Last October I came down with a sinus infection. So I pulled up my computer, opened my insurance companies website, checked to make sure Doctors Care was in network, and drove myself to Doctors Care. My insurance card was accepted. I paid my co-pay, was seen, sent a prescription and sent on my merry way.
A few weeks later, I got a bill for the entire amount of the visit. I called my insurance company, wondering why it would not be covered if that office was listed in network. I was told that the particular doctor that they billed my visit under, for whatever reason, was not covered. Since this wasn’t even the doctor that I saw, I called Doctors Care and was told they would re-bill. No problem.
The week of Christmas I got a fever. When it got worse instead of better I drove back to Doctors Care in case it was the flu. If it was, I wanted to catch it early. I was told it was. My insurance card was accepted, I paid my co pay, was seen, given a prescription and sent on my way again. A week later, the fever was gone but I still felt cruddy, so I went back, where I Was told I never had the flu in the first place. I was given a breathing treatment, another script for antibiodics and sent home.
A few weeks later, I got a bill again for the entire amount of all three visits. I called Doctors Care again, and was told it would be taken care of.
A few months later it happened again. This time, I was told that this isn’t the first issue they’ve had with my particular insurance company, and it would be taken care of. I was told to ignore the statement.
A month ago, I got another one. The same day I was preparing to call and make sure there wasn’t still an issue (admittedly I forgot about it for a little while), I got a letter from collections. After being told THREE times it was going to be re billed, I was sent to collections. This letter informs me I have 35 days to work this out, or its going to hit my credit.
A few swear words may have been involved.
I call Doctors Care AGAIN, explaining that I don’t understand what the issue is. All three visits are billed under a Dr. Ward – at no point was I SEEN by a Dr. Ward. I explain that I know at least 2 of the doctors I saw are listed in my insurance as in network and I simply CANNOT understand why my visits cannot be billed under the correct people. I was told that I’d need to call the billing department. To make a long list of phone calls much shorter, we were basically told by Doctors Care that they have billed this way for a very long time, and are refusing to re-submit my bill using the doctors who saw me. My insurance company, for whatever reason (perhaps to find some loophole to not pay?) doesn’t cover visits billed under Dr Ward (who we are told is the medical director). Bryan was told, point blank, the the CFO of Doctors Care has said that he is tired of dealing with our insurance, and to bill the patients so that we will be the ones to complain to our insurance company.
In the end, this means Doctors Care claims I owe a $517 bill because they will not re submit my information and my insurance will not cover this particular doctor. One of my EOB’s even states that “although Doctors Care is in network, this particular provider, Dr. Ward is not”.
I’m not entirely sure whose issue this truly is. But here is what I have to say:
Doctors Care – if you choose to not accept our insurance, that is your right. However, to accept my insurance and refuse to re-submit my claims under the providers I actually saw is unethical. To not inform me BEFORE I was seen that this might be an issue is unethical. It is YOUR job to convey to my insurance company that you no longer wish to be in network. I visit my insurance company’s website so that I know where I can go, and to find out that you are simply going to bill the patient because you don’t want to deal with the rules the insurance has set is BULLSHIT.
Consumers Choice – please explain to me why you have a list of 10 doctors who work at Doctors Care on your website that you accept in network, but just happen to not accept this particular doctor that Doctor’s Care bills visits under?! Am I REALLY supposed to walk into an Urgent Care with a fever and ASK who my visit is going to be billed under even though you state Doctors Care is in network?!?! And if Doctors Care is billing according to state and federal law, which they claim they are, then why aren’t my visits covered?
Something seems fishy. And guess who is getting screwed?
You know, this post would really be better with some more curse words.