Not fair bill from US Healthworks medical clinic

[Dimu4]

I visited US Healthworks medical clinic(San Jose, CA)

I had urine infection and they did 1 analysis and wrote me prescription.

Before i saw doctor, i asked helpdesk 5 times is it going to be free - they checked my Medi-Cal insurance and told that it is going to be 100% free for me. After 3 month they are sending me bill for 363$

- Why do i need to pay, they told me that it's going to be free?

- Why the bill is so high, in this area all clinics charge 60-80$ for this procedure?

- What should i do?

 

[Zigner]

I visited US Healthworks medical clinic(San Jose, CA)

I had urine infection and they did 1 analysis and wrote me prescription.

Before i saw doctor, i asked helpdesk 5 times is it going to be free - they checked my Medi-Cal insurance and told that it is going to be 100% free for me. After 3 month they are sending me bill for 363$

- Why do i need to pay, they told me that it's going to be free?

- Why the bill is so high, in this area all clinics charge 60-80$ for this procedure?

- What should i do?

Apparently your Medi-Cal insurance didn't cover the bill, so you are now responsible for it. We can't comment on the amount - you'd have to discuss it with them. You may wish to contact them and see if they have some sort of payment plan and/or low income assistance available.

 

[Just Blue]

I visited US Healthworks medical clinic(San Jose, CA)

I had urine infection and they did 1 analysis and wrote me prescription.

Before i saw doctor, i asked helpdesk 5 times is it going to be free - they checked my Medi-Cal insurance and told that it is going to be 100% free for me. After 3 month they are sending me bill for 363$

- Why do i need to pay, they told me that it's going to be free?

- Why the bill is so high, in this area all clinics charge 60-80$ for this procedure?

- What should i do?

Call the insurance provider and make sure that the clinic is cover under said insurance. If the clinic is covered see if they paid the bill for this visit. It, possibly, could just be a mistake on the Dr. Office...

Best of luck.

Blue

 

[justalayman]

is the bill from the provider themselves or is it a charge from a lab or some other service that ran the labs?

- Why do i need to pay, they told me that it's going to be free?

did you call them and ask them?

- Why the bill is so high, in this area all clinics charge 60-80$ for this procedure?

did you call them and ask them?

- What should i do?

call them and ask them the other two questions.

 

[cbg]

I tell people and tell people and tell people.

DO NOT RELY on the doctor's office to find out what your insurance covers. DO IT YOURSELF.

It's your responsibility, anyway - not the doctor's. And if YOU do it, and you later get billed for what you would be told would be covered, you have some recourse. (We will assume that you take the elementary precaution of getting names and extension numbers.)If the doctor does it, you may be SOL.

But do follow the above suggestions.

 

[justalayman]

I tell people and tell people and tell people.

DO NOT RELY on the doctor's office to find out what your insurance covers. DO IT YOURSELF.

It's your responsibility, anyway - not the doctor's. And if YOU do it, and you later get billed for what you would be told would be covered, you have some recourse. (We will assume that you take the elementary precaution of getting names and extension numbers.)If the doctor does it, you may be SOL.

But do follow the above suggestions.

I would make an argument for detrimental reliance. If the doctor is going to go as far as stating it won't cost anything without a ton of disclaimers, I see no reason their statement cannot be relied upon as being factual.




I suspect the doctors position is not going to be so clear that they said it would be a no charge issue.

 

[cbg]

I doubt very much if anyone at the doctor's office is going to support the OP's story.

And I question whether the doctor actually said what the OP claims, or whether that was what the OP wanted to hear, so that's what he heard.

 

[JuanRoth]

I doubt very much if anyone at the doctor's office is going to support the OP's story.

And I question whether the doctor actually said what the OP claims, or whether that was what the OP wanted to hear, so that's what he heard.

I to think the same.

 

[ajkroy]

In my experience, I have seen Medicaid recipients lose coverage, be reinstated, and lose it again all within a month. It all depends upon your eligibility on the date of service and upon whether or not you complied with your caseworker and supplied the required documentation in a timely manner (most states require frequent checks of income, housing status, family status, assets, etc. for continued coverage). A Medicaid patient can also legally become ineligible retroactively, which means that the clinic can verify your coverage on the date of service and Medicaid can drop you after the fact for a date before your service date.

Check with your caseworker and go from there.

 

[Dimu4]

Thanks everybody for advices.
For continuing of situation, i need to ask your help again, i am very new to this country and really don't want to be cheated.
My insurance respond to me: "We show that US Healthworks is not in your HMO network. With an HMO plan, you must call your Primary Care Physicians office when you need urgent care services, and they will direct you to an urgent care that is in your network."
As i understood i will have to pay this bill myself. Is there any way to recalculate their bill? Because i know that 5 minute clinics like CVS charge $60-80 for the same procedure, and here i received a bill for almost $400.

 

[Zigner]

Thanks everybody for advices.
For continuing of situation, i need to ask your help again, i am very new to this country and really don't want to be cheated.
My insurance respond to me: "We show that US Healthworks is not in your HMO network. With an HMO plan, you must call your Primary Care Physicians office when you need urgent care services, and they will direct you to an urgent care that is in your network."
As i understood i will have to pay this bill myself. Is there any way to recalculate their bill? Because i know that 5 minute clinics like CVS charge $60-80 for the same procedure, and here i received a bill for almost $400.

You are free to speak with the other party ask if they are willing to reduce the bill. It can't hurt to ask.

 

[Zigner]

[/B]Because i know that 5 minute clinics like CVS charge $60-80 for the same procedure, and here i received a bill for almost $400.

CVS doesn't do lab work, nor do they write prescriptions.

 

[cbg]

Is there any way to recalculate their bill?

That depends on what you mean by that.

If you mean, is it possible? In the literal sense, can it be done?, then sure. If they are wiling to recalculate their bill, it certainly can be done. It doesn't do any harm to ask them. If they choose to do so, they can.

But if you mean, is there any law I can invoke that will force them to recalculate it, then no.

 

[t74]

Thanks everybody for advices.
For continuing of situation, i need to ask your help again, i am very new to this country and really don't want to be cheated.
My insurance respond to me: "We show that US Healthworks is not in your HMO network. With an HMO plan, you must call your Primary Care Physicians office when you need urgent care services, and they will direct you to an urgent care that is in your network."
As i understood i will have to pay this bill myself. Is there any way to recalculate their bill? Because i know that 5 minute clinics like CVS charge $60-80 for the same procedure, and here i received a bill for almost $400.

It was your error in not checking to see if the clinic was in the network. PAY THE BILL.

 

[ecmst12]

CVS doesn't do lab work, nor do they write prescriptions.

The Minute Clinics at CVS are staffed by nurse practitioners. They definitely run labs and write prescriptions, which you can conveniently have filled at their pharmacy (or not, your choice).