What is the Best Way to Approach Doctor with Billing Issue?

I had a breast reduction at the start of December which allowed me to meet my deductable. My tissue samples were not sent to pathology until January 11th due to the office not having the correct containers. I now have to pay $300 as apposed to $58.80 because my insurance starts over in January. How should I approach my doctor and request he pay the difference? This tissues should have been sent in the beggining of December since that was when my surgery was or am I wrong in feeling this way?

Doctor Answers 5

Breast Reduction - What is the Best Way to Approach Doctor with Billing Issue?

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This is the sort of thing that drives me nuts.  Your surgeon did nothing wrong - he took care of you appropriately, did your surgery well, gave you appropriate followup (I'm assuming that this is all correct, right?) and because of an idiotic provision in your insurance policy, you are now at adds with your surgeon.  The insurance company, if this is left unaddressed, has now become a wedge between a surgeon and his patient.  How ridiculous is that.

You should contact your plastic surgeon and/or office manager, and discuss this situation in an open, honest and calm manner.  Perhaps the lab will waive or modify the payment.  Perhaps the insurance company can reprocess the claim so as to reflect what was actually done, not when the paperwork was submitted.  Perhaps there can be a sharing of any residual costs.

I cannot say how you should solve this with your plastic surgeon, though I have no doubt that your surgeon would/will be horrified to see what has happened.  And I'm sure he will try to help you resolve it in a way that makes everyone happy.

I hope that this helps, and good luck,

Dr. E

Breast Reduction Billing Issue

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Ask to speak to the person in the office that does the insurance billing, ask them to contact your insurance on your behalf, you might find that the charge is based on when the surgery was done and not when the tissue was sent in, but if that is not the case, ask the insurance biller to explain the situation to them. If they find you have to pay but they know it is because of their delay, I would think they would accept some or all of the responsibility. Good luck!

Miguel Delgado, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 81 reviews

Billing issue

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I would ask the office manager at your plastic surgeons office. I know if this happened to one of my patients and it was a mistake made by my office I would try and offer some type of solution that would work for all parties--I would suspect that your PS would do the same. Best of luck, Dr Kerr

Billing issues

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I think that you should probably discuss this in a reasonable fashion with the office biller.  Perhaps they can explain the situation to your insurance carrier?

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Communication with Doctor regarding Billing Issues?

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Thank you for the question.

I do not think it would be “fair” for online consultants to opine on your situation without knowing all the details. However, I do know that it would be in your best interests to discuss your concerns in a calm, not accusatory fashion with your plastic surgeon. Remember, that most plastic surgeons are very eager to “keep their patients happy”;  you may find that he/she is willing to work with you.

Again, calm communication is key.

Best wishes.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.