Jump to content
×
Are you looking for the BariatricPal Store? Go now!

So pissed...



Recommended Posts

I would send a firmly worded letter that per your agreement, the $400 was refundable. If they misbilled the insurance company that is a separate issue that they need to resolve with the insurance company, and since your deductable and coinsurance (if applicable) are paid in full, you will be looking for a check from them within 2 weeks otherwise you will bring the issue to the attention of your state's Attorney General office.

Also, this sounds like backward balance billing...which is illegal in most states if you are using in network providers.

Share this post


Link to post
Share on other sites

DO NOT agree to pay anything above and beyond your deductible and coinsurance or copay. That is balance billing and it is illegal almost everywhere unless you are out of network...and then they can only balance bill you for the difference between what the insurance paid and what they normally would pay (example if they normally pay 80% but only pay 60% out of network, they could bill you for.hour normal 20% plus the 20% difference).

Share this post


Link to post
Share on other sites

They are in network.

Share this post


Link to post
Share on other sites

Then they need to bill insurance correctly and refund you your $400 per your agreement.

And actually, in your state, you would complain to the medical board. There is information in this document about balance billing in your state (and it specifies that it is for out of network providers/facilities only) with links at the bottom who to complain to.

http://www.tdi.texas.gov/consumer/cpmbalancebilling.html

Share this post


Link to post
Share on other sites

I sent the person over this the following email - think it will work?

--------------

XXXX,

I paid Dr. L's cash pay price as a DEPOSIT which was guaranteed to be refunded after insurance paid. I did more research and it appears that what you guys are doing now is balance billing by holding the $ 400.00 hostage. This is not allowable as both Dr. L and Dr. P are in-network providers as verified with my insurance plan. I will expect the $ 400.00 to be refunded asap. If Dr. P does not allow the refund after you speak with her on Monday, then I will contact the Texas Medical Board and United Healthcare. I'm not trying to get nasty, but I do expect you guys to uphold your end of the agreement. I don't have an excess of money and borrowed the $ 400.00 on good faith that it would be reimbursed as promised once insurance paid - and they have.

Share this post


Link to post
Share on other sites

Agree with Mizzz...it's def a good starting point. I hope they do the right thing and refund you right away. But if not, you've got your ducks in a row to start a complaint.

Share this post


Link to post
Share on other sites

If they don't refund, sick your bank on them. Call the fraud department and have them investigate

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • rlcpd

      Two months out from hiatal hernia repair.  Surgeon said to expect a lot more flatulence...something about the 'air' no longer being able to 'burp' out so comes out the other end.  That is my experience but have no understanding of why that swallowed air cannot be 'burped'. ???
      · 1 reply
      1. BlondePatriotInCDA

        As I understand it since your stomach is smaller and not completely resting against your diaphragm anymore you no longer have the ability to "push" burps out as well. Plus, since its smaller and we don't digest slower the trapped air moves a lot quicker out of the stomach so its no longer available to burp out. Hence the other option for removal.

    • Lizette1122

      Anyone had the TORe procedure? How did it go? How much weight did you loose? 
      · 0 replies
      1. This update has no replies.
    • LadyVeteran1

      Sleeve surgery is on April 14th.  I am counting the days!!  Can't wait!
      · 3 replies
      1. Brookie2shoes

        Me too girl!! Are you in the full liquid diet right now? It’s sooooo hard!

      2. LadyVeteran1

        Not yet. I was told I only have to do 24 hours of a liquid diet. But I have my pre-op tomorrow so I’m going to confirm if I need to do longer.

      3. buildabetteranna

        Your so close now! It's gonna be great :) Wishing you a speedy recovery and looking forward to seeing how it goes!

    • buildabetteranna

      Down 33 lbs and slightly stalled, but I'm gonna reevaluate and push through. I started back to work last week after 2 years of being disabled due to mental health as well as my weight. It's a great job and I'm just so happy to have this opportunity at a second chance at life. Hope everyone is having their best journey ❤️ Together, we got this!
      · 2 replies
      1. DaisyChainOz

        Great work Anna! Keep it up 😁

      2. buildabetteranna

        Thank you ❤️

    • Bashbee91

      Hey guys new to the process looking forward to this new life. 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×