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Medical Billing Error - What do I do?

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Whalers11 posted 8/19/2014 10:07 AM

I received a bill in the mail yesterday from an oral surgeon for $1700. It was addressed to me, had my name and address on it, and my patient ID #. However, it was not for any work that I had done.

I did go to this oral surgeon in June - simple procedure, and I paid my co-pays and insurance paid the rest.

This bill had a July date on it, and looked to be for extractions, implants, anesthesia - not even remotely close to what I had done.

Do I just call them and tell them they sent me a bill that was not for me? How does this get rectified?

tushnurse posted 8/19/2014 10:30 AM

You need to call the office and ask if they do their own billing, if so talk to the person in charge of that, because this is a serious issue, if they are misbilling. If they submitted this to the insurance provider you need to also notify them that this was an error submission.

If they use a third party for billing you need to find out who that is and contact them ASAP. The sooner you call the easier it is to resolve. This is most likely a clerical error, transposition of account numbers of something simple. But it needs to be rectified quickly. So they can bill the appropriate patient, and be paid.

Whalers11 posted 8/19/2014 10:41 AM

Thanks. I think it's 3rd party billing because there was an 800 number on the bill that said it was for inquiries. I meant to bring it to work with me today to call but left it on the kitchen counter. I'll call tonight.

It also said that payment was 30 days past due... which I thought was odd because this was definitely the first bill I got. How common is it to screw up this info on subsequent invoices? I need more crap to straighten out!

tushnurse posted 8/19/2014 11:14 AM

Call the office directly, just to see if they can fix it on their end first.

SpecialK posted 8/19/2014 11:15 AM

Could it be a scam? You need to call your insurance company asap.

[This message edited by SpecialK at 11:15 AM, August 19th (Tuesday)]

gypsybird87 posted 8/19/2014 13:35 PM

20+ years medical biller here.

It's a clerical error. You are in their system for the work you legitimately had done. Your name and/or account number is probably close to the person who actually had those services, and the charges were applied to your account by mistake.

Call the providers office directly. If they do use a third party biller (like me) it's their responsibility to bring it to the biller's attention and make sure the issue gets corrected. It's also their responsibility to reverse any claim that might have been filed incorrectly to your insurance. BUT, I would still contact your insurance yourself and let them know that you did not receive services on that date, and they should not pay for any claim stating you did.

Deal with this now, don't wait. Call now and then follow up in about a week to make sure the issue was fixed. I know it's a pain but you don't want this defaulting into collections because no one took care of it. Honest mistakes happen, of course, but you don't want to risk your credit rating on someone else's ability to follow through.

Sorry you're having to deal with this. I know it's frustrating.

[This message edited by gypsybird87 at 1:35 PM, August 19th (Tuesday)]

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