Insurance Billing Dispute Resolution

Summary

If you face unexpected medical bills despite insurance confirmation, request a detailed bill from the doctors office. You can file a complaint with the California Department of Insurance and contact the California Medical Board for further assistance. Consider writing a formal letter to the billing department to clarify charges and seek resolution.

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Last year I had a health insurance and when I scheduled regular colonoscopy presudeure I asked my doctors office if the accept my insurance and it will be covered. In the mean time I called the insurance company to ask the same question. They answer was yes. After several months the doctors office keep sending me the full amount for the service. I do not want to pay, because the doctors office never show me to amount and did not say that I have to pay for the full amount.
Hi ****! It sounds frustrating. Did you receive any written confirmation from your insurance company or the doctor's office stating that the procedure would be fully covered?
no
Hi ****! It sounds like a tough spot. In California, it's important to know that:
- You can request a detailed bill from the doctor's office.
- You may file a complaint with the California Department of Insurance.
Have you tried contacting the insurance company again to dispute the charges?
yes I did disputed the charges. but the doctors office still sending me the bill
Case Rating: *
It sounds like you're in a challenging situation. Here are some steps you can take:
- Request a detailed bill from the doctor's office.
- File a complaint with the California Department of Insurance.
- Consider contacting the California Medical Board for assistance.
Would you like more information on how to proceed with any of these steps?
yes
Case Rating: *
Sure, ****! Here are the steps:
*. Request a detailed bill from the doctor's office to understand all the charges.
*. File a complaint with the California Department of Insurance.
*. Contact the California Medical Board for further assistance.
Would you like more information on any specific step?
can you help me write the letter to the doctors billing department
Case Rating: *
Sure, ****! Here's a sample letter you can use to contact the doctor's billing department:
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[Your Name]
[Your Address]
[City, State, Zip Code]
[Email Address]
[Phone Number]
[Date]
Billing Department
[Doctor's Office Name]
[Doctor's Office Address]
[City, State, Zip Code]
Dear Billing Department,
I am writing to formally request a detailed itemized bill for the colonoscopy procedure I underwent on [Date of Procedure] at your facility. Despite confirming with both your office and my insurance company that the procedure would be fully covered, I have been continuously billed for the full amount.
I would like to understand all the charges associated with this procedure. Please provide me with a detailed breakdown of the costs, including any services provided, their corresponding charges, and any payments received from my insurance company.
I have already disputed these charges with my insurance company, and they confirmed that the procedure should have been fully covered. Therefore, I kindly request that you review my case and correct any billing errors.
Please send the detailed itemized bill to the address provided above or via email at [Your Email Address]. I appreciate your prompt attention to this matter.
Thank you for your cooperation.
Sincerely,
****
[Your Last Name]
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Feel free to adjust the details as needed. Let me know if you need any more assistance!