AboutTricia Expertise Has your medical insurance company denied your claim and refuses to pay? Have
you received a pre-authorization and still your insurance company
refuses to pay? How can you get your insurance company to reverse a
denied claim? How do you get a provider to waive your copayment if you
are financially unable to pay? Can a provider sue you for a unpaid bill and
will they? Can a provider send me to a collection agency for a medical bill?
If my insurance company does not pay, am I responsible? If you have these questions or others on why your insurance company is not paying your bills, I can help. I can give you "tricks of the trade" to get your insurance company to pay.
I have limited knowledge on Medicare and Medicaid and that is not my expertise. Each state is very different regarding Medicare and Medicaid so you need to review their website when you have questions. So please no Medicare or Medicaid questions!!
Experience In the medical field for over 20 years spending majority of time in the collections aspect.
Question I went to Long Chiropractic Center in Brighton, MI. I now find out that by paying through insurance I was charged $50 per visit ($35 by insurance and $15 out of pocket). When I paid by credit or debit or check I was charged $50 per visit. I now I have found out and have COPIES OF THE BILLINGS from others that they were only charged $25 per visit for the exact same sessions/procedures. Is there anything I can do or complain to about this. I would expect for working with insurances it might be slightly higher for processing but a 100% mark up seems unjust. By the time I figure the deductible I have to pay on my insurance and the interest on my credit card they are making quite a profit off of me. They also never charged my secondary insurance (Medicare) even though they do except Medicare, of which I also have proof of COPIES OF BILLINGS where they went through Medicare. Over 3 months this is an excess $900 that I paid or charged to credit due to the 100% markup.
Answer Hi Helen!
Most providers/Dr's have a set price (UCR) for those with insurance and then a prepay price if someone does not have any type of insurance. The prepay is much lower allowing those without coverage to have care.
I am not an expert on Medicare but if they do pay for this type of service, then you should demand that they submit your copay to them. Your claims are still new so I would call them and tell them to bill Medicare and if they pay then you want to be refunded back.
Not much you can do about the difference of charges.......you can complain to them but they are able to do this.
Focus on getting some of your money back by asking them to bill Medicare would be your best bet to help ease the high cost you paid.
