Expert: Ray A Miller - 9/22/2010

Question
My husband had carpel tunnel surgery, trigger release done by an orthopaedic surgeon several months ago.  Prior to this surgeon actually doing the surgery, after conferring with my husband's insurance carrier, it was determined he would have to put $1500 cash down before the surgery was done:  George paid this lump of money, then had surgery.  We believed the bill was paid.

NOT:  This same orthopaedic group is demanding another $960!  In none of their statements has the $1500 been shown.  George finally got a return call from the billing person and, of course, as to be expected "The $1500 was only an estimate".  I find this totally inexcusable.

IF a person has their automobile repaired, any work needed that exceeds the original "estimate" quoted by $10 MUST be
be presented to the client before actual work commences.

George's surgery was not complicated--he was in and out of the OR in MINUTES not hours.  His recovery was uncomplicated.  He was seen by a physician's assistant for follow up.  

How can this kind of tactic be legal?

Answer
Does not sound like it should be but it is.  I am sure that if you check your paperwork closely you will find the word estimate in there somewhere.  If you feel that you have been overcharged, you can report this doctor to the BBB, consumer affairs and your states' attorney general. You may want to tell your doctor your plans before you do it.

You should also get your insurance company involved.  They should have a contract with the doctors office that states how much they can charge.