Legal Question in Legal Ethics in California
Healthcare Law
My first time visit to a doctor, I presented my health insurance card ( a large well-known insurer) which was photocopied by the office staff. I had a small surgical procedure in the office with the removed tissue being sent to a lab for biopsy. I have now discovered the doctor sent it to a non-network provider lab and my carrier has refused to pay any of the $8,500 bill because the pathology lab was not a member of their provider network. I am stuck with an $8,500 bill for a 45 minute procedure because the doctor chose to use a non-network provider lab although there are at least 3 such network labs in our area. He had my insurance coverage card information in his posession and was aware that I was covered by that insurer, yet chose a non-provider network lab which will cost me $8500. I understood the terms of my insurance were that if I used non-providers, I would have no coverage. Apparently the doctor didn't care about my coverage and arrogantly chose the lab based on his own preferences. He has essentially invalidated my health insurance. He should foot the bill for his decision. Could I possibly have legal recourse against him?
1 Answer from Attorneys
Re: Healthcare Law
You have not indicated whether or not you have brought this to the attention of the doctor. It may have been an error by the doctor's staff, that he is unaware of, so if this is the case, bring it to his attention in writing.
If that doesn't work, because of the damages involved, it will probably be prudent on your behalf to consult an attorney, and probably retain him/her.
Good luck!
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