bogus dr bill....could use some guidance

[Alison]

In Feb 2004, I saw a doctor (covered under a program called Wise Woman) and told a test i was having would be covered...she even walked out of the room to varify this. In June 2005, I get a bill for $516. I call, say I was told it was covered and get another bill a month later. I write asking for copies of my signature acknowledging my responsibility for the test, my knowledge of the cost, a itemized bill, explaination of why it took almost 1.5 years to get the bill, etc. Two months later, I get another bill (a FINAL NOTICE one at that). I call to ask where my copies are, and was told they didn't receive the letter, but they would look into it. I just got another bill and I'm writing an "Affidavit of Findings" for the court record and going to court. My question is, is that the correct first step and should I file all the bills and correspondence as well?

thanks,
alison

[Shoonra]

I have a few suggestions based on my own recent experience with a major medical event.

It is very possible that this bill is not "bogus" but the result of some error or misunderstanding, probably between the doctor's office and the insurance company. Some doctors have had so much trouble collecting directly from certain insurers that they tell their patients that they want to be paid immediately by the patient and the patient can then apply for reimbursement from his insurer. Sometimes insurance companies decide a particular item isn't covered by their policy, or that the annual deductible hasn't yet been reached, etc.

I suggest that you phone up the doctor's secretary first ... and be very nice about it. There may be an explanation and maybe some useful instructions or resolution. If they say it's a problem with the insurance company, try to get from the doctor's secretary the phone number they use to reach the insurer. Then call the insurance company, and again be nice about it. It may be a matter of some form that needs to be sent in, or whatever. Even if they insist you pay your own money for this, you may get some extra time or something shaved off the bill if you approach them cordially.

[unknownelement]

I had a similar situation with a dentist recently. It seems to me that you have the right concept, but one thing to remember send all correspondence in these matters certified!!! They will act like they didn't receive it otherwise. With my situation, I was not able to get it straightened out with the doc and insurance, but I was able to get rid of it when it was sold to a collections agency! Good luck!

[Shoonra]

I disagree about the certified letters. Letters, any letters, which seem to require writing a letter in reply, bog down the entire operation and even make it solidify unfavorably. Adding certification to the letters just casts the shadow of adversarial relations and hostility to the mix, which is not good -- at least in the opening rounds.

First, try phone calls. Friendly phone calls. No threats of litigation or other hassles; make them like you and/or feel sorry for you. You may have to explain the situation to a number of people up and down the line, be patient and cordial. After all, you're trying to induce them to do you a kindness.

Only if all friendly attempts fail should you switch to courthouse mode.

If you are going to record sending mail to them, use Registered Mail and a third party to mail them with a certification of mailing by that third party.

Shoon's right:

Start low key, but keep a good record of who you speak with, on what date, at what time, and what was said. Put it on paper or electronic format.

Then, when you pull out that smoke wagon, you'll have some bullets in it.

Henry Franklin

[Alison]

Thanks everyone. I've already tried all that in the summer. Started with the phone call and asked for varification that I was responsible for the bill. This first bill, by the way, was over 1 year and 4 months after the appointment, yet was marked as current...not delinquent. They sent a copy of the doctor's notes and another bill. No varification, as I had asked.

That's when I sent the letter saying I wanted that along with an itemized bill (the prior two just said $516, but there was three tests I wanted to know what each cost). That is the letter they said they didn't receive. I received another bill and this one was marked "Delinquent, Final Notice". So, I called again and got the run around. Such and such said to talk to so and so who said to talk to such and such. Both said they would 'look into it'. But, that was a couple months ago and all I got was this new bill.

I have just finished writing a "Affidavit of Facts" and I'm filing it with the courts. I'm not sure if I should write a Motin of some sort...maybe asking for judgment on whether the bill really is mine? I have all the papers they have sent me, save for two envelopes. The one letter from them is dated July 2004, but all the dates on the bills say July 2005. Also, they told me that they tried to bill me, but all the bills were returned to them. Now, I did move, nine months after the appointment. It's been over a year since the move and I am still receiving mail from my old post office, so their excuse doesn't fly with me.

Really, I think maybe that program did run out of money and they suddenly decided they would just bill me for the tests.

Let me know if you think the Judgment idea sounds about right.

Thanks,
Alison