Insurance/Doctor Shenanigans
Here's the deal...Marsh has had a leg issue that rendered a few trips to a therapist...a Dr. with a good reputation...3 times...the therapy helped...and that is NOT the item...it's the company that he worked for and their BILLING department...
Marsh was told that she was to pay the bill up front, in full, prior to the treatment...OK, no problem...so, 3 times she did so...one of the reasons to go to this therapist, is that it is covered by her insurance...called "in network"...so far, no problems...
Here is where the ordeal began...she then asked if the billing department would pass on to her insurance what she paid, and for what she was paying for...so...that it would then be applied to her deductible...
Ah ha, the bloody deductible...suddenly, there was a shift in paperwork...hmmm...well now, if the billing department was to do this...there would be an adjustment in the pricing of the doctor's services...what?...yup, it's true...the office increased the doctor's fees!!!!...they also added undone services...to increase the amount that is billed to the insurance company...
The insurance company ( MODA), then took a look at the billing and agreed to pay a certain % of it...let's say 85%...in lieu of $180, the accepted amount was like $160...ah ha...looks like, you, Marsha, need to pay this difference...you owe another $60...what?...
After a lot of back and forth...questions to both the billing dept and MODA, it was determined that yup...Marsha you have to pay this "back billing amount"...the MODA Rep actually told Marsha that this was their dirty little secret, that the doctor's offices and the insurance companies do...
You pissed yet?...be aware kids...be very aware...we have since learned that there is two separate rates one can pay...for services rendered...one is cash (lesser) and one for insurance...egads...
Be careful...and you thought you were safe in your doctor's office...you knew YOU WEREN'T in the insurance office...
I'm still ticked...
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