Not really malpractice but.... A few months ago my girlfriends PCP referred her to a gastroenterologist for a colonoscopy.. She's young and didn't want to go through with it if the co-pay was anything too high. After the consult appt we talked to their billing department and they said her co-pay would be $100 and to be doubly sure that this was correct they told us the head of the billing dept would double check and call us to make sure. She called and gave the same assurance---only $100 co-pay. After the procedure we get a bill for $115 and pay it, only $15 off so no big deal right? Then they send us another bill for $100. We went there in person to argue our case but they weren't interested in hearing it and (to my surprise) didn't even offer to reduce it. What are our options? Thanks
Answer
A colonoscopy for a $100????? Even $200 is a deal.
There are a whole lot of things that you do not relate here. Co-pays are not the end of the story. You co-pay if you have insurance. Then after you see the doctor or have a procedure done, the healthcare provider bills your insurance. Then if there is a balance owing you have to pay the balance. That is how it works. You don't have a second co-pay.
And when you have a procedure like this done, there are often separate bills - one from the facility, one from the doctor, one from the anaethesiologist etc.
What your girlfriend needs to do is take the bills and have them reviewed by a patient advocate to see if there are indeed duplicate charges. If there are, then those things should be taken off the bill. If coverage was denied by the insurance provider, your girlfriend would receive an EOB (explanation of benefits) form which would indicate what was paid and what was not.
If the charges are not duplicates, then the charges will stand. The healthcare provider is not obligated to reduce these. There may also be some sort of charity programs to help with the bill or arrangements can be worked out.
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