Doctor cancels subscription to insurance

[webname]

My doctor was previously considered a "network provider" through my insurance company, Unicare. This is the reason I selected her. Everything has always been covered under my plan except for a $20 copay/visit. Unbeknownst to me, she canceled or did not renew her subscription with my insurance company. I was never made aware of this. In fact, I have documents from her office in which her staff hand- wrote my insurance information for submittal to my insurance company. I recently received a bill from the doctor, stating that I am responsible for $400 in medical bills from standard check-ups in March & April of 2000. Confused, I turned to my insurance company which informed me that my doctor no longer had a subscription with them as of 12/31/99. I am only now seeing these invoices from over 9 months ago. Please let me emphasize that I was NEVER made aware of this change. Am I still responsible for this payment? I selected this doctor in 1999 specifically because she accepted my insurance. Is it my responsibility to have her verify her subscription EVERY time I go to the office, even though her staff continues to act as though my insurance is accepted? Shouldn't they have notified me in some way? I don't think I should have to pay this but I don't want the doctor to damage my credit rating either.

Chicago, IL

 

[ALawyer]

The doctor should have notified you at or before the visit, and certainly should have told you after the first visit was rejected by the insurance company. She can not go on hiding the fact from you. (On the other hand once the insurance company notified you hat it would not pay you would have been placed on notice.)

I would suggest telling the doctor that you will NOT pay the doctor anything beyond what the insurance will reimburse you for going out of network. Also, her bill to you is the retail price -- and we all know that other health plans pay her a fraction of that, so if you have to compromise, that's a basis for compromise.