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View Full Version : How do I dispute a physician bill that insurance has already paid?


agolli
Oct 18, 2009, 07:17 PM
My father recently had an MRI done. He had tried 3 times without sedation and could not lay still due to pain. The decision was made to have him sedated by an anesthesiologist for the MRI. My dad told the MD how difficult it had been for him to lay still and flat. He specifically asked that he do whatever necessary to get a good MRI, regardless of recovery time. (This was in a outpatient capacity and different meds would mean a longer "wake up" time.) He was lightly sedated and moved which made the MRI invaluable to the neurosurgeon. After seeing that scan, the doctor (neurosurg) decided to have a CT instead of risking another bad MRI scan. Now the anesthesiologist wants to be paid. How can we dispute at least our part of the bill, since the anesthesiologist didn't really do his job? We have called the office, but they refuse to talk about it. What are the steps needed to take?

We are in Texas, if that matters.

Someone else had told us as long as you are making a minimal payment per month, it can not be turned over for collections- even $5/month- is that true?

Fr_Chuck
Oct 18, 2009, 07:23 PM
He was there, he did give drugs to a point, although it may have not been enough it may have been all he felt OK with giving at a outpatient.

I don't see personally why he should not be paid

artlady
Oct 18, 2009, 07:24 PM
Sadly,that's the way it is,as far as I see it.I am not a legal expert but I do follow the law and fight for patient rights.

The doctor gave his time as promised and he had no idea your Dad would move.

One of those ,you just have to eat it deals.

The doctor delivered on his part.

Don't waste you time fighting this,its not worth it.
I wish you and your Dad the very best!

KISS
Oct 18, 2009, 07:30 PM
invaluable is one of those stupid words in the English language. See: Invaluable Definition | Definition of Invaluable at Dictionary.com (http://dictionary.reference.com/browse/invaluable)

I do believe you meant to say nearly useless or useless in your post.

nikosmom
Oct 18, 2009, 07:30 PM
You still owe for the bill because the anesthesiologist did do his job. He was paid to put your father under light sedation. You still owe for his time and the medicines he used. Putting your father under light sedation was in no way a 100% guarantee that he wouldn't move. You still owe.

In regards to how you pay- is your insurance picking up the tab for any of this? If not, the office may be able to set up a payment plan for it. Are the people at the office unwilling to talk about a payment arrangement or are they unwilling to talk about the billing dispute?

agolli
Oct 18, 2009, 07:32 PM
True, he did give his time, but he did have some idea that he would move. All the previous attempts were at the same facility and one of those was with Valium. They discussed it prior to the exam and even discussed using Propofal versus Fentanyl/Versed combo per an earlier discussion with the doc who ordered the MRI. I work in a pediatric hospital and this seems a bit ridiculous. His "services" actually cost my dad MORE money in the end. Had he gotten the Propofol in the first place, he would have been fine. This anesthesiologist DOES use it, just didn't in this case.
As you can tell, I don't like the possibility of just having to pay it. It seems like a big rip off.
But thanks for the responses!

agolli
Oct 18, 2009, 07:36 PM
There are many different levels of "light sedation." He did require an IV for medications given. And in looking at it, they may have actually gone the more expensive route with 2 meds vs. 1.
The billing part of the office refuses to talk about any charge dispute. We really don't want to even talk about a payment plan until we are ready to pay. Seems like the services only worked about 70-80%, should only have to pay that much...

nikosmom
Oct 18, 2009, 07:37 PM
First, I'm not a doctor so I'm not familiar with all the drugs you named...

But I will say that often doctors want reserve stronger drugs for extreme cases. They probably started with one particular type to be sure there'd be no adverse effects. No, they had no way of knowing for sure that he'd move with certain drugs.

A lot of medical expenses may seem like a rip off... maybe I should've been a doctor after all. ;)

justcurious55
Oct 18, 2009, 07:58 PM
I like this logic. I think I'll try it next time I go out to eat. If the food only satisfies me part way, I'll just pay part of the bill. Wonder how the restaurant will like it...

If you have a medical background, and seem to understand how the drugs work, and know that which drugs to use were discussed beforehand, why didn't you step in and insist that the other drugs be used? Regardless if the outcome was what was hoped for, the procedure was still done.

BriBri2317
Oct 22, 2009, 04:51 AM
There are many different levels of "light sedation." He did require an IV for medications given. And in looking at it, they may have actually gone the more expensive route with 2 meds vs. 1.
The billing part of the office refuses to talk about any charge dispute. We really don't want to even talk about a payment plan until we are ready to pay. Seems like the services only worked about 70-80%, should only have to pay that much...

Regardless of how well the sedation worked, the anesthesiologist still performed his duty and therefore you owe the bill. There is nothing that can be done to make the bill go away. Perhaps the hospital or clinic that your dad went to has a patient relations department which you could file a complaint with. I work in a billing office for a major mid-western hospital and while I understand your frustration once a service is rendered the balance is owed, bottom line.
As far as turning a balance over to collections making a five dollar a month payment on a large balance does not guarantee that it can not be turned over to collections. This is a mis-conception. I am not familiar with the laws in Texas however I see accounts every day that have been turned to collections in spite of patients making payments. The only true way to avoid the account going to collections is to either pay the balance in full, or set up a formal payment/budget plan with the hospital. Make sure that you specify an amount due every month as well as the time of the month these payments are due. If you do not make payments according to their guidelines they are within their rights to still turn the account to collections. Which may or may not be reported to a credit bureau depending on the laws in your state. The other thing you can try to receive a discount is ask the billing office if you pay the balance in full they offer a percentage discount. Some hospitals do.
Sorry that there is really nothing you can do in this situation, I do understand how frustrating it can be. But once a service is rendered there really is no way of disputing the bill. I would in the future discuss in greater detail the services to be rendered before they are done. Hope this helps.