Billing question

[BrotherHolmes]

What is the name of your state? Utah

My doctor suggested I get physical therapy. I then looked online for places near me. I found this one and called them to ask them if my insurance would cover the cost. They said only if you also get chiropractic care as well. I then said I need to ask my doctor. The doctor said it should be okay, but they thought it was weird that the insurance wouldn't cover it unless I got the chiropractic care too. Then considering the insurance would "cover" the cost. I went there for my care. I had gone there for two months and not once did they ever mention me owing any money. If I owed them money, I could then make an educated decision to stop going there. A couple of weeks after I stopped going there because I had my surgery I get a bill for about $700! I sent an email to the email address they had on their website about a week ago and I haven't heard back from them yet.

Any advice would be very appreciated!

On a side note: I have been having lower back pain since I have been to him and he used something like a jack-hammer on my back. Also, he was taking x-rays with no lead shield. I think x-rays are very directional, but that was a little close to you know what and I had a sperm analysis a couple of days afterward that came back abnormal. Was it because of the x-rays, I'm not sure.

 

[quincy]

What did the $700 cover?

 

[PayrollHRGuy]

It is not the responsibility of the Doctor or Doctor's office to know if your care is covered under insurance. That is between you and your carrier.

Have you received an Explanation of Benefits (EOB) from your carrier? If not get one.

 

[quincy]

Curious: Did you have a sperm analysis BEFORE the X-ray or only AFTER the X-ray? There is pretty much no risk of harm to sperm or eggs from diagnostic x-rays.

 

[cbg]

What kind of insurance do you have? HMO, POS, PPO, HDHP?

 

[phoebelambert]

in my opinion, if you owe them any money they would have mentioned it to you on your first visit. I think they are just messing with you and taking a chance if they can get money from you.

 

[Zigner]

in my opinion, if you owe them any money they would have mentioned it to you on your first visit. I think they are just messing with you and taking a chance if they can get money from you.

Your "opinion" means nothing. The OP owes the money for the services that were performed that weren't covered by insurance.

 

[Just Blue]

in my opinion, if you owe them any money they would have mentioned it to you on your first visit. I think they are just messing with you and taking a chance if they can get money from you.

@phoebelambert ...This is a US site. Your "advice", based on your experience working in the social media department of a UK Law firm, is irrelevant here.

 

[Dragonbits]

This could be an expensive lesson.

You checked with everyone EXCEPT the most important entity, the company paying the bill.

If your health insurance has online access to look at your claims, go there to see if those bills were submitted and rejected, otherwise known as your EOB. That is the quickest way. As PayrollHRGuy stated, you should get a paper statement from your carrier about your (EOB), but it's significantly delayed, often you can get bills from months latter that bounced around the system only to eventually get rejected and sent to you to pay.

Assuming the bills were submitted to your health care provider, find out why they were rejected.

It's possible that the bills were coded in such as way as to get rejected, it's possible but not likely that the physical therapy place could resubmit the bills with a different code that would get paid.

An important item you haven't mentioned / checked, was physical therapy covered but chiropractic care rejected. Were part of the bills paid?

It's quite possible that chiropractic care is not covered at all by your health insurance. You need to contact the health care provider to find out what happened.

It also depends on what sort of insurance you are using, medicare has a lot of safeguards that often can prevent you from being charged for bills that aren't approved. Though I have medicare and once had to pay a bill for a blood test that cost $179 but I could have bought online for $40, and if the doctor had coded it a different way it would have gotten paid. Or I could have indicated on a form that the blood test center gave me that I would not pay for bills that medicare rejects. I see one special type of blood test I took in Dec 2018 that cost $500 and medicare rejected, I haven't gotten a bill for that, but I am not gong to be shocked if a bill finds it way to me. Or maybe not, it depend on if the blood test company accepts medicare assignment. Medical billing systems are at best arcane and difficult for most to decipher.