Who pays for this doctor visit?
August 4, 2006 5:49 AM Subscribe
My health insurance company refuses to cover a dr. appt because of a contract dispute of which my dr. claimed to not be a part. Except they were...
posted by superkim to health & fitness (9 answers total)
I had a dr. appt in early July just after the contract (between Piedmont Healthcare and BCBSGa) ended on 6/30. I spoke with my dr. who said that they were not a part of Piedmont and that all services would indeed be covered as in-network by BCBSGa. I asked them to triple-make sure of this because I could not afford to pay the entire expense out-of-pocket. They assured me I have nothing to worry about.
I saw the doctor again yesterday and there was a sign hanging that said that they are indeed contracted with BCBSGa thru 2010.
Last night I received a statement of benefits from BCBSGa that said that the dr appt will not be covered and when I spoke with the dr.'s office this morning I was told that they were "mistaken" about not being affiliated with Piedmont and they will file a continuation of benefits claim but that I should be prepared to suck it up and cut them a check for the full amount.
I don't understand how this happened. Should I have gotten certain things in writing? Would that even have helped me? Was I deceived or just stupid? Is there anything I can do to not have to pay for this?