Doctor owes me $600.00 in copays

A

AprilLLove

Guest
Jurisdiction
Illinois
I had gone to get TMS(Transcranial magnetic stimulation) done at a psychiatrist office. I was suppose to go 25 times to have this done. 5 days a week for 5weeks at 45 minutes each time but it took them 10 weeks bc they kept canceling on me. At this point I didnt know how important it was to keep this schedule. I was not paying a co-payment at all for those 25 times. When I needed a 2nd round of treatment the doctor informed me I owed copayments of $30 for the past 25 times and $30 each future appointment. I made double payments of $60 for 10 appointments equaling $600. I stopped going to see them. They sent me to collections and put a mark on my credit. Finally i did some checking and found out i wasnt suppose to be paying a co payment and they owed me instead of me owing them. I have been trying to get my money for 2 years. Is there something i can do before small claims court.
 
AprilLLove said:
I had gone to get TMS(Transcranial magnetic stimulation) done at a psychiatrist office. I was suppose to go 25 times to have this done. 5 days a week for 5weeks at 45 minutes each time but it took them 10 weeks bc they kept canceling on me. At this point I didnt know how important it was to keep this schedule. I was not paying a co-payment at all for those 25 times. When I needed a 2nd round of treatment the doctor informed me I owed copayments of $30 for the past 25 times and $30 each future appointment. I made double payments of $60 for 10 appointments equaling $600. I stopped going to see them. They sent me to collections and put a mark on my credit. Finally i did some checking and found out i wasnt suppose to be paying a co payment and they owed me instead of me owing them. I have been trying to get my money for 2 years. Is there something i can do before small claims court.
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Did you discuss this dispute with your insurance provider?
 
Your dispute is not with the doctor. It is with the insurer. I'm not sure why you didn't owe a co-pay, nor why you wouldn't have called the insurer as soon as you were told you did owe one.
 
ElleMD said:
Your dispute is not with the doctor. It is with the insurer. I'm not sure why you didn't owe a co-pay, nor why you wouldn't have called the insurer as soon as you were told you did owe one.
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Possibly, unless the doctor claimed she owed 30/visit co-pay when in fact they did not. Am I reading it correctly she paid the doctor directly, not the insurance company? As in, "we (the doctor) contacted your insurance and your policy states 30/visit copay" when in fact they did not contact them at all and decided to take that 30/visit as a tip. If that's the case the doctor owes her not the insurance company.

Good luck getting a straight answer out of the doctor or insurance company.
 
What have you done so far to try and get your money. Do you have your explanation of benefits from your insurance company that shows the visits were paid 100% by your insurance company?
 
Txls, you are correct. My insurance and the doctor agreed on a price and my insurance paid it in full. After 25 sessions I was told I owe for the last 25 sessions and for each session going forward.
I have complained to the insurance company and have tried to work with the billing department at the Doctors office. They keep telling me they are trying to get the EOB's (explanation of benefits) from my insurance but cant get the dates of service to match up. (Thats bc they kept canceling on me.) I called my insurance and gave them the dates I have and I got copies right away. I tried giving them the copies but they refuse to accept the certified letters I send. This has been going on too long and I am worried I am running out of time to collect.
 
You can try bringing a letter in person along with the copies. Make the letter short and to the point, along the lines of "if not resolved by xx date I will file in small claims court, or report to the BBB, or the next letter you receive will be from my attorney." Whichever way you want to go.
 
txls said:
You can try bringing a letter in person along with the copies. Make the letter short and to the point, along the lines of "if not resolved by xx date I will file in small claims court, or report to the BBB, or the next letter you receive will be from my attorney." Whichever way you want to go.
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Thank you txls! I took your advice and printed up a short letter saying everything you said. Took it to their office this morning but had to wait several hours before anyone showed up. I handed the actual Doctor the letter. Now all i can do is wait for April 4th ( the dead line) to see what happens. Thanks again!!
 

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