I have noticed that I am being charged for a specialist copay when visiting a CNS (clinical nurse specialist) or a diabetes educator, who is a RN. I have talked to my health insurance and they say it should be a lower copay. The doctors office says that they charge under the direction of the doctor specialist so that is why it is billed that way. Has anyone had this issue before and how did you resolve it?
How to Correct a Mistake on Your Hospital Bill
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If you find a mistake on your bill, call the hospital's billing department immediately. Write down the date and time you called, the person you spoke with and what action you were told was being taken. Once you point out the mistake, it will usually be cleared up right away. But if you have a billing problem that hasn't been resolved, call your insurance company and the hospital's administrator (a quick call to the hospital switchboard will get you this person's name), then follow up with a letter.
Straight Talk Tip: If your hospital bill seems impossible to decipher, have no fear. Ask the hospital's ombudsman, patient representative or billing department for help in understanding your bill.
If you still can't figure out your bill, here are two services that can help sort things out:
- People's Medical Society (http://peoplesmed.org; 610/770-1670; $24 annual membership fee). They will help translate your hospital bill and tell you how to file a complaint if you've been overcharged.
- MedReview (212/897/6000). MedReview will not only review your bill, they will actually recover your share of any overcharges.
"Legal" Medical Scam
A clerical error is usually a simple mistake, not the result of a scam. But some doctors will try to run a scam on you - the scary thing is the biggest scam around is perfectly legal! It seems a $60 charge for a 15-minute office visit just isn't enough for some doctors. So these doctors come up with some interesting new ways to profit from your illness. And guess who foots the bill? You got it - you!
Doctors often refer patients to clinics for further testing - nothing wrong with that. But what if your doctor has a financial interest in that clinic? Many doctors do. Referring patients to a business in which your doctor stands to profit is perfectly legal, but it's a conflict of interest. And it may mean you're paying for extra tests you don't really need.
Ask your doctor if he or she has any financial ties to the clinic you're being referred to. If your doctor does have a potential conflict of interest, get a second opinion before you have any test done.
Remember: It never hurts to ask.
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