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Should I do a billing dispute because they won't reimburse me?

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Established Member

Should I do a billing dispute because they won't reimburse me?

So I went to doctor's in November of last year and paid about $240 ($5 co-pay then $235 for x-rays).  The doctor's office also billed my insurance and the insurance paid for all the x-rays, to where I should have just paid the $5 co-pay office visit.  This is nothing unusually, It's happened me several times and the doctor's office just mails you a check for the credit they owe you.

 

Now, this doctor's office isn't denying they owe me money, they are just are giving me the go around about paying me.  Back in Febrary I was told they will cut a check on March 1, never happened.  Now, they are saying I'm getting a check, they just don't know when (it's been 7 months now).  Even left messages with their office manager/billing (no one picks up nor calls back) and the front office lady just says "umm... she's at a meeting, just leave a message" and doesn't care, obviously just giving me the go around.

I'm sure the proper route is small claims court but I don't know how to do that or want to go through that hassel.

This is a citi card.  I've only filed one billing dispute in my life and it was Bank of America credit card and it seems like they are IMPOSSIBLE to win.   Basically went to a dealership who sold me a brake job but never did it, then went to another dealership a week later and they did the brake job and sent me a receipt showing my brakes were severly low and gave me my old brakes (surley you'd think Bank of America would side with me).  But Bank of America requested a letter from the second dealership and that letter must say (1) the first dealership by name (2) the date I went to the first dealership (3) the first dealership never did a brake job they charged me for.  I was like c'mon no one is going to write such a letter.

Message 1 of 10
9 REPLIES 9
Super Contributor

Re: Should I do a billing dispute because they won't reimburse me?

Call your insurance company. The physicians have a contract with the insurance companies controlling what they can bill.

In a situation like this, go to the bigger gorilla and ask the gorilla to ask the doctor nicely for the funds.
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Message 2 of 10
Community Leader
Super Contributor

Re: Should I do a billing dispute because they won't reimburse me?

I would quit calling for starters, and send an email so you have a paper trail. Send ONE email or a certified letter to the Doctors billing office, with the demand for refund within 5 days (since they already have payment from both you and your insurance company), or you'll contact your insurance carrier, and the State Administration & Medical Boards for Billings errors.

No need to contact your CC company on this, You'll get your refund. Smiley Happy

Scores held down by umpteen INQ & New accounts
~~~BK7 d/c-08/2013......my rebuild worked for me, but won't necessarily work for you.~~
Message 3 of 10
Regular Contributor

Re: Should I do a billing dispute because they won't reimburse me?


@pizza1 wrote:
I would quit calling for starters, and send an email so you have a paper trail. Send ONE email or a certified letter to the Doctors billing office, with the demand for refund within 5 days (since they already have payment from both you and your insurance company), or you'll contact your insurance carrier, and the State Administration & Medical Boards for Billings errors.

No need to contact your CC company on this, You'll get your refund. Smiley Happy

+1 This is perfect recourse.  If they dont have a check to you within a week, then bring in the big guns to do the work.  Solid advice guys. 

Message 4 of 10
Contributor

Re: Should I do a billing dispute because they won't reimburse me?

Businesses hate it when you file a BBB complaint and leave bad reviews on things like Yelp.  

500K+ TCL / 800+ FCOs
Message 5 of 10
Community Leader
Legendary Contributor

Re: Should I do a billing dispute because they won't reimburse me?

Disputes of billing related matters related to credit cards is provided for under section 161 of the Fair Cedit Billing Act.

An essential element of an FCBA dispute is that any such dispute must be filed within 60 days of first being advised in a billing statement sent to the consumer of the asserted billing error.

 

An FCBA dispute appears to no longer be appropriate since more than 60 days has passed since  being advised in a  billing statement of the asserted error.

Message 6 of 10
Community Leader
Senior Contributor

Re: Should I do a billing dispute because they won't reimburse me?

This happened to me at my dentist. I paid using my FlexSpend CC for a procedure I was told wouldn't be covered by my dental plan; however, it was covered. I called dental office immediately and was told they hadn't received payment from insurance co yet and to give it 10 days. After the 10 days passed, I called every other day over the next 2 weeks, and was promised a check would be mailed. Since the office was right around the corner from where I worked, I even stopped by twice. Finally, I said “well I’ll just dispute the charge on my CC!” I was told I could pickup the check by COB that day. Needless to say, I found another dentist.

Yes, handling disputes within the 60 days makes all the difference in the world.

In your case, I would still contact insurance co in writing about your doctor being paid twice for the same procedure. This is unacceptable medical behavior and I agree with filing a complaint with BBB. It’s amazing how quickly a complaint with them can get things resolved.

GL2U
GOALS: Garden til DEC 2020 and 800 Club



Scores
JUN 2019: EX 788, TU 794, EQ 779
APR 2019: EX 787, TU 789, EQ 781
JAN 2019: EX 794, TU 783, EQ 801
DEC 2018: EX 777, TU 783, EQ 799

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Message 7 of 10
Established Member

Re: Should I do a billing dispute because they won't reimburse me?

I'll see if the insurance company can do anything.  Actually found out about this months ago from them and they just said I need to call the doc's office and get my money back.  Kind of just felt like it's between me and the doc's office at this point.

 

Their BBB profile has 0 complaints, not sure if it'll do anything.

 

Their google rating is 2.2 stars.  The doctor is probably too old to know what the internet even is lol.  Plus he's the only type of this doctor in the area, so it's more of less a monopoly, people go to him because they have to, not because they want to.  Although I didn't think the doctor was bad, just the office staff.  And the thing about the office staff is, they don't care.  At first I thought, great some office billing manger wants to pocket my money, but that's not it.  She's just **bleep** too lazy to write a check and mail it out. 

 

Had the same thing happen with a dentist a year ago.  Front clerk just says "I don't know" and "we'll mail a check, soon" then says will transfer you to the office manager who doesn't pick up and just deletes her voice mails.  Except the dentist goes to my gym, so I told him personally and he wrote me a check. 

By the way, never move to the south.  Just full of lazy people and nothing gets done. 

Message 8 of 10
Community Leader
Senior Contributor

Re: Should I do a billing dispute because they won't reimburse me?


@jasonfodor wrote:

I'll see if the insurance company can do anything.  Actually found out about this months ago from them and they just said I need to call the doc's office and get my money back.  Kind of just felt like it's between me and the doc's office at this point.

 

Their BBB profile has 0 complaints, not sure if it'll do anything.

 

Their google rating is 2.2 stars.  The doctor is probably too old to know what the internet even is lol.  Plus he's the only type of this doctor in the area, so it's more of less a monopoly, people go to him because they have to, not because they want to.  Although I didn't think the doctor was bad, just the office staff.  And the thing about the office staff is, they don't care.  At first I thought, great some office billing manger wants to pocket my money, but that's not it.  She's just **bleep** too lazy to write a check and mail it out. 

 

Had the same thing happen with a dentist a year ago.  Front clerk just says "I don't know" and "we'll mail a check, soon" then says will transfer you to the office manager who doesn't pick up and just deletes her voice mails.  Except the dentist goes to my gym, so I told him personally and he wrote me a check. 

By the way, never move to the south.  Just full of lazy people and nothing gets done. 



@jasonfodor wrote:

I'll see if the insurance company can do anything.  Actually found out about this months ago from them and they just said I need to call the doc's office and get my money back.  Kind of just felt like it's between me and the doc's office at this point.

 

Their BBB profile has 0 complaints, not sure if it'll do anything.

 

Their google rating is 2.2 stars.  The doctor is probably too old to know what the internet even is lol.  Plus he's the only type of this doctor in the area, so it's more of less a monopoly, people go to him because they have to, not because they want to.  Although I didn't think the doctor was bad, just the office staff.  And the thing about the office staff is, they don't care.  At first I thought, great some office billing manger wants to pocket my money, but that's not it.  She's just **bleep** too lazy to write a check and mail it out. 

 

Had the same thing happen with a dentist a year ago.  Front clerk just says "I don't know" and "we'll mail a check, soon" then says will transfer you to the office manager who doesn't pick up and just deletes her voice mails.  Except the dentist goes to my gym, so I told him personally and he wrote me a check. 

By the way, never move to the south.  Just full of lazy people and nothing gets done. 


I’m sorry to say this, but your responses are simply excuses. 

 

It doesnt matter if the BBB has no complaints on this medical office. Every complaint made is a first complaint. 

 

It doesnt matter whether the doctor is too old to know what the internet is about or if he’s the only specialist in town, it’s about getting paid twice for the same service. So are you saying you would still seek medical services from this office again?

 

So, the point is, if you want your money back, you have to do what is necessary to get it back—like you did with the dentist—even if it means going into the office and sitting there all day until you have a face-to-face with the doctor. 

 

And I wont even comment on your last statement. 

GOALS: Garden til DEC 2020 and 800 Club



Scores
JUN 2019: EX 788, TU 794, EQ 779
APR 2019: EX 787, TU 789, EQ 781
JAN 2019: EX 794, TU 783, EQ 801
DEC 2018: EX 777, TU 783, EQ 799

|| AmX Cash Magnate $25K || NFCU CashRewards $20K || Macy's $20K || Discover IT $15.7K || NFCU CLOC $15K || NFCU Platinum $12.5K || AmX ED $11.5K || CitiCostco $7K || CitiDC $6.3K ||
Message 9 of 10
Valued Contributor

Re: Should I do a billing dispute because they won't reimburse me?


@Obscure-Expert wrote:

Businesses hate it when you file a BBB complaint and leave bad reviews on things like Yelp.  


This is true SOMETIMES.  There are also a lot of business that just don't care.   BBB complaint is the same as a Yelp review, it is the complaintants opinion.  The BBB has no power to enforce anything.  If a company is worried about their reputation then they will respond, if they aren't then they won't.  It's really a crapshoot. 


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