What should you do if your doctor sends you a bill for services you believe should have been covered by your insurance? If your doctor says that your insurance company denied payment, then you are responsible. It could be hundreds of dollars. What if the bill is for an older date? How do you pay the bill
You might be able to, but you should definitely check out a few things!
Call your doctor to find out what you are being charged for and why. Although the bill may indicate the exact services, it is not always a good idea to verify. Ask the doctor’s office if you believe your insurance should have covered the service. You may not have been billed correctly. Verify that the insurance company used the correct id numbers. Verify that they charged you for the exact service you received. If they bill you for routine check-ups, but you are actually there for medical reasons, it is a red flag. Routine check-ups are not covered by all insurances. A call to your doctor can often resolve the problem. The doctor’s office can rely on the information you provide and will be able rebill your insurance to pay.
If you are still not satisfied with the outcome of your call to the doctor’s, but feel that your insurance should have paid the charges, contact your insurance company. Your phone number is typically on the back side of your ID card. Ask them to explain why you were not charged. If you were denied the charges and the customer service representative confirms that it is true, you should ask them if they are responsible for paying the charges. Sometimes doctors have a contract with insurance companies so they are unable to bill patients for costs that are not covered. Don’t assume the doctor billing you knows what they can and cannot bill. Many billing staff are not familiar with all aspects of insurance.
If the charges are not timely filed, this is an example of a situation in which the doctor cannot bill you. Insurance companies may require that doctors submit insurance claims within a certain time frame. For example, a claim must be submitted within 90 days from the date of service. The contract the doctor signs states that the doctor must submit the claim within the specified time frame. In many cases, the doctor’s office tries to collect money from patients. It is not the fault of the patient that the claim was not submitted on time by the doctor’s office. Patient goes to the provider expecting that their insurance company will pay the doctor.
The insurance company can often reprocess services based on the information they received from you during your telephone call. Sometimes, services are denied simply because of human error by the insurance company. Sometimes, denials can be caused by a computer glitch. It is worth calling to see if charges can be paid.
The insurance company may have other reasons for denying services. They are too numerous to cover in one article. Sometimes, the services are denied because they are not covered by your plan. If the claim is denied, and your doctor denies it, you can make arrangements with your doctor to pay.
Ask if you are allowed to make monthly payments if the amount due exceeds what you can afford. It is also a good idea to ask the staff if they will give a discount on the bill since it isn’t covered by your insurance. You might not find out if they do, but it is possible.
You shouldn’t pay a bill just because you get it. You should always verify that you are responsible for the amount being charged.
