on: March 01, 2016, 03:28:49 PM »
I went to see my obgyn and I had originally asked to see a doctor that I knew was within my network. They accepted my insurance and set me up to see a doctor. They said that they do things differently and that I would be seeing several different OB's so that I could pick one that I liked the best. I told them that I already had one picked out but they insisted that this was the way they did things there. I thought well ok they know what doctors are in my network and I obliged.

Come to find out a few months in that they sent me to doctors that were not in my network and I am now being charged for the visits that were supposed to be covered. They had also done testing and sent it to labs that were not in my network too. So now I am being billed for thousands of dollars for things that they were supposed to have taken care of and there are more bills to come I am sure.

My question is is there anything that I can do to fight this? I don't have the money to cover these bills and I already have insurance which was supposed to take care of this. I called my insurance but they acted like they had no power over what happens. I have a feeling that when I call my obgyn that they will do the same. Please help!

Cassie

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Re: Screwed by out of network insurance charges?
« Reply #1 on: March 01, 2016, 03:33:49 PM »
This is the doctor's fault and I think they need to reduce your bill and give you the doc that is on your plan. if not I would find someone else. This is really terrible.

Need2Save

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Re: Screwed by out of network insurance charges?
« Reply #2 on: March 01, 2016, 03:37:21 PM »
What insurance company is it?  Almost all have a customer advocate team which can help you navigate around the standard 'can't help you' response you get from the level 1 customer service team.  I would call back and ask them if you can speak to a customer advocate associate.  Then, after explaining to them the runaround you got from the provider,  I would file an official appeal with the insurance company to consider those docs and lab as 'in-network' even if they have to get an approval from the plan sponsor (is this insurance through your employer or your spouse's employer - or through an exchange)?   It's worth a shot. 

After all that - I would take my business elsewhere for future appointments as it sounds like the practice is purposefully confusing patients on in-network and out-of-network status.  Not sure what is behind that but you did your part by verifying up front the in-network status.