In response to kbelle...

Discussion in 'Credit Talk' started by chelechele, Aug 22, 2001.

  1. chelechele

    chelechele Well-Known Member

    Listen, this is my niche here...I have worked AR for doctor's for 5 years now...Sometime we have to send people to collections, but, my boss will NOT do this unless we have a signed assignment of benefits on file...meaning that you signed a piece of paper releasing payment from the insurance co to the Dr.'s Office and also that you will pay oyur portion due..that is a contract...But first you should contact the Dr.'s office and ask them to tell (1) the date of service in question (2)the procedure code in question that was not covered (3) ask them for a copy of the EOB they received from the insurance company that they used to determine that you oewd this amount.... Also, Please tell me, do you have an HMO or PPO, and was this Dr. in network/out of network....Are they providers for your ins...etc...more info on this...I can actually help on this one I think...
     
  2. chelechele

    chelechele Well-Known Member

    or not....
     
  3. kbelle72

    kbelle72 Well-Known Member

    The CA hasn't given me the contact info. But, I was covered by Pacificare PPO and always was covered. The CA sent me a statement that they got from the doctor's office apparantly. The statement shows that on my last visit I made a co-pay, and that the existing balance was prior to that statement range. I've asked them to get the date of treatment, what was done, diagnosis, etc. so I can contact Pacificare and find out what the heck is going on. Or, alternatively, to give me the contact info for the doctor. This was from 4 years ago so I'm not really sure the phone #, address etc. I've tried to look it up but I think they may have moved.
     
  4. chelechele

    chelechele Well-Known Member

    Hmm...see, you have 2 key things to go on here...one is that assignment of benefits and the other is if the Dr.'s office was legally authorized to charge you the remainder for that specific date of service in question...Meaning, they can only charge you what the ins co tells them to ex: deductable, co insurance, copays....it should be on the EOB that you wish to receive. But again, if there is no assignmrnt of benefits....then the Dr.'s office likely doesn't have anything with your signature.....
     
  5. chelechele

    chelechele Well-Known Member

    Oh yeah and was this your primary care doctor? Also, some policies are 80/20 etc...even in network...
     
  6. kbelle72

    kbelle72 Well-Known Member

    It was the primary physician. It's the only office I went to when I lived in Houston. Other than this fee, I had never paid more than whatever the co-pay was. Unless it's an accumulation of overages, but I won't know that until someone tells me what the $159 is made up of.
     
  7. chelechele

    chelechele Well-Known Member

    yeah...when you find out let me know...that is interesting...
     

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