by maurino17 » Sat Aug 19, 2006 03:09 am
Hello My plastic surgeon is in network and the bill for service for removing a mole was minimal for me out of pocket. However, he charged me as out of network for his facility, which is just his office. This bill just arrived for 5K dollars. To remove a mole. . . Can he charge in network for service but out of network for facilities charge ? I call that fraud !
Posted: Tue Sep 12, 2006 12:27 am Post Subject:
The Doctor is not the one who decides if it is network or not. He may be in your network but the facility that he works out of might not be in your network. It is up to you to find these things out prior to have any procedure.
Posted: Tue Sep 12, 2006 02:01 am Post Subject:
hey dan
thanks for the reply nd I have since resolved this. ..
but you missed the point of why i was so upset,
his ofice where we went for the colnsult is the "facility"
it is an office and a facility but he never mentioned that !
thanks
Posted: Sat Sep 16, 2006 05:45 am Post Subject:
I used to pay medical claims and have seen it many times. It is always best to ask prior to any procedure if the facility or any outside party is part of your network. And if the facility was out of network he should have been up front with you. Most doctors have a sign in their office that stress that you check with your insurance to make sure that there is coverage for a procedure and that you know your benifits. This is not their job. One would think that they would be up front with people though.
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