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Old 08-28-2001, 10:24 PM
Kutseena
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Question

Malpractice???


Hello all...I live in Orlando FL and got to a chiropractor in Maitland FL. My boyfriend is also a patient there, we both signed a "Health Care Service Agreement"...Where supposedly the Dr. talked with the insurance company & they agreed upon an amount for the proposed services and our co-pay amount. My co-pay is 10% which I’ve already paid in full. My boyfriend is to pay 25%. His agreement was signed on 7/9/01 and we gave the Dr. the info & paperwork to file the claims. We have paid $300 of his $600+ portion of the services. Last Friday, before we received our treatment, the staff told us that they needed to talk to us about his case…so make sure we have time after our Monday appointment to talk with them. After the Monday treatment, we sit down with them and they tell us that his insurance company doesn’t recognize chiropractic medicine so will not pay for the services! Isn’t that a form of fraud??? He knew the insurance company wasn’t going to pay, yet he did at least two more treatments before telling us!!! And if we argue about this, my treatments (which have already been paid for and my insurance IS covering it) may be at risk. Mainly I’d like to know if this is considered fraud, and who I might be able to talk to about it. Thanx in advance for any help.
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Old 08-28-2001, 11:54 PM
lawrat
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contact both your state insurance commissioner's office and also the board of chiropractors (internet search may be necessary). If it cannot be resolved between these two offices, you will need to hire an attorney based on fraud committed.
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