“My insurer billed me for in-network care!”

Same story, in my case the office confirmed they were in my network, my insurance company’s “catalog” of doctors listed my doctor and the office confirmed by phone as well when I called to double check. After 2 years I got a bill for over 12k. Turns out that this doctor had somehow been listed when they didn’t accept my insurance. The billing secretary at the doctor’s office took 2 years to contact the insurance agency by phone to find out why payment had been denied so consistently. The answer I got from the doctor’s office was - they used the same insurer guide as me, so they all thought they were telling me the truth. Since it was a “simple mistake” no one in the office would admit responsibility and felt I should pay. Sounds unbelieveable right? My solution? I went to the health center, after making sure I wasn’t breaking any laws or local ordinances, and while holding a sign that covered the basics of the situation I handed out copies of my story. At the time I was under going serious treatment that caused my appearance to be very pale and frail. I often had to sit to catch my breath in the parking lot. After about 20 minutes one of the secretaries charged up to me and informed me that the police had been called and I was going to jail. I asked what my offense was, and she informed me that printing libelous material and giving out personal information about the employees at the doctors office was illegal. At this point the police actually did arrive. The very nice officer explained to the secretary that her name and the names of the other employees were publicly posted in the lobby, not private information. He also let her know that her options were to sue me, not have me arrested. He then wrote her a ticket, wrote a ticket to the billing secretary for calling 911 and told the doctor he was an a**h*** for allowing a woman who obviously needed medical attention to wander around the parking lot and then calling the police and not an ambulance. I also took great pleasure in letting her know, “it’s not libel or slander if it’s true honey.” I then continued to return about 3 days a week, sometimes for an hour, sometimes for 15 minutes to do the same. Almost every time someone from the office would come out and harass me verbally. After about a dozen visits the collection agency stopped calling and I received a letter forgiving my “debt.” The damage was done though. The doctor closed his practice and left town taking none of his staff. Turns out nobody wants a heartless jerk for a doctor, especially one that hires vicious incompetent staff. Some would say I should have gone for the insurance company, but honestly I was his patient for 2 years, I asked these women about their kids while I was in the waiting room and the minute they found out insurance wasn’t paying they canceled my future appointments and had me barred form the building and sent me to collections. All without telling me. I showed up to see my doctor and was escorted out of the elevator by security. When I called to find out what the mix up was they hung up on me after I said my name. I got a call from collections 3 days later still having no idea what was going on. They deserved to be run out of town on a rail. I ran into one of the women in the grocery store about a year later, she yelled that I had ruined her life and she hadn’t had a job since I “put them out of business.” I calmly told her it was a mess of their own making, all I had done was tell the truth to everyone that walked into their building. If their behavior hadn’t indicated serious incompetency and an inability to be decent human beings, my efforts would have had no effect. Her response? “I wish you had just died.” Nice huh?

I’ve heard this story before, but it is almost as if I was being cheated by the office staff. I would assume when one mentions ‘my insurance’ over and over that the staff should expect that we want our office visits paid for by insurance. I had two policies, and even stopped seeing that DR. for a time because that DR was not in either network. I thought because we were back with some Co. we had before that we were covered at this office again. NOT SO, the liar at this office took my insruance cards & made the copies just as if they were participating in those plans and never said a word. Not a word until it was time to send me a bill, when I asked about participation she said “oh we participate, out of network” well neither plan covers a cent for us if we go out of net work. So now I pay $1.00 a bill. I just can’t believe she did not say they did not belong to either of these plans. I even had discussions with her about returning to this office because they were in our plans network now, due to my husbands Co’s ever changing insurance plans. I just feel this was VERY decietful on her part.

So the lesson is, ask this question every time and perhaps we should have a form for them to sign stating it is so, ARE YOU PART OF
%#&*^%#@’S INSURANCE Co’s NETWORK
TODAY??? and we should get it in writing.
Have a great day!

I have similiar issue with United Healthcare. I called them and verified an acupuncturist office was covered by them. I had treatment at this office and they did accept my insurance card. Issue is I saw the wrong acupuncturist. United Healthcare and the acupuncturist never told me their contract was only with one person in the office. The office is trying to work it out with United Healthcare and I am hoping I am not held for the entire bill. I think the office should at least take half the blame.

archive.org allows you to view cached versions of websites as they existed on certain days. Depending on the time frame and traffic at the website, there may be several snapshots of the site throughout the year. This would allow you to see exactly what was posted on the website, and when.

I work in the billing office of a prominent oncology practice in Raleigh, NC and can relate to this dilemma all too well. The person who wrote in should be held just as liable for the bill as the office. The person should have verified themselves w/ UHC on the phone whether or not the office was going to be a PAR provider around the time that treatment was going on and the office as well should have verified coverage and benefits when the person was coming in for treatment.

I agree with the physician that said
to hold the office accountable since
they accepted the insurance card at the
very beginning. It’s not believable to think that the person at the front desk doesn’t know which major insurers
the doctor is on panel with!

As a retired physician, and previous chair of our State Insurance Committee, I feel that this patient also has an axe to grind with the doctor she saw. It is up to the doctor (or their staff) to advise the patient if they’re no longer on the panel when they ACCEPT your insurance card. You should go back to the doctor and demand a partial refund.

Sanjosemike

UHC is one of the worst to deal with when trying to resolve a dispute, whether you are a patient, doctor or hospital. They aren’t too concerned about customer satisfaction because they keep their rates low enough to attract lots of employer-sponsored plans. Check with your state’s insurance department or office. They are usually very helpful.

I don’t think rob from ottawa is familiar with U.S. insurance companies - to the contrary, some of their websites are updated manually - and expecting straightforward efficiency from a health insurance company is really quite laughable, at least in my experience - they are large, unwieldy, inefficient bureaucracies that have excelled at one thing - figuring out how to create insurance programs that are so complex that consumers are left completely in the dark while profits can be maximized

I am going through a similar situation with UHC. My gripe is the lack of customer service. Shouldn’t they want to keep us as customers? They have made the process unbearable!

I was in the same situation. Luckily I printed my web search and had the dated hard copy as evidence. Game over for the insurance company. It galls me that they fall back on the excuse of the web site being out of date when most of these outfits suggest you use their websites (while waiting on telephone hold!)

This is basic UHC ‘gotcha’. If this consumer did not have the energy or savvy to contest, and many ill consumers do not have the energy, then she would be stuck in bill collector hell and the carrier could not care less. If UHC changes it terms and conditions so frequently that its own webmasters cannot stay current, why should it reasonably expect its customers to stay current?? How about a little customer focus UHC?? How bout cutting your CEO salary by a million or two and hire a few more webmasters??

It’s not about webmasters keeping up, web pages draw that sort of information in real-time directly from corporate databases, so updates like that occur if not within a couple of minutes, then within a few hours.

It would be wholly impractical for any website to maintain that sort of information manually, so it’s quite safe to day that the information comes directlty from the corporate database.