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Help Please, Health insurance question?


I visited my doctor a while back and he wanted me to undergo some exams. I had asked prior to the exams if any sort of pre-approval was needed from my insurance to see if it covers it, his staff told me no. Now, 2 months later I have received a bill from some debt collecting agnecy asking for nearly 4,000 dollars that I owe his office for the services provided. I am a current full time college student and have no idea what to do. Pls help, I feel as if his office really has wronged me and now I am stuck with this nonsense, but huge bill. (also after we found out something was up he didn't treat it and I ended up seeing another physician who ended up giving me a free supply of meds to treat it and without a bill that is a couple of thousand dollars) There just seems like something can be done about this, any help would be immensly appreciated.

I have not checked with my insurance company and I have no idea how this info got to this collection agency. I don't really have anyone to turn to also for help, so thank you to everyone who gives some advice.

Have you checked with your insurance company to see if claims were in fact filed and processed? You should have EOBs or other notifications. How did the debt get to a collection agency without the physician billing you first?

Check with the Doctors office and see if they submitted a claim to your insurance company. If they did it has apparently been lost and you should ask them to refile it. If they did not, you may have to file the claim yourself. Most physicians file there own claims but some do not. Maybe your insurance will still pay. You may also want to ask your insurance company if the test were covered. If so, they should pay the bill. I would also get into contact with the collections agency and tell them that there has been a hold up with the insurance and let them know if the insurance says they are going to pay the bill.
Good Luck

Yes, if it has only been two months, and no claim was filed, you just need to ask the service provider to file the claim. If they won't, you need to ask the insurance company for claim forms, so you can file the claim yourself.

The service providers would have sent everything to the collection agency. Are you sure it's a collection agency, and not just the billing department from the service provider? Two months is awfully fast to go to collections.

File a claim with the insurance company. Ask them for instructions on how to do this.

1) If your insurance company said no claim was filed, it means that they weren't billed for the services. They didn't pay b/c they weren't billed. The doctor's office needs to bill your insurance company so that they can pay their portion. After your insurance company pays, you should receive a corrected bill for whatever is left as your portion.

2) It is ultimately your responsibility to confirm with your insurer whether or not procedures are covered, need prior authorization, whether a specialist they want to send you to is in your network, etc. Your doctor's office may try to be helpful and give you the information as best they can. However, if they make a mistake, you're still liable for the bill. Don't just assume that your doctor's office has all the answers regarding your insurance policy - always call your insurer directly. Its the only way to protect yourself. If your doctor's office makes a mistake regarding your benefits, your insurance company will still consider you liable for the charges. Always protect yourself by getting the info directly from your insurance company.

You are going to have to proceed with caution as you approach your insurance company for coverage.

First you need to get an original copy of the billing. Second a claim of that size usually always needs to be pre-authorized by an insurance company before you get the service.

You may still have hope though, depending on what they billed you for. Doctors offices bill health plans by codes. Each service provided can fall under a different code. Some codes will have limits under your insurance policy and some will not, meaning more could be billed to that code.

You really need to get the bill and then review your insurance policy coverage with your insurance company.

I also would report this guy, seems he is trying to scam you!

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