I’ve payed this doctor’s bill in full and keep getting never ending bills for more for things like insurance adjustments from up to 8 years ago!

judicamedeus

New member
What’s going on?? Is this normal? I’ve paid a couple of times to settle whatever adjustments or things they said insurance didn’t cover. Was told that’s it, you paid off everything. I check my account online and it says I owe them $300. WTH? What steps do I take to find put if I’m being fraudulently charged? Please help, thank you!
 
@soulknight This is a doctor/health company I go to for prescription refills (which have not changed in years). Other than that, I think they’ve done 2 tests (meaning the billing should not be that complicated and has been quite consistent). The last time I paid for these ‘pending’ charges for things the insurance didn’t cover was in June 2020. Got an email confirmation saying I didn’t owe them anything anymore. Today, I login to make an appointment and it says that I owe $300 from things between 2014 and 2019. I’ve always paid for my appointments in full, at the time of the appointment. I’ve never had any other doctors keep charging me over again or had multiple adjustments or such complications with the same 2 insurance companies. Only this place!
 
@judicamedeus You would need to see the amount on your insurance EOB, for that specific date, and compare it with the bill from the provider, for that specific date. If you don't have these documents, one for each specific claim date, then you need to get access to them.

Specifically, there should information on the EOB document from your insurance company that says something like "Not Covered Amount" for each line item, and then a "Total Amount Disallowed" for the entire claim for that date. Then there will be remark codes as to why something is not covered. Then there will be a patient liability amount. If you agree with the EOB on the patient liability amount, then we're good there. If not, let us know more specifics and we can provide further guidance.

Now you need to look at the provider bill and ensure it matches what the insurance said the patient liability amount should be. If it does, then there isn't a problem, besides how the provider handles billing obviously. If the EOB doesn't match the bill, then let us know more specifics and we can provide further guidance.

Finally, you need to look at the receipts you have from payments and verify they are reflected accurately in the billing system.

It seems like you switched insurance companies, so making sure they billed the right ones makes your situation a little more complicated. But yea, it seems frustrating if they told you that you were good and then a bill from 8 years ago pops up.
 
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