cardiologist common errors

By cobrasmach Sunday, May 20, 2007

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Everyone who has a cardiologist be very careful when you schedule a stress test that costs over 4000 dollars. My heart doctor supposedly contacted my insurance company and got preauthorization for the test. Come to find out I have a bill and my ins company knows nothing.My cardiologists office says i signed a self pay form stating I am responsible if my insurance doesn't pay? Is this common practice?

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Mindaleigh

6/ 9/07 12:36pm

Please take a close look at your benefits booklet from the insurance co., (not the summary, but the one that is proabaly 10 or so pages)and see what it says about payment when the provider doesn't pre-authorize services. Also WRITE - do not call - the insurance co., and explain what happened. There should be an address for grieveances and appeals in your benefit booklet. Copy the physician on the letter and send him/her a copy. It may be your physician has a "habit" of doing this. If so, the insurance company will probably know that.
If you do have to pay - you should pay the negotiated rate - the rate your insurance company would have paid for the procedure, not the entire amount. (I can promise you the insurance company doesn't pay $4000 for a stress test!!!!)
Finally, it never hurts to call the insurance company customer service number on your insurance card to double-check that pre-auths have been submitted every time one is needed. That way you can follow up before the fact, not after. Good luck!!

cobrasmach

6/ 9/07 4:56pm

thanks a lot I let the doctor and ins company battle it out and turns out the lack of preauthorization was the fault of a human being in the doctors office so they cancelled the charge for the stress test and only charged me for an office visit.

wooooooooooooooow

cardiologist common errors

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