How do I get my doctor to pay up?

February 26, 2013 12:48 PM

Short version: Outpatient facility acknowledges they owe me money but has not paid up. Their eternal answer is "The check will go out Thursday. We know it was supposed to go out last Thursday but it will go out this Thursday. Promise!" It's been over a month now, and I've called several times a week. How do I get my money back? More details inside if you want them.

Two months ago I went to an outpatient facility for a medical procedure. I had checked with my insurance beforehand and they told me the procedure was 100% covered. I arrived at the facility at 7am all prepped for the procedure, and they told me it was not 100% covered and I would have to pay them just under $500 before they would admit me for the procedure. This was not the sort of thing one can put off, so I paid.

I called my insurance provider two weeks later and learned that the procedure was 100% covered and that they had paid everything. I then called the outpatient facility asking for a refund.

The outpatient facility denied all knowledge of the payments my insurance company had sent until I read them the check numbers, at which point they suddenly "found" them. For about a month now, they've told me the check will go out on Thursday. When the check does not appear by Monday, I call and they tell me there was a mix-up but it will go out this Thursday.

What are my options to get them to pay up? Do I take them to small claims court or just camp out in their lobby on Thursday until they give me a check?

posted by rednikki to work & money (10 answers total)

Note: if you are in Los Angeles and would like the name of this facility in order to avoid it, let me know!
posted by rednikki at 12:48 PM on February 26

You don't necessarily have to actually sue them. You can just threaten to take them to small claims court. Send a certified letter informing them that, following up on your previous conversation, you expect the money to arrive no later than Friday; if it doesn't, you'll initiate legal action. (If it were for more money, or you happen to know a lawyer, a quickly-drafted letter from one will serve the same purpose but with better-wrought language and a bit more punch.)
posted by Tomorrowful at 12:52 PM on February 26 [2 favorites]

In similar situations, once it's become clear that no one in the office is either interested or empowered enough to be the problem-solver in the scenario, I'll adopt a very, very specific tone in order to force their hand. The key is to be pleasant and friendly while at the same time being extremely specific and firm. For example: "What is the name of the person who will be preparing the check? Could you connect me to [Jane], please? Hi [Jane,] what time are your checks typically ready? 10:00 a.m.? Great. I will be happy to come by and to pick it up in person from you so that you don't have to worry about the hassle of any further delays or mixups. Is there anyone else I need to speak with in order to confirm our appointment? And what's the best way to reach you the night before to confirm our appointment -- by phone or email?"

This will usually shake the tree enough that the check will fall out. If you get the runaround on this sort of phone call (e.g., the refusal to put you through to anyone who can actually help you specifically), or if you show up and they still don't have the check, then you've essentially gotten confirmation that you have to go to the next step.
posted by scody at 12:59 PM on February 26 [20 favorites]

How vindictive do you want to be? I imagine that if you stood outside their office with a sign saying "this clinic stole $500 from me" for an afternoon, you'd get a response very quickly.

Alternatively (and more reasonably), Tomorrowful's answer is well taken. If you were to actually sue them, you'd send them a demand letter anyway. So, if the demand letter doesn't work, you can sue them. If the demand letter works, you don't have to sue them (and you still end up with your money).
posted by saeculorum at 12:59 PM on February 26

Write one firm letter stating your demand, and a deadline. Tell them if they don't comply you're taking them to small claims. Send it via registered mail so you get a delivery receipt. Then stick to it -- if they miss the deadline, go for small claims court. (Seconding Tomorrowful's advice that if you have a lawyer friend draft this letter for you it's will probably help scare them into acting sooner. But if you don't have a lawyer friend then don't bother paying a lawyer to do it.)

Small Claims is easy (I've done it in LA and it's not as much of a pain as you'd imagine) and when you are before the judge you can also ask to be reimbursed for your costs -- so, court costs, the cost of mailing the registered letter, anything else. Not sure if you can ask for interest on the $500 but it's worth a google to find out.
posted by BlahLaLa at 1:01 PM on February 26 [3 favorites]

The other fun thing you could do is challenge the payment through your credit card/check card (assuming that you used said card for payment.)

Also, file a complaint with your insurance company and with any state board. I'd also escallate this to the Practice Manager/Office Manager (if you're not already talking to this person.)

If you can talk to the doc, do so, he/she needs to know that his office are buffoons.
posted by Ruthless Bunny at 1:10 PM on February 26 [3 favorites]

You should contact your insurance company. You know how insurance companies negotiate rates for their customers? Sometimes sketchy care providers try to circumvent those reduced rates by doing what they've done to you. So if you alert your insurance company to what's happened they may be able to resolve this for you quickly. I'd do that today.
posted by stowaway at 2:02 PM on February 26 [9 favorites]

Yes, stowaway has a good suggestion. Your insurance company has much power over them and may be willing and able to negotiate this for you. The insurance company may even withhold the $500 from the doctor's office's next payment, and send that money to you instead.
posted by Capri at 2:29 PM on February 26

This happened to me. I found out who made out the cheques and talked to her. I was super nice and cooperative. I told her I really understood that she was busy, since I was busy in the same way, but was there anyway she could help me? She did. My insurance company was no help.
posted by fifilaru at 3:24 PM on February 26

I just wanted to note that I used scody's advice and it worked like a charm. As of today I have gotten my money back!
posted by rednikki at 10:24 PM on March 4 [2 favorites]