Who's at Fault? Medical billing dept. or insurance company?
I needed to see a dermotologist and found a provider for my insurance. I saw a physician's asst. and didn't get a bill for 2 months, after my 4th call in. They were billed lower than another dr., not the dr. who I had asked for. The dr. they billed underneath was out-of-network. I talk to the billing dept. and they waived profoundly of fees. I asked them why they didn't submit it under the dr.'s cross who I had requested. They said he doesn't work at that organization, he just owns the clinic. They said that it would be fraud to detail anything under his autograph since he doesn't practice at that specific clinic. However, the insurance company has him down as a provider at that specific location. I looked at their website today and called the hotline, and they said he is still scheduled as a provider. Does this mean I want to fight the insurance company? I hold called both party so many times and don't know who to blame anymore. At this point, it newly looks like I'm reaching. Help!Answers: The faculty where on earth you are being see at needs to drink the cost, they has it timetabled as a providing provider they are fully aware of what they are doing did not tell you so they are responsible the insurance company just pay for the service at out of lattice work prices.
Ask your insurance co. if it's fraudulent for the Dr's office to bill you underneath another name, and especially when you weren't see by ANY Dr., and only a psysicians **'t?
But also? It seem to me that the ins co has a responsibility to hold their roster up to date. Failing to do that, they induced you to seek treatment specifically not covered. Do NOT pay anthing till this is resolved. Good luck!
This sounds fishy to me adjectives the way around. I work for a group practice, and as long as ONE of my docs is within your network, we embezzle your insurance - all of our bills step out under one Tax Id#. That said, the provider have a responisibility to bill the claims under the identify of doctor the patient see. To do anything else is fraudulent - except in the satchel of a PA or Nurse Practitioner - those can be billed under the label of the supervising MD. The insurance company has the right to audit merciful charts at any time, and if they find this the provider will be required to refund the payments.
However, insurance company rosters are occasionally up to date. I have some insurance companies that register us at a location we vacated 11 years ago! There's another that needed to verify the information of a doctor who left our practice six years ago.
Question nearly medicaid eligibility...Can someone please answer this!!?
I have applied for medicaid after my husband lost his assignment and health insurance. I applied for myself (pregnant) and our 2 children (ages 4 and 2). I spoke next to medicaid today, and she says that my husbands November income will determine wether myself and my children qualify or not..The problem I hold with that is to say my husband is NO LONGER EMPLOYED.therefore, does not take home that money weekly, if he did, I would not be applying for medicaid because we would have form insurance. Can someone please explain to me why income from 3 months ago matters surrounded by situations like this? I am only about feed up, I dont know what to do...I am extremely stressed, have no insurance for my pregnant self and my 2 childish children, I have be paying for appointments out of pocket, and I can't do it anymore, let alone own to pay for a C-section beside 4 days in the hospital! I work full time, but do not label nearly enough to be disqualified by my income alone.Answers: If you call for coverage for November, his income in November will enjoy to be counted. Also, if you applied in November, it is standard to hold to supply documentation for that month. HOWEVER, since you are pregnant, there should be a separate eligibility for you,since the State have a different set of eligibility rules for pregnancy. If your husband is no longer emloyed, you need to notify your worker of this and provide documentation to that effect. If you don't be aware of like you are one heard, as to speak to a supervisor.
It might depend on what state you are within. I applied for my last pregnancy here surrounded by California. And if I remember (2 yrs ago) they just asked for his final 2 paycheck stubs. I wasn't working. And the coverage ended 1 month after i deliver.
I set up an HSA in February, 2008. Can I use the funds from the HSA to pay for a procedure from January?
Answers: The Rules for HSA contribution and usage are governed by the IRS - as it is a tax-advantaged account. In order to establish an HSA, you must first be covered by a qualifying plan. Once the account is established, you can then start paying for or reimbursing yourself for medical expenses incurred after the date of the qualifying plan, or the month in which you opened your account, whichever is later.
It may be possible. It will depend upon when you had the HSA qualified insurance plan. If you had the insurance plan in January you can use the funds from the HSA account to pay for the January procedure. If you did not have the insurance you can't. In fact, if you had the plan in 2007 you can deposit funds for 2007 until April 15th.
See the IRS guidelines for HSA accounts: http://www.irs.gov/pub/irs-pdf/p969.pdf
you might be able to if you had your HSA insurance plan before your claim.
you should check with the bank or your health plan