Kingley Institute - Overcharged for Nutritionist and Psychological Evaluation
Over a month ago, I had attended a informative seminar where I had an opportunity to meet with one of the alsom "Insurance Specialists" who informed me with my insurance (Lumenos Blue Cross Blue Sheild) I would have "No Problem" getting this procedure completed. I was even informed, that if persistant I could end up having this procedure done within the month.
And so I began setting up the appointments I was told would be required, to qualify for this surgery. I spoke with the ALSOM's office and was referred to meet with the nutritionist and psychologist at Kingley Institute down in Piscataway, NJ.
This is an In Network provider, who quoted me a rate of $275 over the phone for both the Nutritionist and Psyche Eval, mind you my insurance has a $0 copay for any office visit. Just the same I was told I would have to pay upfront. Soon after, I received a phone call from the Kingley Institute, informing me that due to the insurance coverage I had I would have to pay an additional $250, due to my having a high deductible.
I have never had a doctor's office ever mention that my deductible was so high that I would have to pay the rate out of pocket upfront. In an attempt expedite my surgery, I attended both appointments the weekend I phoned, and paid the $525 upfront.
As an aside, the therapist was wonderful, sadly her name escapes me at the moment. I'll be certain to recommend her to anyone who would require the services of a therapist in the Piscataway area. Sadly, that location is 2 hours south of where I live, and so her services were not going to be employed by me.
I found the 40 minute session with the nutritionist was a complete waste of time. She was accompanied by a trainee who had more empathy and manners then the brochure-reading-nutritionist I had paid an additional $250 for. Sadly, this seems to be par for course with most the nutrionists I've encountered.
The Monday following my consult, I called Alsom to cement my appointment with Dr. Abkins. The date was set, and i was looking forward to my consultation, when I recieved a phone call from the office informing me that I would have to pay nearly $2,500 out of pocket for the surgery upfront, rather then having the office submit my bills to insurance like every other docotor I have ever visited had done in the past. Whilst I was on the phone receiving this call, on another line, I was being phoned by the insurance "specialist" with the same message.
This raised a red flag for me.
I have cancelled my appointments with Dr. Abkins, and am left with a sour taste of this whole experience. I thought it best to wait for the EOB (Explanation of Benefits) from my insurance provider. And now that I am in receipt of this docuemnt, I am amazed to find that I was only responsible for the initial quote of $275 In Network amount. Immediatey, I phoned the insurance company who was perplexed that I had to pay upfront to start with. Let alone that I was overcharged by $250 for the experience.
I was informed that I would have to chase up this difference due to me by the Kingley Institute.
Perhaps my experience will help anyone else.
And so I began setting up the appointments I was told would be required, to qualify for this surgery. I spoke with the ALSOM's office and was referred to meet with the nutritionist and psychologist at Kingley Institute down in Piscataway, NJ.
This is an In Network provider, who quoted me a rate of $275 over the phone for both the Nutritionist and Psyche Eval, mind you my insurance has a $0 copay for any office visit. Just the same I was told I would have to pay upfront. Soon after, I received a phone call from the Kingley Institute, informing me that due to the insurance coverage I had I would have to pay an additional $250, due to my having a high deductible.
I have never had a doctor's office ever mention that my deductible was so high that I would have to pay the rate out of pocket upfront. In an attempt expedite my surgery, I attended both appointments the weekend I phoned, and paid the $525 upfront.
As an aside, the therapist was wonderful, sadly her name escapes me at the moment. I'll be certain to recommend her to anyone who would require the services of a therapist in the Piscataway area. Sadly, that location is 2 hours south of where I live, and so her services were not going to be employed by me.
I found the 40 minute session with the nutritionist was a complete waste of time. She was accompanied by a trainee who had more empathy and manners then the brochure-reading-nutritionist I had paid an additional $250 for. Sadly, this seems to be par for course with most the nutrionists I've encountered.
The Monday following my consult, I called Alsom to cement my appointment with Dr. Abkins. The date was set, and i was looking forward to my consultation, when I recieved a phone call from the office informing me that I would have to pay nearly $2,500 out of pocket for the surgery upfront, rather then having the office submit my bills to insurance like every other docotor I have ever visited had done in the past. Whilst I was on the phone receiving this call, on another line, I was being phoned by the insurance "specialist" with the same message.
This raised a red flag for me.
I have cancelled my appointments with Dr. Abkins, and am left with a sour taste of this whole experience. I thought it best to wait for the EOB (Explanation of Benefits) from my insurance provider. And now that I am in receipt of this docuemnt, I am amazed to find that I was only responsible for the initial quote of $275 In Network amount. Immediatey, I phoned the insurance company who was perplexed that I had to pay upfront to start with. Let alone that I was overcharged by $250 for the experience.
I was informed that I would have to chase up this difference due to me by the Kingley Institute.
Perhaps my experience will help anyone else.
To: Agirlost,
I want to say how sorry i am for your experience so far. I will say that I am a patient of Dr. Abkin and I totally adore the people that work in his office and think they are truly working to help the patients get through a web of insurance hurdles.
I also attend and speak at the seminars and share my patient experiences with prosepcetive patients. I am retired and felt so strongly about how we as patients were treated that i went back to school to learn about medical billing and coding. So now i work with several doctors doing various jobs including insurance verifications.
So the sad truth to the patients is that in this bad economy employers are trying to make cuts in costs and one way to do this is to pay less premium to the Insurance Companies... however as enticing that is to the employee... it doesn't come for free... the trade off.. is USUALLY an ELEVATED DEDUCTIBLE which the Patient will be responsible to pay EACH YEAR BEFORE INSURANCE COVERS ANYTHING.... along with that many of those plans then also have Co-Insurance....meaning Once YOU PAY the deductilbe insurance will cover maybe 80% and you would be responsible for 20%, or it can be a 90/10 split etc.
Bottomline is AS PATIENTS we need to be more proactive to read the paperwork our employers give us and speak up before switching to new plans, or going to another company. Another thing they are doing is putting in EXCLUSIONS to MORBID OBESITY TREATMENT.. so watch out for that as well.
As part of Dr. Abkin's practice we have insurance specialists that do the legwork for you and they will check on those deductibles and see if there are any exclusions. If you get denied coverage for procedure they willl fight for you to get it covered. If denied a second time we then have an attorney that will work with you to see if it's possible to get it covered. So this practice does go the extra mile to try to make this work for the patient. I can't say it works for everyone... but they do get things done for most people that come to them.
I have given this message to Laura the office manager and she is speaking to Kingley about your concern with them. I agree with you that once again your insurance should guide what your responsibility is and you should not have to pay more. I am sorry that you had a bad experience, but I assure you most people have a great experience using this practice and we would like to show you that this is the way to go
If you'd like to call me my name is Pat and you can reach me at Dr. Abkin's office Wed - Fri. afternoons (973-410-9700) or email me at: [email protected]
I want to say how sorry i am for your experience so far. I will say that I am a patient of Dr. Abkin and I totally adore the people that work in his office and think they are truly working to help the patients get through a web of insurance hurdles.
I also attend and speak at the seminars and share my patient experiences with prosepcetive patients. I am retired and felt so strongly about how we as patients were treated that i went back to school to learn about medical billing and coding. So now i work with several doctors doing various jobs including insurance verifications.
So the sad truth to the patients is that in this bad economy employers are trying to make cuts in costs and one way to do this is to pay less premium to the Insurance Companies... however as enticing that is to the employee... it doesn't come for free... the trade off.. is USUALLY an ELEVATED DEDUCTIBLE which the Patient will be responsible to pay EACH YEAR BEFORE INSURANCE COVERS ANYTHING.... along with that many of those plans then also have Co-Insurance....meaning Once YOU PAY the deductilbe insurance will cover maybe 80% and you would be responsible for 20%, or it can be a 90/10 split etc.
Bottomline is AS PATIENTS we need to be more proactive to read the paperwork our employers give us and speak up before switching to new plans, or going to another company. Another thing they are doing is putting in EXCLUSIONS to MORBID OBESITY TREATMENT.. so watch out for that as well.
As part of Dr. Abkin's practice we have insurance specialists that do the legwork for you and they will check on those deductibles and see if there are any exclusions. If you get denied coverage for procedure they willl fight for you to get it covered. If denied a second time we then have an attorney that will work with you to see if it's possible to get it covered. So this practice does go the extra mile to try to make this work for the patient. I can't say it works for everyone... but they do get things done for most people that come to them.
I have given this message to Laura the office manager and she is speaking to Kingley about your concern with them. I agree with you that once again your insurance should guide what your responsibility is and you should not have to pay more. I am sorry that you had a bad experience, but I assure you most people have a great experience using this practice and we would like to show you that this is the way to go
If you'd like to call me my name is Pat and you can reach me at Dr. Abkin's office Wed - Fri. afternoons (973-410-9700) or email me at: [email protected]
Hi
I read your post with interest as I also had issues with that office and then with Kingley at a later time. There may be an underlying "reason" the doctor's office did that - perhaps you present a possibility for risk that they are not willing to take.
I went through all the necessary appointments - did everything they asked about losing weight - went back to the office expecting to hear "OK we will work on getting a date" only to be told they would not be doing the surgery because of a condition they were well aware of at the first appointment. Easy for them to say but I had alot of out of pocket expenses for those appointments PLUS when I found a doctor who was honest and forth right, I had to pay for all those appointments again. Some of them full price because my insurance only covered them one time.
There are ALOT of good doctors out there that will work with you & your insurance. If you are not comfortable with how they handled your case, seek another opinion. Also call your insuance company again and ask them for the information in writing so it cannot be disputed.
Good Luck~!!!
Vicki
I read your post with interest as I also had issues with that office and then with Kingley at a later time. There may be an underlying "reason" the doctor's office did that - perhaps you present a possibility for risk that they are not willing to take.
I went through all the necessary appointments - did everything they asked about losing weight - went back to the office expecting to hear "OK we will work on getting a date" only to be told they would not be doing the surgery because of a condition they were well aware of at the first appointment. Easy for them to say but I had alot of out of pocket expenses for those appointments PLUS when I found a doctor who was honest and forth right, I had to pay for all those appointments again. Some of them full price because my insurance only covered them one time.
There are ALOT of good doctors out there that will work with you & your insurance. If you are not comfortable with how they handled your case, seek another opinion. Also call your insuance company again and ask them for the information in writing so it cannot be disputed.
Good Luck~!!!
Vicki
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