A follow up to my bad experience with new doc

I'm opening my email and I get a notice from my insurance company about a claim they received and paid. Yup. That's right. The doctor I went to see for a consultation - but didn't really get to talk to - charged me $150.00 at the time of the visit because I'm a self-pay patient. Then they turned around and billed my insurance company. They did not use a bariatric surgery related code so my insurance company paid the claim. That's right. The doctor's office got paid twice for the same office visit. Even though he didn't even spend 5 minutes consulting with me. I've called the insurance company who said that they have to assume the doctor's office used the correct code and under that code it is a payable charge. Which means, as far as the insurance company is concerned, I'm owed a refund of $125.00 from the doctor's office. I've called and left two message. Of course now that they know I know they owe me money it's probably going to take some doing to get my call returned. I should have followed my gut instinct and stayed away from his office.

Sorry, you have a mess like that, hon! I'm sure there are plenty of situations, like that. Good luck, on getting your money! Some of these doctor's, really, make me wonder! Keep us posted, Carole!

Thanks Sharon. I wonder about some of these doctors and their staffs, too. This is just plain crazy.

You deserve that money back immediately! That office is really something else...

Thanks Marcia. I'm going to call them again this morning and if I don't talk to someone by noon I'll call the credit card company and dispute the charge. One way or another I'll get my money back. I was really worried, though, about the charge being approved by the insurance company - because I know it shouldn't have been. Clearly the doctor's office coded the office visit as something other than an applicable bariatric surgical code. But according to the insurance company it isn't my problem. She said that even with me telling her what the appointment was for they go by what code the office uses on the claim. So unless the doctor's office changes the code the claim is a payable charge and I'm owed money back. I just know that some how or another this is going to come back to bite me in the butt. This is not going to be the end of this headache.