deltadawn

Consequences of not following through

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I suggest contacting the DR directly, explain what happened with the ins. co and ask if he'll accept the 181.35 as payment in full. Ask if he will pull the account back from the CA and instruct the CA to delete the TL as it was one big misunderstanding. Try to sound really innocent.:roll: If he agrees, ask for something in writing. See if he will email something to you.

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Thanks swirlgirl. I guess I should put this on my agenda for the end of next week since the benefits department will be contacting the Dr this week and sending them a check on Thursday.

Hopefully, when they contact the physician this will not open up another can of worms because I have no idea who the doctor is that submitted the bill and did not mention this discreptancy when I filed the appeal.

The medical services were rendered by a nurse practitioner. I assume she was working under the Dr license for insurance billing.

Do I actually contact the Dr or go through the billing department?

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To my disappointment, I discovered through my annual credit report that this had not been resolved.

My former employer did pay what was suppose to be paid; however, the doctor did not adjust the bill for the contracted rate.

After speaking with the CA (doctor will not return call) they said that since this was payed by my employer and not the insurance plan, I did not qualify for the contracted rate.

Such bull.............They finally agreed to show a zero balance (followed up and the account does show zero). and that it will stay on CR for the full 7 years; however, they will not report paid less than agreed. Of course I will be verifying this once they have had an opportunity to report.

Although I did not get the acct deleted from my CR, I guess that I was lucky. I would never thought to file an appeal,

Lesson learned - Do not depend on medical facility to file a claim correctly and always follow through will any disputes.

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