why do medical biling agencies charge people more than they would charge an....
By ilumpruj
@ilumpruj (11)
Philippines
December 27, 2010 1:09pm CST
why do medical billing agencies charge people more than they would charge an insurance company?
a while back i was receiving physical therapy. I was under the impression that the sessions were covered by my insurance. After I was done with 20 sessions I got billed for 6 of them that were not covered. And to top it off they billed me almost exactly 4 times the amount they would have billed my insurance company. Does anyone know why they would do something like this? It seems unethically and immoral to me.
1 person likes this
3 responses
@shattered (1728)
• Philippines
28 Dec 10
The insurance company pays less because they get a bulk purchase discount. They have accreditation agreements that gives insurance companies and health maintenance organizations (HMO) a lower price for their services.
It is not unethical, actually that is the industry practice. The insurance company and HMO get a lower price because they bring in clients(patients to the health provider which could have gone to another provider. It's like their finder's fee for bringing you in as a patient.
It is always important to ask your Insurance provider the extent of you coverage. If you were not informed by your Insurance provider then that would be immoral.
Hope I can help
@lingli_78 (12822)
• Australia
28 Dec 10
i don't really know the reason why because it doesn't happen here... and most of the doctors and medical services i receive from here are bulk billed... that means, i don't have to pay even a penny for it... even the one that i have to pay the gap, usually the bill will be paid by the insurance first and i pay the rest... that's how it works here... take care and have a nice day...
@hardworkinggurl (37063)
• United States
28 Dec 10
Is there anyway to call the insurance company and place a complaint. As it has always been my understanding that once they bill the insurance company they cannot change the fee.
Since you say they are not covered they had to have gone through the insurance already right. So make a call and find out what they charged the insurance, as once they charge the insurance you should received a estimate of benefits notification saying it is not covered. Therefore, they now cannot make the fee larger.
I betcha if you call the insurance first and inquire, and if the amount charged to them was lower then call the doctors office and tell them that you will be putting a complaint to the Insurance Commissioners office and I can almost guarantee that their tune will change, if not call the insurance back and tell them of the occurence. I betcha the insurance will call then ASAP, once the hear the words insurance commissioner you best believe people will be on their toes.
