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If A Medical Health Professional Says They Accept Your Insurance, But In Reality They Don't, What Do You Do?

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If A Medical Health Professional Says They Accept Your Insurance, But In Reality They Don't, What Do You Do?

Postby Tyronne » Wed Oct 04, 2017 5:42 am

A person calls a medical health professional and asks, "Do you accept Insurance Company X?" The professional says, "Yes, we do.
We just have to fill out and submit some forms." The patient then begins treatment and paying for treatment out of pocket, which is expected to be reimbursed.
After many rounds of expensive treatment, the patient comes to find out that Insurance Company X does not consider the medical health professional to be in their network, thus all costs fall on the patient.
In this situation, if the medical health professional won't issue a refund for giving you faulty information, what is the best course of action to take? I think the professional is responsible for misleading the patient into receiving care that they couldn't afford.
Tyronne
 
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If A Medical Health Professional Says They Accept Your Insurance, But In Reality They Don't, What Do You Do?

Postby Colbey » Thu Oct 05, 2017 3:11 am

You take a lesson from that.


Look, most WILL take your insurance - but you forgot to ask if it's "in network" or "out of network", or how your insurance even applies!

Ultimately, it's up to YOU to take responsibility for your own financial well being.


This sort of thing happens ALL THE TIME, there are probably 5 questions a week here on YA, for exactly the same thing.
YOU are responsible to check with your insurance, to see WHAT is covered, for whom, and how much.
The doctor's office has NO obligation to get your insurance coverage straight for you.


How in the world can you blame the medical professional for taking care of HIS finances before yours, when YOU couldn't be bothered to take care of your OWN finances? No one is EVER going to look out for your money, more carefully than you . . .and for pete's sake, he was SELLING you something.
You bought it.
Now you'll have to pay for it.
if you don't, they'll sue you, and win.
Colbey
 
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If A Medical Health Professional Says They Accept Your Insurance, But In Reality They Don't, What Do You Do?

Postby Terrance » Fri Oct 06, 2017 6:33 am

You must pay the bill, in full, yourself.

The professional is not responsible for keeping track of which insurance companies consider the professional to be in network or out of network.
The professional is not responsible for providing that information to you.
You are responsible for asking the insurance company, yourself, whether or not they consider the professional to be in their network.
Terrance
 
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If A Medical Health Professional Says They Accept Your Insurance, But In Reality They Don't, What Do You Do?

Postby Bardulph » Fri Oct 06, 2017 2:04 pm

It is the patient's responsibility to know what their health insurance covers. You should always call the insurer to verify who is or isn't in their network. Did the medical professional give you this advice in writing. If not, then it is verbal and difficult to prove. Please learn from this.
Bardulph
 
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If A Medical Health Professional Says They Accept Your Insurance, But In Reality They Don't, What Do You Do?

Postby Elija » Sat Oct 07, 2017 5:54 am

Nothing.
That is YOUR responsibility to ensure that YOUR insurance carrier is covered by YOUR provider and the services that YOU are being provided before YOU seek treatment.
Its called "personal accountability".
Your problems that you create are not someone else's fault.

Edit:

Well someone needed to break it down into common sense terms for you since you have no idea what due diligence is OR taking responsibility for your inactions.
Didn't your momma ever tell you "Don't believe everything you hear!"??
Elija
 
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If A Medical Health Professional Says They Accept Your Insurance, But In Reality They Don't, What Do You Do?

Postby Fabrizius » Sat Oct 07, 2017 6:09 am

i've got faith there is distinctive waste and too lots crimson tape. I even have faith that there are too many indian cheifs and not sufficient indians doing the hands on jobs. Our artwork lots develop as does the quantity of our documentation. I do beleive that many quite everyone seems to be getting extra efficient healthcare in some factors than till now because of the fact of our extra effective information and technologies,yet that extra is predicted from the coverage companies,and not quite everyone gets an analogous style of care.although that's a tremendously sturdy gadget,extra efficient than many structures. i've got faith that some human beings make it tough for others additionally,going into the ER for centers that they could circulate into their dr for(colds and the flu) yet cant because of the fact their very own drs often are booked up
Fabrizius
 
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If A Medical Health Professional Says They Accept Your Insurance, But In Reality They Don't, What Do You Do?

Postby Raimundo » Sun Oct 08, 2017 4:16 am

It is up to the patient to check a couple of things with their insurance. One, that their particular insurance plan covers the procedures you will be getting and two, that the medical provider is in network. That is YOUR responsibility. You signed paperwork with the provider which makes you liable for the bill if your insurance company wont pay. Providers are able to tell you that they accept billing your insurance but that is where their knowledge ends.

You are an adult, I presume, you have to find out these things first.
Raimundo
 
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If A Medical Health Professional Says They Accept Your Insurance, But In Reality They Don't, What Do You Do?

Postby Carlatun » Mon Oct 09, 2017 2:35 am

You?re going to have to consider this a lesson learned, I?m afraid. Asking ?do you accept insurance from company X? isn?t always enough. Many medical service providers are glad to ?accept? your insurance and submit claims for the care you receive, etc. Unfortunately, that doesn?t mean that they?re actually a member of the plan?s provider network.

It?s possible in this case that the medical provider gave you some incomplete or misleading information, but it doesn?t necessarily mean that they are legally obliged to pay for the mistake.

For better or worse, it really does fall on the patient ? that is, you ? to make sure that the medical services received are covered by the insurance plan, AND that the provider offering services is within the network.
Carlatun
 
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If A Medical Health Professional Says They Accept Your Insurance, But In Reality They Don't, What Do You Do?

Postby Finan » Mon Oct 09, 2017 4:04 pm

Ryan, is right. All you can do is pay. That's it. YOU are responsible for ALL costs your insurance doesn't pay regardless.
Finan
 
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