Legal Question in Insurance Law in Colorado

Medical Billing Practices

What are my options when I beleive that a doctors office is billing incorrectly. Advertises as acceptable provider under insurance but bills as associated with out of network facility. In order words I and insurace company get billed by both parties, doctor and facility charge from hospital. No doctors office was located 5+ miles from hospital.


Asked on 9/26/01, 5:14 pm

1 Answer from Attorneys
Steven Murray Steven W. Murray, APC

Re: Medical Billing Practices

Your insurance company has an agreement with network providers that you only pay a co-payment and they must take the insurer's payment in full. The doctor gets a steady steam of business and volume, and accepts a reduced rate for it.

If you are treated by a network provider, you are not liable for additional bills. If you complain to the doctor to stop double billing, they will stop. If not, complain to the insurer and ask what good is the insurance if you have to pay "retail" for a network provider? You are then really being defrauded by the insurer. This is in addition to being defrauded by the doctor who is falsely advertising.

A lawyer could file a class action and get this stopped. So could the state medical board.

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Answered on 11/06/01, 8:29 pm


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