Doctor's Bill

[overanalyzed.livejournal.com]

Hi,

I recently switched my primary care physician to the Davis Square Family Practice. The doctors have been friendly, but the office as a whole seems very disorganized. After my first visit nearly three months ago, I have yet to receive a bill, and they have three times misplaced my insurance information. Today I received a lab bill from Quest Diagnostics that was billed directly to me and appears to have over $400 worth of tests that I did not ask for.

Is this legal? Can I contest this? I don't know why they continue to bill me directly when I have provided them with my insurance information. I chose this clinic because I had heard positive things but now I am worried that they might be crooked. Does anyone have any suggestions about what I should do in this situation? Also, has anyone experienced similar problems with this clinic? I am considering switching doctors at this point, so any doctor recommendations would be appreciated as well

Thanks so much.

Comments

[surrealestate.livejournal.com]

Qwest may not have your insurance information. I suggest calling them to pass it along.

The same thing just happened to me with my doctor, who is affiliated with Mt. Auburn Hospital (and use their labs for testing), except the bill was quite a bit larger, despite just being "routine tests". I called today to give them my info and they're going to bill the insurer.

[overanalyzed.livejournal.com]

Thanks for the response. I know that once Quest gets my insurance info the bill won't be as large, but it still bothers me that I'll be paying for a portion of numerous tests that I didn't ask for. Can doctors order tests for you without your consent, even if they qualify as "routine"?

[docorion.livejournal.com]

Yes and no.

Doctors will frequently order tests without identifying every test; for instance, if the doctor discussed doing any 'panels', the panels often contain a bunch of tests. A 'chemistry panel' for instance, contains anywhere between 7 and 24 tests. A cholesterol panel has at least 3 tests, and a 'cardiac risk panel' has something like 6. A 'thyroid panel' has at least 3. And so on. And the tests cost a metric ton of money, except if you have insurance-you'll find that your bill goes down *markedly* when they find out you have insurance, because when they bill you, they bill full price; insurance companies pay at a discounted rate. (Yes, it's perverse. No, I don't like it at all, but it's true).

So you're probably on the hook for the ones you've had done so far. My recommendation-talk to them about your experience. Ask them to clear all testing with you (if that's what you want), and tell them why. I suspect you'll find they're be very apologetic, and they'll be more careful in the future. I use DSFP for my care, and they've always been very responsive.

[overanalyzed.livejournal.com]

That makes sense. Actually, this all does stem from a cholesterol test, which I have never had before so I thought it would be interesting to see my results. But the bill is so cryptic, it's hard for me to say whether the tests are all related to cholesterol or not. However, I am fairly sure that it is DSFP and not my insurance that resulted in the bill being sent to me directly, mainly because they keep misplacing my insurance information, which is worrisome to me.

[syntheticnature.livejournal.com]

The lab inside DSFP is a little island of Qwest. The DSFP doctor may send you there, and a DSFP nurse may escort you across the hall, but actually it's you dealing directly with Qwest. I'm not even sure if they can legally get your insurance info from DSFP; if you didn't give it to them yourself, they don't have it.

[narya.livejournal.com]

The first thing to do is to call them and get specific in asking them questions. I've had problems with getting billed for random people just due to a birthdate mixup and a similar name.

If you have insurance coverage, it would be a good idea to call them and ask them if they have received the bills and if so whether they paid them. It is possible that the insurance company screwed up and declined to pay them for some reason so you need to verify that the problem isn't on their end.

For what it's worth, I've used DSFP for a couple of years now and have never had a problem with the billing. I've also never received any separate statements from the lab, which is why I think your insurance company might have screwed up and declined to pay. That happened to me at the Somerville Hospital's emergency room and it took years to get everything straightened out.

[perspicuity.livejournal.com]

tell your doctor to deal with Quest. that's not your job.

also, if they ordered tests you didn't want, or Quest decided to do them, that's between them and your doctor who ordered them, not you, imho. the fact that Quest even knows who you ARE is ... slimy. i'm sure it's just within HIPAA regs, but still, slimy. why do they need to know WHO the tests are for? just do the tests, and hand them back - absolutely they shouldn't even be contacting you directly - ever - imho. that's another thing to discuss with your doctors.

#

[sapphira-altair.livejournal.com]

I agree that it sounds like quest doesn't have your info. Call dsfp and ask them to deal with it; that's what their billing dept is for. Fwiw, I've had quest screw up countless times and continually 'lose' my insurance info.

[suzybuzz.livejournal.com]

they're really great at Davis Square Fam Practice. i'm sorry this happened to you. i've gone there for over 6 years. sometimes they'll accidentally bill but if you just go and talk to the receptionist she'll tell you exactly what to do. i also know that one of the NP's left, and now there is only one doctor. i personally like the personal approach, but i think they have a large client load that they are constantly trying to manage. on the positive side: i've never had to wait to get a good appointment, they always call me back when i need advice, and i find the office to be friendly and conveniently located. much better than a sterile med center.

[suzybuzz.livejournal.com]

yeah, it may have more to do w/Qwest than Davis Square...

[dystocia.livejournal.com]

I know DSFP is awesome for me personally; they recently switched over to electronic medical records, so perhaps something got mis-placed in the switch?

[intuition-ist.livejournal.com]

since you have insurance, I'd recommend contacting them directly to say "oh by the way, i'm billed for thus-and-such, do you have any record of Qwest attempting to bill you for this?" that way, when you call the doctor's office, and they shrug and point you to the insurance company you've already done it.

also, BC/BS is absolutely the pits when it comes to communicating with anyone but themselves and you. if you have them as your insurance, expect to have to do a *lot* of legwork to make sure all the paperwork gets to the right places so they know they have to pay something.

[ron_newman]

Please let us know (with an additional comment, or an edit) how this finally works out. Thanks.