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View Full Version : How do we protect ourselves from over charging docs?


ryans
Oct 1, 2007, 09:30 AM
Went to doc cancer test, uterine. My test took all of 15 min. I had to pay separately for machine rental. I was charged $4,100.00 for this service. I had no insurance and my doc knew it. My daughter had a uterine aplason done by same doc and her bill was less. Am I wrong or am I being over charged? Is there any recourse?:eek: :confused:

LearningAsIGo
Oct 1, 2007, 10:49 AM
Have you called the doctors office to ask for an explanation? Even if your daughter had the same procedure, what you pay depends on your insurance coverage.
You may think your doctor knows you don't have insurance, but they really don't pay attention to that sort of thing. Even if you tell them, they aren't likely to remember.

Your doctor should have a pre-certification or billing person to look at insurance coverage before you are seen. This is much more common in a specialist's office such as Oncologists, but family practices may not have someone in the office to handle the DETAILS of coverage. Meaning, they might have a person who can tell you WHAT insurance they take but not what tests are covered, percentages, etc. If someone is not in the office though, they will have a contract biller who you could call. Doctors are regulated as to how much they can charge for what. Everything is coded (ICD-9 & CPT) so that they cannot over-charge. To help insure this, random audits are performed on doctors offices by insurance agencies who might suspect over charges. Therefore, its possible, though not likely that they overcharged you.

As a consumer, its really up to you to find out before tests are done. If you had insurance, you could call the 1-800 # to find out what's covered. Because you don't have insurance, you should have asked what the cost would be up-front. Talk to the billing staff about these things... you will rarely find a doctor who is up to date on billing procedures, ICD-9 codes, CPT codes and all the other factors you must deal with for reimbursement.

For now, give them a call and ask for an explanation of the charges. Machine rental... I'm not sure they can charge you for that... though I'm not 100% sure. You will probably be able to set up a payment plan to settle the bill if nothing else.

Good luck to you.

michealb
Oct 1, 2007, 11:02 AM
Bring your daughters bill and yours to the doctor and tell him that you think you were over charged. Deal with him as you would any merchant that has over charged you.