Can I dispute a medical bill if my doctor's staff lied to a disability ins. company?

[TNUtammy]

Can I dispute a medical bill if my doctor's staff lied to a disability insurance company?

I have been having trouble for over a year now with trying to get a short term disability case approved by Cigna. There have been several issues with the way my case has been handled, both by Cigna and the doctor who originally approved my leave of absence from work.

My case has been denied twice now by Cigna, so this time I requested my complete case file from them before sending in my 3rd and final appeal. What I found in my file about what my doctor's staff told Cigna completely threw me for a loop.

The receptionist who took the call actually told Cigna that my doctor 1.) did not take me out of work, 2.) did not list any work-related restrictions, and 3.) wrote in my file that I did not have any severe symptoms.

Obviously this is the reason why my case was denied, despite the fact that the office notes written by my doctor about this visit state the exact opposite! My doctor DID take me out of work, DID state that I could not function at work, and DID list my severe symptoms.

When I went back to the facility (several times) asking that they send in a statement proving this, they outright refused. I have been unable to pay off the rest of my medical bill to this facility because I have not yet been paid by Cigna.

I highly doubt that I am ever going to receive my disibility pay from Cigna because the doctor and their staff will not send anything else in. Now my doctor's office is threatening to send my account to collections, but it is actually their fault that I do not have the money to pay the bill in the first place.

I plan to dispute the remaining bill, about $80 (I know it's not that much but I really do not think I should have to pay for the trouble they have caused me, not to mention the fact that they have cost me 3 months of pay).

Does anyone know if it is possible to successfully dispute this kind of thing? I know that you can dispute whether or not the bill is yours, but what about disputing that you did not receive the service promised to you? In fact, the facility in question has been very counterproductive to my cause (which is a difficult case in itself).

I would really appreciate any answers about a similar experience or insight into the process for filing a dispute. I am going to send a letter to the doctor's office and hope that it doesn't go to collections, but if it does then I will need information about how to proceed.

I would also prefer to do this without paying for a lawsuit. Even if I won the case, I would probably only recover the 3 months of pay I lost and then end up giving it right back to the attorney to pay my fees. However, I would be open to requesting a mediator or state funded attourney if there is a chance that I could recover the 3 months of pay I should have been entitled to.

Thanks.

Edit: I am not sure why this post is being placed under Auto Accidents since I am trying to post it under Debt Collections.

 

[ecmst12]

No, this is not a valid reason to dispute a bill. Maybe if you paid the bill, the doctor would be willing to send the information you need. Have you spoken to the doctor directly?

 

[lya]

TNUtammy,
You need an attorney to handle this for you. You are attempting to deal with CIGNA's disability department and it is my opinion that it is a section of hell run by the devil himself. Got any letters from SL? I've never reviewed a disability claim problem when dear old SL wasn't involved.

You aren't getting anywhere with your physician.

An attorney can cut through the crap and get this straightened out for you.

 

[TNUtammy]

To ecmst12:

Yes, I have talked to my doctor and her superiors many many times and they still refuse to correct their mistakes. They stopped helping me before this bill was even due, so I highly doubt paying it will make them change their minds.

To lya:

What is SL? Also, there apparently aren't any lawfirms in my area that handle short term disability cases, only long term. Their reasoning is that the only money that can be recovered from short term is just a few months worth of pay, and it costs at least that to pay the legal fees.

I have looked at a lot of options and I think it will just be best to cut my losses and move on. However, I'm not going to pay any more money to these crooks, so that's why I want to dispute the medical bill. Even if it goes to collections, they still have to listen to my side of the story right? I find it hard to believe that anyone (even a doctor) can charge you for something that they failed to complete, so there has to be a way to dispute it.

Also, I forgot to mention that this doctor initially asked me to make an appointment with her every 2 weeks during the illness, which I did since I thought it was necessary. However, everytime I went in she did less and less to help me, didn't treat my illness, and didn't fill out the paperwork correctly. Then when I asked for a copy of my office notes I saw that she wasn't even writing down what I had told her during the visit. The only notes that were decent were from the inital visit, and these are the notes that discredit the statement that the receptionist made to Cigna.

To me it looks like she initially put me on short-term so that I would keep coming back every 2 weeks, even though she didn't really plan on helping me with Cigna. I have paid the bills for all the other office visits, regardless of the fact that she didn't really do enough to earn what I paid her then either. I couldn't really do anything about it then because I didn't have any proof, but now I have the proof from Cigna that the receptionist lied to them and cost me the case. Is this still not sufficient proof to dispute at least one of the charges on my bill? It's only one of the several office visits that I haven't paid for yet.

 

[ecmst12]

You received the service (had the appointment), you have to pay.

 

[TNUtammy]

To ecmst12:

Do you have any insight into the collections process if I don't pay? I'm looking for information like if they will review the situation or the documents I have if I send them to the collection agency.

 

[ecmst12]

If you don't pay, you get black marks on your credit report, and you could get sued.

 

[TNUtammy]

That wasn't exactly what I asked. Somehow I don't think I am getting anywhere with this so I am going to close the thread. If anyone has more insight into the collections process I'd appreciate it if you would PM me.