Traditionally Speaking…by Pat Larsen - Double Billing

There seems to be a suspicious trend of late…let’s hope you haven't unknowingly been on the receiving end of this increasing occurrence. But based on my own personal experience and the fact that I am working with a large segment of the Senior population, we’re all beginning to notice this trend to be double billed for our medical appointments.

To make matters worse, it’s such a frustrating mistake to actually correct once you've received these charges, that I believe some are actually just “paying the double copay” rather than attempting to reach out to resolve.

After receiving my third bill for the same Drs visit with different practitioners names attached, I knew I had to find out how to correct this issue. So I contacted a noteworthy Insurance Broker that we all know and love and she recommended that I send an “appeal” letter to the insurance company. It seems like a “bother” for sure but in truth it worked. I did this three times so far, yes, that’s how many times I was double billed from three different offices.

Here’s the details of my story.

I went for a regular office visit and signed in and was asked to cover the copay for that visit. It’s basically my share of the office visit, in this case it was $35, which I then paid.

That should’ve covered the visit. But, a few weeks later, I received a bill from this same office stating that on “that date” I had a $35 copay charge still due that I was now being billed for.

Hold on now. I thought I had paid that charge at the office on that date.

Luckily I keep a folder with a listing of all my Doctor visits and the amount I have paid. I quickly reviewed that visit.

So I called the office and was told a Nurse Practitioner had seen me for the visit and I was then being billed separately for the EKG done by the office TECH on that date as well.

Two separate practitioners billed my insurance company for one visit.

I literally got nowhere with the actual medical office. So I contacted my medical insurance company next which was also pretty frustrating to deal with.

That’s when I remembered the advice of the insurance broker suggesting that I appeal the charges. My first response was that I didn’t want to get involved in this web of letters and phone calls. Then I realized that perhaps it could be much easier than I thought, so I vowed to try to resolve this on my own.

This is literally how easy it was…

A letter is pretty much always attached to the EOB (estimate of charges) notification that we get in the mail detailing the amount paid by the patient as the copay and the amount the Dr was paid and all the charges that came with that visit) which gives the patient a detailed list of exactly how to appeal a charge.

It really took no time at all. I wrote directly on the bill at the bottom of the page and explained that I had made a phone call to the Drs office to review my pre-op instructions before my surgery AT THEIR REQUEST. The call lasted 10 mins as a means of reviewing my arrival for the surgery visit. It was not a required phone call as was stated on the pre-op instruction letter. So incurring a cost for this phone call was not chargeable.

I received a notification from my insurance company within the 60 day window that they suggested it would take to review my appeal. In the meantime, I was not required to pay that particular bill for the co-pay OR if I felt I wanted to pay the copay, I could do so, as the insurance broker suggested and then my payment would be returned or credited.

Sure enough, within that appeal time frame, I received a letter stating the date of the office visit, the name of the provider that had billed the visit to me, and the reason for the charge.

The letter stated that the co-pay had been waived after investigation of the charges had determined it was not my responsibility.

This had been the third time I appealed a charge that I had from other offices in just a few months. Each time, the charges were waived due to a thorough investigation resulting in the copay charges being waived.

Of course I was happy not to have been responsible for these copay's but I was also getting more and more curious as to why this seemed to be the trend.

Life has become increasingly more complex the older we get.Therefore we often need more Doctor visits. That doesn’t mean we have to fall prey to sloppy or irresponsible billing practices or charges that we haven’t incurred.

Hey, we’re the generation that coined the phrase “BUYER BEWARE”... so just because it seems like it’s a bother, doesn’t mean we have to get stuck no matter what the amount is.

Please be sure to keep your paperwork in a file to review either for yourself or with someone who can help you to make sense of the trail of payments paid or due.

We’re not stuck with being Double Billed. Appealing a charge will help set the records straight for all concerned.

Pat Larsen is a syndicated columnist who lives in Greene county.

Feel free to contact Pat at 518-275-8686 to chat or if you have a story to share.