Received a bill from doctor even after I paid the co-pay

Most likely simple greed, rather than a "mistake." If you call them on it, they'll usually say, "Sorry; it's a mistake."
I saw such a doctor 12 years ago at my diabetes diagnosis. He immediately tried to soak my insurer for thousands of dollars by telling me I needed to be hospitalized for "dehydration" when lab tests showed I wasn't the least bit dehydrated. Then, after I paid the bill in full, he started sending me additional bills which I ignored for two months. Then he started calling me, asking for payment. I suggested he do some "research" & talk to his billing department & hung up on him. After he verified that my bill was paid in full, he sent me an e-mail, telling me "You are correct; ignore the bill." I responded: "I already ignored your bill as soon as I received it."
Am I a sarcastic prick, or what?
:D
 
This new ophthamologist I don't like at all. I was seeing a doctor and getting along with him just fine, then he retired and sold the practice. The new owner demands copays up front and seems arrogant to me. I kept complaining about the sudden blurriness in my left eye, he gave me glycerin drops for it. On returning for my follow-up appointment, he didn't even bring the subject up an only seemd concerned that I may have glaucoma. When I complained again about the blurriness, he sighed and gave me a perfunctory vision test and grudgingky wrote a prescription. The eye test never really did away with the blurriness. Right now I have to sit with my nose practically on the computer monitor and I am getting scared to drive.
 
debodun said:
This new ophthamologist I don't like at all. I was seeing a doctor and getting along with him just fine, then he retired and sold the practice. The new owner demands copays up front and seems arrogant to me. I kept complaining about the sudden blurriness in my left eye, he gave me glycerin drops for it. On returning for my follow-up appointment, he didn't even bring the subject up an only seemd concerned that I may have glaucoma. When I complained again about the blurriness, he sighed and gave me a perfunctory vision test and grudgingky wrote a prescription. The eye test never really did away with the blurriness. Right now I have to sit with my nose practically on the computer monitor and I am getting scared to drive.
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deb, have you been checked for cataracts? I assume if you are given a comprehensive glaucoma test you would have had a test that medicare doesn't pay for - I get a bill for $40 for that each year. Worth it, thought.
 
I have had cataract surgery in both eyes. The right one was one 10 years ago and the left was 4 years ago, but by a different surgeon. The right eye was about the same afterwards, the left eye was much better afterwards until about 6 weeks ago when suddenly it got blurry. That's what prompted me to see the doctor. I didn't know the business was under new management.

If he saw anything amiss, he didn't say anything except that I may be in the early stages of glaucoma. My left eye is watering like crazy, also, but he didn't seem to think that was significant, or at least didn't say so; just gave me some glycerin drops. I do not like his reticent, uncommunicative attitude. A friend of mine goes to him and she thinks he's wonderful.

Thanks for thatinfo on Medicare. I can never figure out what they pay for. Just got a bundle of booklets today about the changes to Medicare and my Part D for next year. I wouldn't understand it if I read it!
 
debodun said:
This new ophthamologist I don't like at all. I was seeing a doctor and getting along with him just fine, then he retired and sold the practice. The new owner demands copays up front and seems arrogant to me. I kept complaining about the sudden blurriness in my left eye, he gave me glycerin drops for it. On returning for my follow-up appointment, he didn't even bring the subject up an only seemd concerned that I may have glaucoma. When I complained again about the blurriness, he sighed and gave me a perfunctory vision test and grudgingky wrote a prescription. The eye test never really did away with the blurriness. Right now I have to sit with my nose practically on the computer monitor and I am getting scared to drive.
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You need a new doctor.
 
Medicare sends a quarterly statement showing what they have paid on your behalf. Start reading it. I once saw a payout to an eye doctor for a visit I never made. I had seen him about a year earlier but not that year.

I called his office and the clerk said "Well, it was time for you to see him again."

Me: "But I wasn't even in Page, AZ last July. I was on the east coast."

Clerk: "Well, if you knew how expensive it was to keep this office open, you wouldn't complain. Anyway you shouldn't care. It didn't cost you anything, Medicare paid."

Me: "Tell your boss that he had better get his records ready for an auditor from Medicare."

I did report it to Medicare office but THAT clerk said, "Oh that happens all the time. It's such a small amount, it probably isn't worth investigating."

Medicare was set up to work on the honor system and when it comes to honor vs. greed, honor often looses. If we don't check our records and verify charges, it is wide open for fraud and when the fraud is small, Medicare doesn't care.
 
In our area it seems pretty straightforward, the payments that is. I always go with my $10 in hand as that is my usual co-pay. Some days, for certain exams, they tell me there's no co-pay for that particular test or lab work. Never seemed to be a problem.

In the past, when co-pays first appeared, they'd forget to ask and I didn't remember to offer. later I'd get a bill in the mail for the 10 bucks. Nothing ever seemed sinister to me?
 
Quick lesson: it's called "back billing" and it's ILLEGAL as long as they are billing you for the difference between what they billed and what medicare "allows". Doctors used to do it all the time. If the patient was savvy, they'd say it was a billing mistake. If the patient didn't object, the doctor would make off with some extra moolah. It was getting blatant and Medicare stomped on a few doctors and scared the rest.

NOW, if you have a procedure that Medicare DOESN'T allow, the doctor can bill you for the full amount and you're on the hook.

To recap.....your procedure costs $100..
.Medicare allows/pays $40 for it. Doctor HAS to accept $40 in full payment. If the procedure isn't allowed by Medicare, he can bill you the full $100 for it. If they're nice, they may only bill you the $40.
 
debodun said:
I have had cataract surgery in both eyes. The right one was one 10 years ago and the left was 4 years ago, but by a different surgeon. The right eye was about the same afterwards, the left eye was much better afterwards until about 6 weeks ago when suddenly it got blurry. That's what prompted me to see the doctor. I didn't know the business was under new management.

If he saw anything amiss, he didn't say anything except that I may be in the early stages of glaucoma. My left eye is watering like crazy, also, but he didn't seem to think that was significant, or at least didn't say so; just gave me some glycerin drops. I do not like his reticent, uncommunicative attitude. A friend of mine goes to him and she thinks he's wonderful.

Thanks for thatinfo on Medicare. I can never figure out what they pay for. Just got a bundle of booklets today about the changes to Medicare and my Part D for next year. I wouldn't understand it if I read it!
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MIL had cataract surgery and had to have an additonial operation. That might be what's happening with you. New doc is needed, of course, gal.
Read that a lot of folks need additional surgery after initial cataract operations. Guess its fairly common.
 
Liberty said:
Read that a lot of folks need additional surgery after initial cataract operations. Guess its fairly common.
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Yes, it's a simpler and quicker procedure that is done in an office. I think you'd be best to go either to the eye surgeon who did that eye cataract or to a different new one, to find out if that's the correction you need. If it is, then it IS correctable, but a lens refraction correction with glasses will not improve it, if that is the problem.
 
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About the bill, Deb, you could tell that office that you want to wait (and not pay the bill) untill you get the Explanation Of Benefits form in the mail from Medicare, which will show you the maximum that you can be charged.
 
If I were you, I would go to a different doctor.

Here, doctors' offices always collect the co-pay p front. Nothing weird about that part.

Ask the office if the doc accepts Medicare "assignment." It is my understanding that if he doesn't, he can bill you the difference between what Medicare pays and what he charges, not to exceed 15% over what Medicare allows.
 
That bill actually looks very possibly accurate to me, Deb, but I am not an expert on any one else's matters.
 
Liberty said:
MIL had cataract surgery and had to have an additonial operation. That might be what's happening with you. New doc is needed, of course, gal.
Read that a lot of folks need additional surgery after initial cataract operations. Guess its fairly common.
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You'd think the ophthamologist would have recommended that if he noticed anything amiss.
 
debodun said:
I have traditional Medicare A & B. I have to stay on that or I'll lose my Medigap coverage, which is paid through my former employer. Also have Part D (Silver Script) through the same plan.
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Sounds like you've got good coverage then.
 

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