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kitty b | Doctors billed my secondary insurance but not bill my primary? How to make them fix this? |
My doctor billed my secondary insurance. The secondary paid then asked to refund., and sent me letters said that if the doctor does not refund, I will have to reimburse them for it.
I called but the doctor's biller does not do anything to fix it- do not bill my primary, not refund tsecondary. I proposed I paid money first, they gives me bills and I file the claims to my primary. The doctor's biller just ignore all of these. It has been one month. I called many times and send one written notice.
How can I make the doctor to bill my primary then refund my secondary? Is there any goverment or agent can give a bit more push to let doctors to do this?
Or can I directly send the refund request letters from the secondary insurance to my primary for reimbursement so I do not need to go thorugh the doctors?
The doctor nurse argues I did not provide her complete insurance info. I can not prove that, I just handed my cards and they copied. Is this enough excuse for them not fix? |
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notshyviolet
|
If your doctor's office is a network provider with your primary insurance company, they are required to submit a claim on your behalf to them. If the doctor's office gives you a problem with this, contact your primary insurance carrier.
In general, it is your responsibility to give complete insurance information to the doctor's office at the time of your visit and advise them which they should be billing as primary. (Even so, the doctor's office should still be obtaining a benefit verification from your insurer, where they should have discovered which one was primary.)
This is a very common situation, and your doctor's office really should be able to handle it themselves. If they are a network provider, then most likely you wouldn't be able to file the claim yourself as its a contractual obligation for them to file primary claims. (Note - this is assuming that you used a network provider, of course.)
Simply tell your doctor that you will not be paying them any money until they bill your primary - I would bet almost any amount of money that they have a clause in their contract w/your primary insurer (again, assuming they are a network provider) requiring them to bill the insurance company directly. And you are under no obligation to pay until your primary has adjudicated the claim. Again, if they give you a hard time about this, get your primary insurer involved! |
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Ladybug
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Get the bill and do it yourself with a letter! |
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kadnil
 |
I would contact my first insurance company and tell them what happened and ask them what to do to straighten this out first...if they wont help you...you will have to deal with the doctors office and have the money refunded and have them charge the first insurance company...it doesn't sound to be difficult...as the nurse said... |
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SCH
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There is a 3rd option...get the bills (by law they must give them to you, just call and ask for the billing department). Bill the 1st insurance company and pay the 2nd.
The birthdates of the insured persons usually is what determines the status of 1st and 2nd insurances (ie my birthday is in April and hubby's is in July...our kids would be covered under my plan 1st and his 2nd). So did the doctor's office know for sure which one was 1st and 2nd, it sounds like no and it isn't really their responsibility to figure it out. You are probably going to wind up having to do most of this leg work yourself now. |
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mbrcatz
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OK, doctors bill your insurance company as a COURTESY. You can't make them do it, but you CAN call your insurance company, ask for a claim form, fill it out yourself, bring it to the doctor, have him sign it, and mail the claim form in YOURSELF.
That's really your only option.
No governmental agency will make a doctor bill an insurance company - as it's a COURTESY they perform, not part of their regular duties. |
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