Expert: Frances Davis - 9/16/2006

Question
In Dec of 2004, I found outI was pregnant with my secound child. I went to the doctors office to begin my prenatal care. They evelauted my insurance,called the company and determined my copay for the prenatal and delievery cost. They prepared a contract for a normal vaginal delievery. It stated the cost in full, then that my insurance covered 90% and the cost of my copay. This cost was 257.00 and they divided that up into payments per visit and until my 6 month to pay in full. I wrote a check that day for the first 200.00, the following visit they demanded the remainder of the bill andI paid it. They facilty houses many doctors all obgyns, I was told when I asked all doctors there were covered under my insurance.To this day the recepationist claims all there dr. take my insurance :quote they all in network providers for united Health care when in fact one Dr. is not. The office staff including doctors incourage you to set up an appt. with each of their doctors because you have no choice in which doctor delievers your baby. They work on rotation and whom ever is on call delievers your baby no exceptations. I am a high risk pregnancy they knew this from day one, i used the facuiliy with my 1 st child the only difference was I was covered under TNCare. Approxmitely 3 weeks before I dievered, I was having a procudure done with dr.k when she was called to the hospital, The test sometimes takes several hours but they weren't getting the results the wanted and were going to send me home to eat lunch and come back, but needed Dr's approval. The nurse came in and ask if it was ok if Dr. W came in and check me for release.I said who I had never heard of him, She stated he just joined are practice  don't know much about him but he seems nice. I approved he released me. Nothing was said when I checked out about him not taking my inurance, there was no notice madein the officeabout a new dr. nothing. A ew weeks later I was hospitalized in active preterm labor. This was Wednesady night, the doctor on call said they were not going to help me have this baby and we were doing anything to stop the labor, so I lied there wed, thur, fri ,sat, each day I had a new doctor all content with letting me lay there.On Sunday morning, Dr. W comes in breaks my water in 30 min we had a baby, he leaves I never speak with him again. My husband brings me the mail at the hospital  my son stayed because he was premature. I recieved my first bill stating I owed for seeing Dr.W a few weeks prior I didn't question fiqure the insure hadn't went through. The the bill came from the office regarding my delievery charges ? I had already paid this. Then the insurance send there paperwork showing we owed the doctor for the delievery because he wasn't covered by my insurance. I contacted the doctors office to dispute the bill but they told me that by law it was my responsible to find if the doctor prior to him rendering his services cover by my insurance.s  I realize I shouldn't have assumed since he was in there practice that he took there insurance but when I asked there office they confirmed he did take my insurance. After arguing with billing specialist they took the amount off the bill and for several months I recieved other bill from there office that didn't include this amount and showd balance owed . I had paid all but one and it was late. the following month I started recieveing bills with the charges now added back on the bill. I told them I refuse to pay the bill I already paid the contracted amount. Am I obligated to pay this bill, can they continue to charge finance charges on the bill. It's not the cost presay of the bill but the principle behind it. How do I go about disputing this no money for an attorney, it would cost more then the bill. Thank you for your time, sorry it was so long. I would appreciate any questions

Answer
Hi Shannon,
This is really out of my expertise.  It doesn't sound like it is such a large bill that could not be paid. I would recommend just paying it and getting it behind me.  I'm not an attorney, so I really can't respond to whether you are obligated to pay it or not.  It would seem the clinic would have an obligation to you, but- if they turned it to collections the problem would just grow and for sure you do not want it on your credit history...and like you said it would cost more to hire an attorney than to pay it...

Good luck to you.
Frances

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