Scam?

[SDianneB]

So, you feel awful, it's a holiday weekend, your doc is out of town, and you go to a walk-in clinic near your home, run by what you think is a reputable medical facility. You have a chest x-ray, knowing that even though one isn't in the building, a Radiologist will interpret and report on that x-ray, and that you will receive a separate bill for that interpretation.

The desk where you checked in assured you that their facility is a participating provider in your insurance plan, and confirmed the contractual status of your plan. Weeks later, you get an EOB (explanation of benefits) from your insurance company for the $34 Radiologist bill -- $34 less $22 discount = $12 that you owe. You then pay the $12 and that one's taken care of. Right? Well, maybe not.

You continue to get bills for the $22 from the imaging center and then get a final notice, so you call them up and let them know that the $22 was a contractual discount and that you don't owe it, only to find out that unbeknownst to you, the particular doc that read your x-ray dropped his contract with your insurance company a mere 2 weeks before reading your x-ray. Not only that, the twit who answers the phone has every expectation that you - the patient - will pay this bill, saying that it's your insurance company's responsibility to notify you when doctors drop out of their program. (As if any insurance company could reasonably do this with tens of thousands of providers they contract with? Yeahright)

Here is the rub -- you are assured when you check in that this is indeed a preferred provider. They don't tell you, and probably don't know themselves who is/isn't a preferred provider among all the various specialty doctors who provide services to their clinic. So, who DOES know? You couldn't even ask about it when you check in, because -- YOU HAVE NO WAY OF KNOWING who will be reading your x-rays, and neither do they! Good grief.

So, in my usual shy and laid back demeanor ( ) I let them know that I will NOT pay this. She then tells me I'll pay it or it will go to collection. Haha. So, I have to inform her that:

1) I'm a cancer patient. Does she think that a lousy $22 bill is going to send me away quaking in my boots? Think again, sweet cheeks.

2) I have thousands of dollars in medical bills to pay -- deductible, co-pay, etc., and this $22 scam of theirs isn't even close to being at the top of what I'll be paying next.

3) The x-ray they made was of such poor quality that it had to be repeated when I got to the hospital.

4) The radiologist in their imaging center misread the x-ray, and called the pneumonia I had "possible scarring from previous disease." Had I listened to him, I'd probably be near dead today, if that much.

I did contact my insurance company, and they are going to reprocess my claim. Now, my deductible has been met, so they are going to treat the claim as an in-network provider even though it wasn't, per my policy, and probably will pay all but about $7 of the bill. I've also filed a report with the Better Business Bureau, and will do the same with the state Attorney General's office if they fail to respond to the BBB inquiry. (Companies aren't required to respond to the BBB, but they are required to respond to the AG's office.)

Why, oh why should I even have to be dealing with this now? Geez!!!