? about OB contract..

m0132 · December 2010

I'm just curious if other offices handle things this way.. I signed an OB contract at my first prenatal visit stating that I would pay $250.00 for my prenatal care by the time I was 20-something weeks..I have until the end of this month to meet those charges. I am fine with that but my office is pulling money for other bills out of what I have already paid towards my OB contract..and not telling me. I will get my EOB from ins. and expect to get a bill from my OB (for blood work or u/s charges) and never receive it. I called to make sure my account wasn't saying I owed money and they said I was all paid up and then when I went in for a visit I asked how much I owed on my OB contract and I was told I had only paid $30 when I thought I had paid $60..well turns out they took $30 of what I paid and applied it towards bw & u/s charges that came up after the fact.. Is this right? I keep bringing this up and asking to speak to someone in charge of billing because I want to know WHERE my money is going when I pay it, and they aren't even notifying me before they do this. I would much rather they leave my contracted amount alone and send me a separate bill in the mail for other charges. Doesn't sound right to me and I go in on Friday and want to make sure this the norm...

BeetleLinz1125 · December 2010

I agree, this is not right. When you make your next payments I would make sure I specify that it is to go towards the $250.00 for your contract. I would even write it in the memo line of the check for clarification, that way you are covering yourself. I think it's pretty shady of them to do this.

Addi517 · December 2010

I work with billing at a chiropractors office, and it can get pretty tricky when you have people pay ahead. If they have a system anything like ours it would be impossible to separate the money you pay into 2 different accounts, BUT they should be able to send you bills still for the amount you are responsible for other services. The only other thing I can suggest is that when you get an EOB from insurance, just go ahead and send your OB a check for whatever about insurance is saying you owe them, that way they would not technically be taking away from the other money you have paid for the prenatal care. Hope that helps

Piad1 · December 2010

They should also be giving you itemized bills each time you make a payment. For example, if you go in and pay $50 for an ultrasound, they should give you a receipt for the $50 and a bill for the ultrasound showing the procedure code and the amount paid. Are they out of network with your insurance company or are they submitting directly to insurance for you?

JUSTBEYOURSELF · December 2010

all of that does not make sense to me. I did not have to sign a contract. I have insurance and they bill my insurance co.

where are you located?

I just have never heard of a 250.00 charge along with visits...

lilbabykt235 · December 2010

if im correct your talking about the universal somthing or another.... its a one time payment?

yea i didnt understand what this was for ... but i payed it off first and they billed the copayments and what not

i would talk to the doctor and check this out

Piad1 · December 2010

Was it the global obstetrical package? I had to pay $200 upfront, but that was to cover the out of network deductible for my insurance. Aside from that, there were no other charges other than co-pays for any lab work or procedures not covered under the global obstetrical package.

EmjayTheHunted · December 2010

BeetleLinz1125:
I agree, this is not right. When you make your next payments I would make sure I specify that it is to go towards the $250.00 for your contract. I would even write it in the memo line of the check for clarification, that way you are covering yourself. I think it's pretty shady of them to do this.

You can write anything you want in the memo line. In this state, it doesn't cover you for anything.

You could write paid in full, and send a check for 1$ to Visa, and they will cash it, because they don't read that stuff. But you're not paid in full.

Those were originally put there so when you got your canceled checks back you knew what you wrote each check for. It was for your convenience. Then people started writing account numbers just to make sure things weren't misdirected. But it does NOT cover you if you write something there about paid in full or half payment or anything else. You are bound by your contract. The memo line does not supersede the contract.

m0132 · December 2010

Thanks ladies. Last time I went in (when I found out I only paid $30 instead of $60) I had the billing manager print out an itemized list of all charges and compared them to my EOB, so its not like they are taking money they aren't entitled to..I just want to know WHERE my money is going. When I hand them my debit card and say I am paying towards my contract, I assume that is where its going. They never give me an itemized receipt (even though I have requested one be mailed to me for every payment) but I just get the receipt from the credit card machine, so I will have to bring that up on Friday I guess. I don't know anything about this stuff because with DD I had different insurance and EVERYTHING other than delivery was covered at 100%..so this is all new to me. I don't pay a copay or anything..I can chose to pay when I go or not, I just have to meet my $250 by a certain point. My OB is in network and I do have a deductible but I have met that already, so I just assumed the $250 was for my prenatal care since I am not paying any other copays. Good idea though to just spend the payment when I get my EOB..I just worry about them taking the money twice then and owing me money back.. I think I am a little leery about the office in general lately, my OB left abruptly and it makes me wonder whats going on there..I am meeting a new OB in the office this month and if I'm not crazy about him I am leaving.

BeetleLinz1125 · December 2010

EmjayTheHunted:

BeetleLinz1125:
I agree, this is not right. When you make your next payments I would make sure I specify that it is to go towards the $250.00 for your contract. I would even write it in the memo line of the check for clarification, that way you are covering yourself. I think it's pretty shady of them to do this.

You can write anything you want in the memo line. In this state, it doesn't cover you for anything.

You could write paid in full, and send a check for 1$ to Visa, and they will cash it, because they don't read that stuff. But you're not paid in full.

Those were originally put there so when you got your canceled checks back you knew what you wrote each check for. It was for your convenience. Then people started writing account numbers just to make sure things weren't misdirected. But it does NOT cover you if you write something there about paid in full or half payment or anything else. You are bound by your contract. The memo line does not supersede the contract.

I was just offering it as a suggestion so that she and the doctor's office would know what it is supposed to go to. I know that is not legally binding, but if she wants it to go to something specific that might better assist the office in knowing that she wants it applied a particular way. It sounds like they kinda just do what they want there anyways.

Bree4011 · December 2010

My Dr. office had me do one of those as well. They calculated what my bill will bill, then deducted what insurance would pay and then they are having me pay my portion of the bill, except it's only considered a deposit because they aren't acutally going to bill me or bill my insurance until after the baby is born in case there are other charges to add. Anything I over pay will be refunded in the end.

They also told me that I had to pay by the 5th month, but then the receptionist said that it was flexible.

LipstickLibrarian · December 2010

JUSTBEYOURSELF:
all of that does not make sense to me. I did not have to sign a contract. I have insurance and they bill my insurance co.
where are you located?
I just have never heard of a 250.00 charge along with visits...

The $250 might be what the office is estimating that her insurance will not cover. I have insurance also, and because we know I am going to have to have another c/s, my responsibility in advance is $600 because the office can estimate what my insurance will not be covering. My office didn't call it a "contract" but it is an agreement.

LegalLadyBug · December 2010

JUSTBEYOURSELF:
all of that does not make sense to me. I did not have to sign a contract. I have insurance and they bill my insurance co.
where are you located?
I just have never heard of a 250.00 charge along with visits...

This.

I pay my copays when I go see my doctor and I receive a bill in the mail for any portion of things I had done that was not fully covered. It seems odd to me that you have to contract to pay $250, is this above and beyond what you would normally pay? Are they basically making you pre-pay for delivery costs etc. that your insurance wont cover? How confusing, I guess I'm just glad I don't have to deal with that. I would definitely ask them how they determine what goes to your $250 and what doesn't. What happens if you don't pay the $250?

m0132 · December 2010

LegalLadyBug:
JUSTBEYOURSELF:
all of that does not make sense to me. I did not have to sign a contract. I have insurance and they bill my insurance co.
where are you located?
I just have never heard of a 250.00 charge along with visits...
This.
I pay my copays when I go see my doctor and I receive a bill in the mail for any portion of things I had done that was not fully covered. It seems odd to me that you have to contract to pay $250, is this above and beyond what you would normally pay? Are they basically making you pre-pay for delivery costs etc. that your insurance wont cover? How confusing, I guess I'm just glad I don't have to deal with that. I would definitely ask them how they determine what goes to your $250 and what doesn't. What happens if you don't pay the $250?

I don't "normally" pay anything for pregnancy. If I were not pregnant I would pay a $20.00 copay but I now that I am pregnant I don't pay a copay..I am just supposed to meet the $250.00 agreement for any prenatal care. It makes sense that this would be the amount estimated for now that ins won't cover..I just don't like the way the are taking it upon themselves to pay my other bills out of this contracted amount I am already paying. They should send me any separate bills and let me pay those on their own.

kappanole · December 2010

I've never heard of this kind of contract. My doctor just bills my insurance and then bills me for whatever my insurance doesn't cover. I signed forms that said I was responsible for whatever insurance did not pay. Interesting, I guess every doctor's office does things differently.

desdemona39 · December 2010

I don't get it. You have insurance, your provider is in-network, and you have met your deductible... what on earth is the extra $250 for??

They shouldn't be charging you upfront for what they think your insurance won't cover. If this is advance payment for the delivery, well, as a participating provider, they can't really ask you for any money besides the copay until the claim has been settled with your ins co., as it is a breach of their contract with the ins co. If this is for your convenience to pay over time rather that be stuck with a large bill after delivery, then it should be optional.

If I were you, I would call my ins co and ask them what charges you are responsible for, what they can and cannot bill you for and when they can bill you. If necessary, your ins co can conference call the billing dept at your doc's office with you on the line. What they're doing sounds shady.

I once had a Dr's office try to bill me upfront for the full cost of the gardasil vaccine ($950!!) "in case" my ins didn't pay for it. Well I had called my ins ahead of time to determine coverage and was told that it was covered, and asked the dr's office to call and verify. They refused to call, and responded that their office policy was to charge patients up front, and reimburse them the amount that the ins paid. I informed them that A) it's illegal to balance bill when you're contracted with an ins co as a participating provider, and It's in direct violation of their contract with the ins co to charge me prior to filing the claim and having it settled. My ins co 3-way called my dr's office and explained this to them with me on the line. When the dr's office refused to budge, they were kicked out of being a provider for my ins co for breach of contract, and I was informed that if I had paid upfront for the vaccine and didn't get my $$ back, that was grounds for a lawsuit.

Do you have a copy of the "contract"? If so, does it state what the charges are for? If you don't have a copy, they need to provide you with one, as well as receipts at the time of payment. Furthermore, I would fax a copy of the contract to my ins co to see if the dr's office can even do this.

I just HATE when healthcare providers take advantage of ppl. I work in a Dr's office and have done insurance billing (the right way) for 9years. Offices like that make everyone else look bad.

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