Help billing issuea

[lovely29 19]

Hi all so my doc who is out of network took advantage of me. Prior to procedures I was told that he would accept what insurance gives him and after this whole thing he billed a redic amount to insurance and only got portion of his bill so now he is billing me the crazy difference and apparently bc he is our of network he can do it. Any one know any legal grounds here I mean he waived my copays due to hardship he promised he wouldn't bill me anything I did not sign anything but also don't really have much execpt verbal conf

I don't regret any decision in my life because at the end I will make it work

[labwalker 1,177]

This could be a screw up with his billing department. I'd suggest you call and talk to him. Agreements like this should be in writing. But, give him the benefit of the doubt first, and call and talk to him.

[brianb 81]

It seems like in the US, the average rate for lap band is 15k. And if you are below 35 BMI, it's typically 10k from what I've seen.

If he charged over that amount, I would suggest negotiating with the office and only pay up to what is reasonable. (Might need to do some research to find WLS prices in your area.)

I wouldn't give them 1 cent though until I got something in writing that clearly states what they require to release you from any money/debt due.

Wish I could help more. Hopefully someone else who has experienced this will jump in.

[homestead16 12]

^{Since you didn't sign anything I don't see how he can legally require you too pay anything. If he were to sue you, a judge would want to see a signed agreement which he doesn't have so I would remind him of that if he starts to threaten you. Good luck.}

[Luka Beth 78]

When you use a provider that is out of you're network the provider reserves the right to balance bill you for the billable amount over what insurance pays because they are not required to accept the negotiated network rates. If your insurance would pay for you to have the surgery, why did you go out of network and not use a provider that would have accepted the insurance payment? You may or may not have legal recourse, especially if you have nothing in writing stating that the provider was going to give you a break on charges. Good luck.