Legal Question in Credit and Debt Law in Missouri
doctor refuses to submit claim correctly now in collections
Had pap smear at doctor's office plus lab,xray for upcoming surgery. Pap smear, ofc visit completely paid by UHC. White spot appeared on xray, doctor looked at it, referred to MRI. Doctor will not submit claim indicating pap smear (which is totally covered)but says xray consultation takes priority and must be submitted that way. My insurance will not pay until is submitted correctly. I have paid everything except the office consultation fee (which has pap smear charge also) because doctor will not separate the pap smear charge and the office visit consultation charge. I paid amount insurance indicated would be due if doctor had submitted correctly, plus an additional $10 with under protest listed on check. Now doctor has turned over to collection agency. What recourse do I now have to get the doctor to submit property so will be covered by insurance and my credit will not be ruined. Can I report the doctor to any agency at State level as I feel the charges are totally misrepresented since will not submit claim to insurance company truely deplicting services provided to me. Thank you.
1 Answer from Attorneys
Re: doctor refuses to submit claim correctly now in collections
Your best bet may be to contact your health insurer in writing and explain the problem. Ask for them to deal with the doctor. If that doesn't work, then the next best approach is probably to pay the bill if you don't want to mess up your credit with this kind of issue. Understand, you probably don't have a legal obligation to pay the bill, but a person looking at your credit report won't know that.
If you are dead set against paying anything, wait until the doctor sues to collect on his bill, and present your policy and your payments as a defense.
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