Question about copays

[APFSR]

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

My doctor's office is trying to charge me extra if I come into the office without my co-pay - IE - in an emergency situation when i come strait from work and do not have my wallet. I am a tradesman and do not carry cash from job to job. They are telling me they can charge me a fee - even though I have insurance to cover the visit - and sometimes do not have a co-pay if my deductible is met. Is this legal?? Do they have the right to charge me if I come empty handed??

 

[You Are Guilty]

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

My doctor's office is trying to charge me extra if I come into the office without my co-pay - IE - in an emergency situation when i come strait from work and do not have my wallet. I am a tradesman and do not carry cash from job to job. They are telling me they can charge me a fee - even though I have insurance to cover the visit - and sometimes do not have a co-pay if my deductible is met. Is this legal?? Do they have the right to charge me if I come empty handed??

Are you asking whether its legal for them to charge you a late fee? If so, the answer is Yes.

 

[ecmst12]

That is a question you will have to ask your insurance company. While no LAW prohibits them from charging this fee, it's possible that their contract with your insurance company does.

 

[cbg]

It's also quite possible that your insurance policy requires that you make your co-pay at the time of the visit. Certainly your doctor's office can have such a policy, and yes, it's legal.

 

[lealea1005]

The Doctor may be trying to cover the fee s/he has to pay their billing service to bill you for your copay.

 

[momm2500]

if they are charging you more than your co-pay then you need to contact your insurance company. this could possibly be in violation of their contracted agreement if they are a participating provider of the PPO.

 

[lealea1005]

if they are charging you more than your co-pay then you need to contact your insurance company. this could possibly be in violation of their contracted agreement if they are a participating provider of the PPO.

The way I read it is that the office is only charging the additional fee if the patient shows without their copay. I see it no different than a bad check fee, or a fee to fill out forms. It cost approxiately $5 to generate a bill to send to a patient, not to mention a percentage of the collection of that bill also going to the billing service.

OP knows his Physician's (and probably his insurance company's) office policy is for copays to be paid at the time of service. He should keep that amount in his wallet, just as he would if he unexpectedly needed to stop at the gas station or the grocery store on his way home from work.

 

[ecmst12]

While I agree that it's stupid to go ANYWHERE without at least a check or credit/debit card with access to $25, that doesn't change the fact that it COULD be a violation of the provider's contract to charge the patient more then his copay in this manner.

 

[You Are Guilty]

While I agree that it's stupid to go ANYWHERE without at least a check or credit/debit card with access to $25, that doesn't change the fact that it COULD be a violation of the provider's contract to charge the patient more then his copay in this manner.

But even if it is a breach of contract, that doesn't mean it's "illegal", which I think is the question that was asked.

(Then again, since the OP never bothered to come back, I don't know why I'm even bothering to write this.)

 

[ecmst12]

A breach of contract is sort of illegal under contract law.

 

[You Are Guilty]

A breach of contract is sort of illegal under contract law.

Under common legal usage, a breach of contract is considered a breach of contract. Breaking a penal law is "illegal".