Author Topic: Patient Rights of Billing Changes  (Read 1927 times)

ch496

  • Newbie
  • *
  • Posts: 1
Patient Rights of Billing Changes
« on: December 06, 2011, 04:05:08 PM »
In 2010 I visited a doctor's office to have a test done.  My insurance was accepted and everything went as it should.  On January 6th, 2011 I went to the same doctor's office, at the doctor's request, for more testing.  I have received a bill for over $3200.00.  After investigating I have found out that this particular office now bills through a different hospital and it makes them out of my network.  Was the Dr's office legally responsible to inform me that they no longer accepted my insurance?  Am I responsible for the bill?

PMRNC

  • Hero Member
  • *****
  • Posts: 4562
    • One Stop Resources & Networking for Medical Billers
Re: Patient Rights of Billing Changes
« Reply #1 on: December 07, 2011, 08:15:09 AM »
Did you know where the charges were coming out of prior to receiving the testing? If not, you can contact the insurance carrier, and see if an appeal might help. Is this an HMO? The provider, if they have not seen you in  year really doesn't have any legal obligation to inform you of where they are sending the tests, however they should have seen your insurance information and had you check to see if they were in network.  I'm assuming the physicians charges were covered from the 2011 visit? 
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Medical Billing Forum

Re: Patient Rights of Billing Changes
« Reply #1 on: December 07, 2011, 08:15:09 AM »