[azhangie]

Its way too early for me to be pissed off, but I come to work to find a statement from my doctor's office this morning. I look to see that they're trying to retro-bill me for services from 2006 up until just recently.

So this is what happaned: I've been getting my depo shot at my doctor's office since 2006 (so two yrs now). And each time the nurses have to apply for an authorization from my IPA. Each time the authorization comes to me and the co-pay is listed as $10.00, because that's how much it is suppose to be for seeing my primary doctor. Each and every time I get this shot, the head nurse in the office always complains (to me and sometimes mutter to herself or other nurses) that this shot costs them more money than what the insurance covers. Well honestly, that's not my problem..they need to take it up with the insurance company.

Apparently, the head nurse found a way to do that. So this last time she applied for me for the shot - she modified the application so that I would have to go pick it up myself at the pharmacy and pay $150.00. When I found out I called my IPA and asked what was going on. The lady working at the time said that the doctor's office applied for it that way and she wasn't quite sure why they did that. So she modified it back for me...so I went in and got my shot.

Now 2 weeks later...I get this statement from my doctor's office. What happened was the modification listed my copay as $35 instead of $10 this time. Ok honestly, I dont care about a $15 dollar difference this ONE TIME. But then I look again at the statement and they are actually trying to bill me that extra $15 for the last 2 years!!!!!! The statement balance is $200.00 instead of the $15.00.

Ok..honestly WTF?! Even if the co-pay was always $35.00 instead of $10.00 you would think that they would have caught this back in 2006 when I got my first shot and not 2 yrs later. I called my IPA and they that its too much work for them to go back and find all the authorization from 2 yrs ago (the only authorizations i've had in the last 2 yrs were for this shot - so i dont really understand where the work is) and that my doctor's office should have all the paperwork there. So I call the doctor's office and the stupid lady answers and tells me oh no we dont have the paperwork anymore...shes like "well you can just mail us a check of what you think you owe and we'll check for you and get back to you". Wat the hell kind of answer is that!? I honestly think that the billing lady (which is also the head nurse of that office) is using this last time's $35.00 co-pay as an excuse to bill me for all times in the past. I'm soooo livid right now. My friend, who used to go to this doctor as well, has changed doctors recently and I think I will too.

But does anyone know if they're allowed to do this? And if not, can they get into trouble if I reported them?!!? Right now I'm going to call my IPA a little later to see if I can get a different lady to have my previous authorizations faxed to me, so I can bring to my doctor and shove it in her face.

(Sorry its long...But i didnt somewhere to vent. Thanks for reading! Any advice is appreciated!)

[artich0ke]

That's really shady... I didn't know they were allowed to do that? I'd call your IPA back and bitch about it, because this isn't your job to figure out, it's theirs.

[oogiewoogie]

Shady shady shady ... best of luck to you

The head nurse/ billing person should've took care of this to begin with.. oye.. sending positive vibes your way!

[Batel]

I'd definitely be calling your IPA back and once you get that sorted, I'd switch doctors if I were you, that lady sounds shady, if she's going to do that sort of thing to you, who knows what else she might do...

[JSH812]

I've noticed a lot of offices making patients go to the pharmacy to pick up Depo, Gardasil and even b12 shots..... it's all about the $$$ anymore, and not about caring for patients.

If I were you, I'd send them amount you believe you owe, and leave it at that.

[lovinalotofbags]

I would say something. These doctor's office agree to contract with certain insurance companies and yours happen to be one of them. They have agreed to what the insurance will reimburse them for the medication and services performed. I too used to get Depo shots in the office and only paid copay with no problem.

[jellybebe]

Ugh I'm so sorry to hear this. Why doesn't the US just get a universal healthcare system?!?!?!?!?!

[he432]

^^ watch Sicko.

I love universal health care as much as the next canadian but we have problems of our own too. No system is perfect.

azhangie that is pretty sketchy. I hope you find away around it.

[azhangie]

I called my IPA and apparently it's been $35 but they just never stated/updated it on previous authorization letters. So I always thought it was $10 instead of $35. But you would think the doctor would have caught this like ohh...1.5 yr ago!??!
Ugh...watever. I already switched doctors today. I cannot deal with bitchy nurses in my already hectic life.