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.

 

[mercy1]

@prettypeacock1 I know this stinks, but she's going to have to pay her deductible anyway. It's only a matter of time before she hits her deductible and starts paying coinsurance. In the end, it's costly to have a baby and won't change the overall cost by much

 

[erin30ga]

@prettypeacock1 I agree.

It is just underscoring why you should never rely on the receptionist or even the doctor any time but in particular when you are doing something a bit out of the ordinary.

I also feel this way about tests that a doctor might suggest there are standard tests but if a doctor recommends something that is not what I generally have gotten, I ask why and if it is time urgent and I then check insurance. I do this with drugs as well as I have had doctor change to a formulary with a lower tier if they appear to be the same.

 

[xuxana]

@prettypeacock1 So what do you recommend I do? You seem to indicate that there's not much wiggle room - it's on me to have asked my insurance?

Is it appropriate to ask for a discount if I pay promptly? I'm just really frustrated about this situation

 

[princess7]

@xuxana The front desk could say the moon is made of cheese and it would still be the patient's responsibility to know insurance coverage

 

[prettypeacock1]

@xuxana You can ask for a discount, sure. It was on you to verify your insurance coverage prior to the visits.

 

[curtisptrsn]

@xuxana What exactly are they billing for? If there truly was no medical content in the meet & greets, I'm not sure how they could bill that at all. But it seems likely to me that there was at least something medical discussed (even if only a "how are you feeling"). In theory you could fight the bills on this basis, but I'm not sure it's worth your while.

I disagree with the commenters who say it was on you to confirm coverage with the insurance company. That's generally true, and you probably should have done that here too, but the insurance company has no way of knowing whether the OB office will bill global or not.

Was there some fine print you could have read somewhere that specified they wouldn't bill global if you started at 20 weeks? Probably, but you were misinformed by the front desk receptionist. (As a matter of policy, the practice also probably shouldn't be scheduling these meet & greets like this for patients who aren't going be billed global.) You can certainly politely ask for a discount on that basis, and of course you're free not to use this practice again, not to recommend them to friends, to give them bad reviews online, etc.

 

[curtisptrsn]

All this being said, how much of a difference is it going to make to you in the end? Giving birth this year, you were likely going to hit your deductible either way?

Also, congratulations!

 

[josie129]

@xuxana Sorry but when you change practices both groups end up billing. It was antepartum care. Who meets and greets 7 times? Happens all the time.

 

[samuelc]

@xuxana As everyone else explained, unfortunately you don't have much recourse. I can't tell you how many times we see on here that receptionists make false claims about things not being billed that are just unbelievable (why would those doctors spend time with you for free?). Honestly, I don't know if they lie on purpose like car salespeople or if they are that clueless and ignorant about basic health insurance common sense. Regardless, never believe the front desk!

What I would do now is speak with the office manager (not the biller). Tell them what the front desk told you. Better if you remember the name of who said it. Tell them so they can train the front desk staff and not put another patient through this. Ask them to intervene to remove those charges because it was the front desk's lie, and when they tell you they won't do that, then let them know you'll include this information in your reviews of the practice both online and with your insurance company. Sorry not much else you can do!