Medical Bill

[will1980]

What is the name of your state (only U.S. law)? AZ

I'm not sure if this is where I should post this or not, but thouoght I'd try here.

Beginning of 2008 my Dr changed partnerships. I checked with his new office to make sure they accepted my insurance and they said they did. I went to his office in March and everything went fine. I paid my copay and the insurance paid the rest.

Went back in November 4 times, each time they took my copay. I received a letter from the Dr's office in January 2009 saying that in October 2008 they stopped accepting my insurance and that I owe them $2,900 from the 4 visits in November. They also apologized for not telling me. If I would have known they didn't accept my insurance I would have changed Dr's. Do I have any recourse?

Thanks

[lealea1005]

If they are not contracted with you insurance company, they can bill and collect their regular fees. You may try speaking with their office manager to see if you can negotiate your payments to the amount that your insurance would have paid if the office was still contracted. Ultimately, it is your responsibility to check with your insurance company to see if a Physician is in network.

[cbg]

Rule of thumb: If you ask any given doctor's office if they accept any given insurance, they will say yes. If the insurance company sends them a check, they will cash it.

What you want to ask is, Are you a participating provider with (fill in the blank with both carrier and type of policy (HMO, PPO, POS, etc.) ) insurance?

You'll get a much more accurate answer that way.

[will1980]

In March they were contracted with my insurance company. They did not renew their contract in October. I went back in November they did not tell me that they no longer accept my insurance. Shouldn't they have some responsibility to tell patients. This change could have affected quite a few patients that now owe thousands of dollars.

[cbg]

As I keep telling people, your insurance is your responsibility, not your doctor's.

It's a shame this happened but I really don't think it reasonable to expect your doctor to go through every one of his patient files looking to see who has what coverage and sending them out a notification.

Tell me, if your insurance changed tomorrow, would you immediately call your doctor's office and tell them? Or would you (like most people) wait until your next visit and then update your record?

[ecmst12]

All my doctors now request to see my insurance card at every visit to make sure nothing has changed. I won't disagree that when the desk person took your card in november, she had a MORAL obligation to say, oh I see you're with X company, just so you know, we terminated our contract with them last month. Doctors offices don't usually drop contracts lightly and there was most likely a lot of aggravation and negotiation prior to making the decision to drop it, so I would think even the front desk person would know unless they were brand new or something.

However, it's still not a LEGAL obligation. You received the services, you owe the bill, and you have the primary responsibility to verify coverage before receiving services. Hopefully they will negotiate a discounted rate for you.