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Pregnant after 35
TypoJenny
member
I fired my OB/GYN
TypoJenny
member
Let me start off by saying I am hormonal but that had nothing to due with me firing my OB/GYN and finding another doc. The day I got my BFP I called the first name on google. I explained my history and they had me come in right away for blood work. The next day they called in progesterone for me, and the following day I had my first visit. I was very impressed with the service. They scheduled me for another sonogram in 2 weeks and then a follow up appointment 2 weeks after that. They set me up with specialist to test the baby for all kinds of things. When I checked out after the first visit I expected to pay my $35 co-pay. Because I work in the health care billing industry I know to check with my insurance company. My insurance company Blue Cross Blue shield explained my coverage. However I was also told it depended on how the office billed. Visit by visit or "global". Anyways, not to bore you with the fine details of medical billing... When I checked out I was told it would be a one time co-pay of $60, and that would cover everything to post delivery and 96 hours in the hospital. WOW I thought that was amazing. I remembered back to what the insurance person had told me and I assumed this was because they are billing "global". Awesome!! until after my third visit they call and tell me I owe $360 a month until the baby is born. WAIT, WAIT, WAIT... What happened to the co-pay? I was told that was standard policy to collect the $60 on the first visit. Excuse me, but it's got to be one way or the other, not both. You can't charge me a co-pay for the visit then bill me global against my deductible. That is insurance fraud. The lady on the phone couldn't answer my question regarding billing, she had no clue how my insurance worked and referred me to my insurance company. I explained it wasn't my insurance it was the way they billed. She explained she didn't do the billing, she was in collections. I then asked if they could work with me and get the cost down. She gave me a firm NO, and then proceeded to asked me in a very snotty voice "Well, how did you plan on paying for the pregnancy then?" I responded in a snotty voice "by paying my co-pay". She then told me that I could cancel my appointments at anytime. So I did!
I got on the phone and started calling around and asking more specific billing questions and found an office that would work with me. A plus is one of the doctors is friends with the doctor I work for and I think I will be much more comfortable in this new office. My first appointment is April 11th.
I guess I surprised them with my working knowledge of the current insurance billing practices. Don't let them confuse you and don't pay more than you are supposed to, and don't let the insurance companies confuse you either. It is a messy time for billing right now and it's only going to get more messy come October. I promise, nobody is going to know what they are doing come October..
This discussion has been closed.
Re: I fired my OB/GYN
You have to do what you feel comfortable with. It sounds like your provider's billing person doesn't understand the difference between charges and what actually gets billed to patients based on insurrance coverage - maybe they don't coordinate up front. Even if they bill your insurrance based on their global fee, you are only responsible for what your insurrance won't cover after deductable and co-pay. Most don't collect the whole fee up front (or per month like they were trying to do with you) because you'll likely use services that apply to your deductable and out-of-pocket max in other areas. What a pain - work in consulting specifically in healthcare and I know what you mean, even when you do have knowledge of these things it's difficult to navigate.
On another note, I-10 is likely to be delayed until 10/1/15 - The House passed H.R. 4302 on Thursday with a clause for "at least" a one year delay - Sentate votes today but the AMA has lobbied hard for the delay and despite billions spent to comply, it's probably going to be delayed again.
January PAL siggie challenge; Good advice:
I just got a bill in the mail from the Doc that I fired. They didn't even submit the charges to my insurance. Let alone credit me for the "Co-Pay" that I paid already. I think I need to have another talk with the billing department...
I ran into a couple of OB Nurses and asked them what they knew about the first office that I went to and what they had heard from the grapevine... Let me just say I'm glad I went with my gut and changed docs....