OT: extra bills from dermatology doctor....

[learlove]

This past Nov. I saw a dermatologist (Family Dermatology of Pennsylvania, New Hope Office) to have several skin tabs removed.

This is an in and out procedure and not usually covered under health insurance.

The 2 visits were $75 each and I paid both in full (in cash) after each visit (75 first visit and 75 the second visit). As indicated above I gave no and used no health insurance.

A few days ago I get a bill for $128.00. I call the office and they say it will have to be handled by their accountant that comes in once a week. So today about an hour ago the accountant calls me back.

Right away without even hearing my side of the problem she (the accountant) offers to reduce the bill to half ($64). I'm like "no, there should be no more bill, I was told that each visit for this procedure was $75". Then then told her how I paid in cash ect.. She said she would have to check with the office and would get back to me. end of phone call.

This sounds way shady to me. What can I do to prepare if they call me back and still try to stick me with this bill. Its really not about the $$ to me it just seems shady.

I figure I can tell them I will notify the:

1. Local Better Business Bureau
2. Put a review on health grades.com (I now see they already have 2 not so nice reviews)
3. Write a letter to the local New Hope paper
4. Write a letter to the local Philadelphia paper
5. take it to small claims court

anyone have and advice on this matter?

here is a list of events/visits with this office:

1. On (or about) Nov12 I was running errands and saw this office (Dermatologist) and decided to stop in to find out how to have the tabs removed.
2. in the office the staff told me it was $75 fee to have up to 15 removed.

3. I made and appointment for the next day

4. Nov 13 I showed up and they removed the tab on one side of my neck/shoulder. The Doctor said that the other tabs on the other side of my neck would have to be removed in another visit because removing them now would cause too much discomfort in conjunction with the one removed on the other side.

5. I paid ($75) for the visit and made and appointment fort the following week to remove the rest.

6. Visit #2 the Doctor removed the rest and I paid ($75) and thought I was finished until I got the bill for $128

[Pete Serotta]

First thing, write a letter to the doctor (by name) explaining the events and include"

- a copy of the receipt from when you paid and a copy of the bill presented at the time of payment and the follow on bill you received.

- at end of letter, state that based on your visit and the payment that you consider the bill "Paid in Full"

Now, put a copy of the letter and receipts away and wait to see if you ever hear from them.

Based on "accounts" only comes in one day per week, it is not that big of practice and probably has "loose" procedures. The question is "where did they come up with the new amount"? But do not worry for if they feel they are correct they will get back with you.


You would not believe even with insurance, how often many of us have to have these types of interactions with the Doctor and/or insurance company.


Good luck and do not lose too much sleep over it.....


PETE

[rwsaunders]

Tell them that your cousin Mort is a malpractice attorney and you'll never hear from them again.... :cool:

[93legendti]

What is written on your receipts?

[1centaur]

Pete's got it right. The worst case scenario for you is that they hit your credit record. The worse case for them is that you do all the things you say you'll do, which would hurt them far more than the satisfaction, if any, they'd get from trying to hurt your credit.

This sounds like (at best) sloppy billing habits leading to confusion (such as between what your staff quote was and how your procedure was eventually classified in the back office by perhaps an upcoding accountant) and at worst a raw grab for easy money from unthinking payers (perhaps including insurance payers and the accountant did not figure out you were a private payer). Neither sounds likely to get them to attack your credit record. Bet the doctor's heard these complaints before.

Annoying, but that's about it.

[thwart]

Good for you for not just paying it...

Elderly folks frequently are (whether intentionally or not... ) fleeced by medical bills like this. Generationally they tend to be less questioning of authority (M.D.).

[chuckred]

Physician billing is typically done using an itemized claim form called the "CMS 1500". It would indicate the charge and number of procedures performed by "CPT Code".

That's the first thing you need to see - they may have coded additional charges - the office visit consultation as one charge and the removal of the tags as the second one.

Secondly, they should have an itemized statement that reflects your $75 payments and a balance.

There may have been an error between what the receptionist told you and the way the charges were entered.

Finally, as you well know, the charges have nothing to do with what the practice is paid by insurance, Medicare, etc. If it was submitted to insurance, there would have been a contractual adjustment, a copay, application of a deductible, and then if still a balance, the insurance company would have paid it. Assuming the physician was participating with the insurance company, there would have been no balance billing to you.

All that explains why the accountant was quick to make an offer of an adjustment.

Before you get too upset, I think you're best bet is to walk through the bills and charges and assume that there was an honest mistake made in the process. Since you've already paid $150 from what sounds like a $278 total bill (rightly or wrongly), that you have a reasonable expectation that they will write off the difference since it's likely more than they would have been paid if submitted to insurance.


If you have health insurance, you're better off to use it and then pay if it gets denied, then at least you get the benefit of the contracted rate.

[Moontrane]

Give ‘em heck. For future reference on skin tags (mine haven't grown back):

http://a1468.g.akamai.net/f/1468/580/1d/pics.Drugstore.com/prodimg/13151/300.jpg
http://www.zamberg.com/files/CustomField/aeee1e94-1dcb-4c7e-8ffa-5b1e551ec910.jpg
http://ecx.images-amazon.com/images/I/31h5AUJADVL._SS500_.jpg
http://micro.org.pl/lib/exe/fetch.php/grupa9:bacitracin.jpg

[learlove]

moontrane,

yeah I know. when I inquired about having them removed the person behind the desk said something about using a laser to remove them. Then the next day I'm on the chair/table in the office and the Doctor whips out a pair of clippers/scissors like you show and start snipping away. I'm thinking to myself I could have just had done the same thing myself or had my mom who has been a nurse for 40 year do the same thing.

[Tobias]

After spending almost $3,000 I received a bill for about $150 additional FIVE months after my visits. Needless to say I raised hell about their billing practices (which wasn't the first time) and they dropped it, and with an apology.

I like my doctor but his office needs serious work. :crap: