Billing Disagreement on Meet and Greet OB Sessions with Weill Cornell - Seeking Advice on Next Steps

[xuxana]

Hi, I live in NYC and just had my first baby at Weill Cornell. I switched from Mount Sinai OB to Weill Cornell ~ 20 week mark.

1. I just saw that I was billed $4,390.00 (and charged 2,217.30 towards my HD plan) for a routine OB in-network April visit.
2. I flagged this to the billing department, and they followed up that "Your insurance processed the claim towards your deductible leaving the balance due from you. Per the records you have over 7 visits"
3. I responded:
   1. "It seems there’s a mistake in the billing - When we asked back in January 2024, I was explicitly told by the front desk receptionist at West 80th Weill Cornell that these sessions would not be billed, as they were simply 'Meet and Greets', and only lasted 3 - 5 minutes with no medical content at all. Had I been told otherwise, I would not have scheduled them, and I would have expected this to be clearly and correctly disclosed ahead of time, when your teams offer a meet and greet as part of the OB practice. This situation is very upsetting to me, and negatively impacts my perspective of Weill Cornell’s practice given this misinformation that we were told and the subsequent unfair billing policy, and I hope we can rectify it fairly and promptly.
   2. Correct Visits:
      1. 1/11- initial prenatal - YES
      2. 2/12- prenatal care - 3 minute Zoom Meet & Greet - NO
      3. 3/13- prenatal care - 3 minute Zoom Meet & Greet - NO
      4. 3/22- prenatal care - 3 minute Zoom Meet & Greet - NO
      5. 3/25- prenatal care - 3 minute Zoom Meet & Greet - NO
      6. 4/1- prenatal care - 3 minute Zoom Meet & Greet - NO
      7. 4/5- prenatal care - 3 minute Zoom Meet & Greet - NO
      8. 4/8- prenatal care - 3 minute Zoom Meet & Greet - NO
      9. 4/10- prenatal care - YES
      10. 4/18- prenatal care - YES
   3. I suggest that you 1. Retract the meet and greet sessions from being billed in order to enable you to resubmit these final visits with Allegra Cummings, as part of the fully covered prenatal visits 2. Additionally, it is incumbent on the Weill Cornell staff to provide an accurate and clear policy regarding billing for these “meet and greets” to all obstetrics patients to prevent future misunderstandings."
4. They just got back to me that:
   1. "Per the department: Since this is a group practice and this pt was a late transfer at 20 weeks, we do not bill global for the delivery. We billed for the visits including the other MDs at the practice and the midwife. Altogether, pt had 12 visits with providers with the practice. "

What would you do if you were in my shoes? I feel like they should have disclosed that a 5 minute Zoom Meet and Greet is billable, which they didn't and I don't understand what it means that "we do not bill global for the delivery" or why that matters to me in this scenario

 

[aletia]

@xuxana Why would there be 7 meet and greets?

 

[xuxana]

@aletia Seven other doctors and midwives in the OB practice

 

[prettypeacock1]

@xuxana

I was explicitly told by the front desk receptionist at West 80th Weill Cornell

Always call your insurance to find out about coverages. The ins company does not care what the receptionist says or promises you.

we do not bill global for the delivery

What Is Global Billing? Global billing is done when there isn't a division of expenses within a medical service since the service was given by one entity alone.

Non-global OB care
Non-global OB care, or partial services, refers to maternity care not managed by a single provider or group practice.

Billing for non-global re may occur if:

A patient transfers into or out of a physician or group practice
A patient is referred to another physician during her pregnancy
A patient has the delivery performed by another physician or other health care professional not associated with her physician or group practice
A patient terminates or miscarries her pregnancy
A patient changes insurers during her pregnancy

 

[kgr13]

@prettypeacock1 As a PSA to anyone else switching mid-pregnancy, it is very common for there to be a "flat fee" charged by the OB/GYN which covers all charges through normal delivery.

If a patient switches - mid pregnancy for whatever reason - the standard billing can't be used and so it needs to be billed as separate line items.

It is always incumbent on a patient to verify coverage with insurance but particularly this is so when one is not doing something standard

Although one should NEVER rely on reception or anyone else in the doctor's office including the doctor - to confirm coverage or costs, the receptionist probably wasn't focusing on OP's unusual situation as I would bet that almost 100% of patients being treated by the office weren't new patients starting mid-pregnancy and so those "standard" patients would have no charge because they were included in the flat fee quoted and charged at the first meeting when a patient decides to use the doctor and facility

 

[prettypeacock1]

@kgr13 The receptionist not thinking about OPs situation is more reason to not rely on them to verify your coverage. Unfortunately, OP is going to learn an expensive mistake.