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Medical Billing Requirements Patient Rights

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ronrepp

Junior Member
What is the name of your state (only U.S. law)? Massachusetts

This is not a malpractice question but it is related to healthcare and this forum was the closest I could find related to this industry. I am trying to find out if medical service providers are required to provide a detailed itemization including description of services and associated costs for all services provided to patients. I pay for services from a medical provider directly and in order for me to be reimbursed for out of network services by my employer provided medical insurance, I must provide a detail of services including CPT medical codes for each service provided and associated cost. However the provider in question claims they charge an "all inclusive" fee and refuses to provide detail to me for the specific services and the associated cost. However this provider also accepts patients with Government backed health insurance, (medicare, mass health), and DOES provide specific service detail and associated charges to these insurance providers in order the receive reimbursement. So basically as a private pay client I am not receiving the same level of service from this medical provider as a patient with Government sponsored insurance. So what I am trying to find out is if there are specific laws, rules, or regulations, for medical providers related to billing practices and who the agency would be to assist me with enforcement.

Thanks,

Ron
 


Zigner

Senior Member, Non-Attorney
Ask them for a claim form that you can submit to your insurance company.


ETA: Or, find another doctor.
 

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