PDA

View Full Version : Should I file a complaint?


melou
Feb 12, 2009, 02:57 PM
I am 24 weeks pregnant. At 19 weeks I went in for my routine ultra sound. Everything at the check looked fine. Before I left with the doctor I told her that I would be moving to another state and having the baby there and I hoped to get in one more visit before leaving. The front desk clerk wanted me to pay a 30.00 co-pay and I told her that all my maternity visits were covered by my insurance. When I got the claim back they did not code it as a maternity visit. When I called them they said that I was complaining of lower pelvic pain and this is why the ultra sound was needed. The doctor called me at home saying that if I made them send this back in she would release me as her patient and make me pay all back co-pays. She also said that the reason why they coded it like this was because my insurance company does not pay for two ultra sounds and she liked to do two. I called to check on this and they do pay for two. I called the doctors office back to let them know and they have refiled but exactly the same. I think that she is falsifying my records to get money out of me and my insurance company. I am not sure if I should file a complaint against the State Board or not?:confused::mad:

twinkiedooter
Feb 12, 2009, 03:06 PM
YOu need to discuss this with your insurance company and see if in fact the doctor's office has improperly billed your insurance company for visits you didn't make and keep amongst other things.

melou
Feb 12, 2009, 03:17 PM
I have already filed a fraud claim with my insurance company. They advised that I do so. But should I take this a step further and file with the state?

LearningAsIGo
Feb 13, 2009, 01:51 PM
I have already filed a fraud claim with my insurance company. They advised that I do so. But should I take this a step further and file with the state?

Wait and see what comes of the fraud claim.