I had been a patient for many years until yesterday. 3 days ago I was called by the office while driving there w/my daughter for an appt& told that my daughters account had a balance of more than $600.00 going back to 2015. Even w/out my EOB's & bank statements I knew that just didn't sound right, as I haven't received a bill in quite some time & when I do I have to provide a copy to my ex per our divorce decree. I always pay any remaining balances w/ them in full at time of service. I was literally just there w/ my daughter a couple of weeks ago & told I didn't owe anything at the conclusion of her appt, & the claim for that date is still being processed w/ my insurance company so I have not received an EOB or bill yet. No prior balance was mentioned at that service, & nothing was mentioned when I made that appt for my daughter, or when I subsequently made my appt for yesterday.Their desk sign says payment is due at time of service, so the idea that a balance would roll for multiple years, through multiple subsequent services, never going to collections & never been collected for at time of a service, not to mention I have made many payments at appts as has my ex husband during the intervening time, it is ludicrous to think a balance from 2015 would still be outstanding. My daughter & I both go in regularly, so for this balance to have been outstanding for more than 3 years, something had to be wrong. When I asked for details, the individual on the phone said that they didn't have that info, & that the office manager was working remotely that day. She said that she would call her & I could talk to her when we arrived for my daughters appt.
When we arrived they kept my daughter in the waiting area for over 30 minutes while they called the office manager, who refused to talk to me, & I was told she has small kids & couldn't access her records. When I asked whether they would still see my daughter, they did, but told her there was nothing wrong w/ the tooth that has been causing her pain & sent her back out to the waiting room. They continued to ask me for payment, but refused to provide me w/ EOB's & I at that time had no access to my bank statements or insurance info that would give me some indication of where they were arriving at this figure from back in 2015-present. From what they had offered, a generic print out that showed service dates, balance, & finance charges, I knew some of the info was inaccurate. They agreed to waive the finance charges & let me check my records, so we left. The next day (yesterday) they called & said that they put copies of my insurance EOB's in the mail, & that once I had a chance to review them we could reconvene next Monday- I still have the voicemail. Today I go in for my appt, still never having received the info from them, therefore having had no opportunity to look at my insurance info or bank statements, & was again held n the waiting area until the new office manager, who is the Dr.'s wife, came up to talk to me about my bill. She started by acknowledging the message she left yesterday, & that she knew I hadn't had a chance to receive the items in the mail, but that she had printed them off for us to talk about then. All she had were some of the insurance EOB's, & when advised her that those are estimates & not final bills, & that I had never received a bill from them for an outstanding balance, & in fact made multiple payments & been in for multiple appts since that time, I was told that she shouldn't have to call me or say anything to me because I am the patient & it is my responsibility to pay for their services & they only process the insurance as a courtesy, however I was never presented with the option or documentation necessary for me to file my own claims at any appointment. I mentioned that I was there over my lunch period for my appt, & I hadn't had the chance to look at any of my records, & asked if they were still going to honor my appt, & she said they wanted to be paid first. I said I had never seen a bill from them & she said that she has called me multiple times & left messages & sent bills. I asked for the dates that she called & left messages & she fumbled around at her computer for a minute & said
two dates. W/ her standing there looking I check my cell phone for those dates for calls & voicemails & there were none. I asked her if she could print off the statements that they claimed to have mailed, she said that she could "print every one of them" & I said good I would like to see them, then she fumbled w/ her computer more & said "you know what I can't print it", I asked if she could email it to me & she said she the software would not allow her to email it, I asked if she could take a screen shot of the letter that was mailed & print that, & she said she couldn't actually see the letter, but that the software just had a note a letter was mailed that day, I asked where they mailed it to & she said she couldn't tell me, she could just see my current address- which she verified was accurate. When I reiterated that I have never received a bill, she had no real evidence of one ever having sent me one, & that I have made multiple payments which I was told were in full for the accts at those times, I was asked to leave. I have subsequently identified numerous errors based on the information and EOB's she showed me, and I have yet to receive any bill from them to verify the balances against my bank statements, insurances, credit cards, ex's records, etcetera. I feel that I have the right to an accurate medical bill and to timely settlements of conflicts associated with my medical bill, which they have both failed and refused to provide to me. I feel that it was entirely inappropriate for them to discuss this with me in the lobby area, and that the conversation could have been had at the conclusion of my scheduled appointment, or next Monday per Ms. McHargue's (the office managers) voice mail from the day prior - in which she indicated she had mailed the EOB's to me specifically so that I could review my records and talk to her about it on the following Monday.I feel that they should honor the Provider Agreement between their office and the insurance companies which often requires that they file a claim in a timely manner using the correct billing codes and that if a doctor does not do this they prohibit the doctor from billing the patient. Many of the errors I identified in the bill stemmed from that issue. I have always provided them with my current insurance cards, but they have processed to the incorrect providers and used incorrect codes. The Provider Agreement often requires the doctor to file a medical claim correctly, and I feel that the medical claim needs to be refiled with my health insurer, even if the claim is late, and that they should provide me with all of the necessary documentation to do so. Additionally, I feel that they need to honor the agreement to waiver the finance charges on the account as they said they would. And I feel that they should adjust the bills per the submission of my evidence of payments made by the insurance companies, myself, and my ex. Furthermore, I feel that I should be reimbursed for my time off of work and mileage for they cancelled my appointment without any warning or cause, as the standing agreement was to allow me to receive the documentation that they mailed, review my records, and discuss the billing matter next Monday, after my appointment (per the voicemail I still have).
by MoMom
xxx.xxx.206.187
April 20, 2018