joshanelson9
Junior Member
St Louis, Missouri
First off if I am in the wrong area I apologize but I really have no idea where this would fit.
My Father has an eye disorder and has been receiving treatments for the last 4 years. About every three months he has a checkup and depending on how it goes he may or may not receive treatment. Until now we have had no billing problems with this physician. Back in January my Father went for a checkup and had another treatment, but this time was a little different because his insurance had changed from just a private plan he had through work to medicare and a private supplemental plan. His treatments before this point were covered through the private plan and an assistance program provided by the treatment's manufacturer. The assistance program provided us with a card to submit to the doctor's office. On the back of the card it states that if you are enrolled in Medicare you do not qualify for the assistance program. As my father checked in for his appointment in January he asked if this would be a problem. I was with him because we wanted to make sure that we had everything in order because of the changes in insurance. The reception desk told us they did not know, but they would get us an answer before my father received a treatment. As my Father was getting checked out he told the doctor of our concerns and he said they would let us know before he did a treatment. Shortly after being checked out, we were told that we would still be able to use the assistance program by a secretary at the office. We assumed that they had checked and made sure this was accurate and the Doctor proceeded to administer a treatment to my father. We finished up and left the office.
Now with the assistance program we usually get a bill for around 20 dollars which has always been paid. We received the bill for the January's visit about two months latter, it was the same as every other bill we had gotten over the years and my Father paid it. My Father then had another check up in April. We gave them all of our information again and proceeded to have a normal check up which was followed by another treatment. Once again we received a bill like we had always had about two months latter and it was paid. With out the assistance program the billing would be around 1000 dollars.
Yesterday we received a phone call from the doctors office that only said that we needed to discuss enrolling in another assistance program. We thought this was an odd call because no one had told us that the old program was a problem. So we returned the call. The person that handled these matters at the office was unfortunately not able to talk to us, but the person on the phone told us that they could tell us what was in their notes on the account. They then told us that my father was no longer eligible for assistance program that we had been using, but if we called back tomorrow that their were other programs we could apply for and should be able to take advantage of. They also informed us that we would be responsible for the treatment that had been received back in January. Unfortunately these treatments are not cheap and that was a huge shock to us. We were only doing these treatments because the assistance program made them accessible to my Father. If we would have known this back in January when we asked if this would be a problem, we would have discontinued the treatments until something was worked out. But we also figured that this couldn't be the whole story because the person that handled all of this stuff at the Doctor's Office was not there.
The next morning we called the Doctor's office again to discuss these matters. We reached the person that handled these issues and she told us that we needed to enroll in another program in order to cover the April treatment. We proceeded to give her the information that she needed to accomplish this. Afterwards she mentioned that we needed to do this quickly because these programs could only cover charges that were no more than 90 days old. This was rather odd because the last treatment was 120 days ago. My father asked her if she realized it had been quite a few days beyond 90 days. She didn't really respond. We then began to discuss their contention that we would have to cover the January treatment. We explained to her what happened and she said that shouldn't have happened. She said she could work with us on this and mentioned a payment plan. My Father did not know what to say, and told her exactly that. She then began to tell us more details of the bill and as the conversation went on it was both clear to her and us that if they would have told us back in January that we could have gotten this worked out with another assistance program. She also told us what the costs of the 2 treatments were. The totals were not the same despite the visits being identical and every bill from them in the past being consistent from the last. My father did not yell at her or get angry. He was very polite and directly told them that he felt that these charges were their office's fault and not his. She did not dispute this but also did not offer us any sort of resolution. Now it seems we are stuck with a bill that may not be ridiculously high but is a considerable amount to my Father. I can cover the bill so that it will not be a burden on my Father but I feel that we should contest it before paying. Should we see a lawyer, threaten legal action or do something else? I really don't know and any advice would be greatly appreciated.
Thank You for your Responses
First off if I am in the wrong area I apologize but I really have no idea where this would fit.
My Father has an eye disorder and has been receiving treatments for the last 4 years. About every three months he has a checkup and depending on how it goes he may or may not receive treatment. Until now we have had no billing problems with this physician. Back in January my Father went for a checkup and had another treatment, but this time was a little different because his insurance had changed from just a private plan he had through work to medicare and a private supplemental plan. His treatments before this point were covered through the private plan and an assistance program provided by the treatment's manufacturer. The assistance program provided us with a card to submit to the doctor's office. On the back of the card it states that if you are enrolled in Medicare you do not qualify for the assistance program. As my father checked in for his appointment in January he asked if this would be a problem. I was with him because we wanted to make sure that we had everything in order because of the changes in insurance. The reception desk told us they did not know, but they would get us an answer before my father received a treatment. As my Father was getting checked out he told the doctor of our concerns and he said they would let us know before he did a treatment. Shortly after being checked out, we were told that we would still be able to use the assistance program by a secretary at the office. We assumed that they had checked and made sure this was accurate and the Doctor proceeded to administer a treatment to my father. We finished up and left the office.
Now with the assistance program we usually get a bill for around 20 dollars which has always been paid. We received the bill for the January's visit about two months latter, it was the same as every other bill we had gotten over the years and my Father paid it. My Father then had another check up in April. We gave them all of our information again and proceeded to have a normal check up which was followed by another treatment. Once again we received a bill like we had always had about two months latter and it was paid. With out the assistance program the billing would be around 1000 dollars.
Yesterday we received a phone call from the doctors office that only said that we needed to discuss enrolling in another assistance program. We thought this was an odd call because no one had told us that the old program was a problem. So we returned the call. The person that handled these matters at the office was unfortunately not able to talk to us, but the person on the phone told us that they could tell us what was in their notes on the account. They then told us that my father was no longer eligible for assistance program that we had been using, but if we called back tomorrow that their were other programs we could apply for and should be able to take advantage of. They also informed us that we would be responsible for the treatment that had been received back in January. Unfortunately these treatments are not cheap and that was a huge shock to us. We were only doing these treatments because the assistance program made them accessible to my Father. If we would have known this back in January when we asked if this would be a problem, we would have discontinued the treatments until something was worked out. But we also figured that this couldn't be the whole story because the person that handled all of this stuff at the Doctor's Office was not there.
The next morning we called the Doctor's office again to discuss these matters. We reached the person that handled these issues and she told us that we needed to enroll in another program in order to cover the April treatment. We proceeded to give her the information that she needed to accomplish this. Afterwards she mentioned that we needed to do this quickly because these programs could only cover charges that were no more than 90 days old. This was rather odd because the last treatment was 120 days ago. My father asked her if she realized it had been quite a few days beyond 90 days. She didn't really respond. We then began to discuss their contention that we would have to cover the January treatment. We explained to her what happened and she said that shouldn't have happened. She said she could work with us on this and mentioned a payment plan. My Father did not know what to say, and told her exactly that. She then began to tell us more details of the bill and as the conversation went on it was both clear to her and us that if they would have told us back in January that we could have gotten this worked out with another assistance program. She also told us what the costs of the 2 treatments were. The totals were not the same despite the visits being identical and every bill from them in the past being consistent from the last. My father did not yell at her or get angry. He was very polite and directly told them that he felt that these charges were their office's fault and not his. She did not dispute this but also did not offer us any sort of resolution. Now it seems we are stuck with a bill that may not be ridiculously high but is a considerable amount to my Father. I can cover the bill so that it will not be a burden on my Father but I feel that we should contest it before paying. Should we see a lawyer, threaten legal action or do something else? I really don't know and any advice would be greatly appreciated.
Thank You for your Responses