Bad doctor - who can I file a complaint with?

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I've been seeing a certain doctor for about 6 months now, and I thought he was great. I do not have any complaints about how he has treated me medically, but out the blue he decided to do his best to screw me and my insurance company for no apparent reason.

Long story short, is there somewhere I can file an official complaint against a doctor? Anybody have any idea where that would be?
 
Originally Posted By: SecondMonkey
I've been seeing a certain doctor for about 6 months now, and I thought he was great. I do not have any complaints about how he has treated me medically, but out the blue he decided to do his best to screw me and my insurance company for no apparent reason.

Long story short, is there somewhere I can file an official complaint against a doctor? Anybody have any idea where that would be?


What do you mean by screwing you and the insurance co.? From my experience, the ones who usually get screwed are the elderly on MediCare when they are subjected to unnecessary procedures. Private insurance companies usually do not get screwed - they are usually the ones who screw the insured.
 
Good luck if it comes to financial issues between the insurance company, you, and a physician. I don't know your particulars, but I've been through enough of them myself.

Put him on the $5/month club. Nothing can be done to you.
 
Originally Posted By: Gary Allan
Good luck if it comes to financial issues between the insurance company, you, and a physician.

Quoted for truth. Get another Doc.
 
You've got my heartfelt sympathies. You put your health into the doctors hands and it hurts when that trust is violated. My wife lost her first kidney transplant due to pure doctor incompetence and to this day, she feels like she let down the donor's family by losing that kidney. She's got my left kidney now and as Reagan said, we "trust but verify."

First, I'd go to the insurance company. Generally, they *love* going after doctors who try to defraud them. Fraud costs them money and they know it.

Over the years, my wife and I have caught several double/triple bills, bills from doctors she never saw, etc., and in each instance, BCBS was *very* interested in hearing about it and it was made right. Did the doctors get in trouble? I have no idea.

After that, see a lawyer.

later,
b
 
Originally Posted By: Pablo
Quote:
Bad doctor - who can I file a complaint with?


A lawyer.


great, after making one monopoly fat, you make the other one...

Hopefully it doesnt come to that... hopefully the insurance company takes on the work, and our OP doesnt have to shell out $ making another lawyer rich for providing precious little real value.

JMH
 
Originally Posted By: Gary Allen
Put him on the $5/month club. Nothing can be done to you.
Yup, if you're making payments, it's an honest effort to pay back the debt, they have little (maybe no) recourse.
 
Originally Posted By: GeaugaFletcher
Originally Posted By: Gary Allen
Put him on the $5/month club. Nothing can be done to you.
Yup, if you're making payments, it's an honest effort to pay back the debt, they have little (maybe no) recourse.



I've offered to pay the normal managed care negotiated amount. All I get is silence. Let me explain: I got sent to a specialist (and anesthesiologist) for a steroid shot in my back. The neurologist was in my "network". The anesthesiologist, was not. Both took BC/[censored] ..but he was through Indendpence BC/[censored], and I had Capital BC/[censored]. I argued that if this was Medicare, DPW, IBX, or any number of other entities, I would receive the preferred rate, but since I was covered but out of network, I got to PAY MORE than any of them ....including cash pay (I'm covered and get to pay more cash than a cash pay :confused). Now I do get to turn in the bill (once paid) and if I reach my deductible, get Xx% back ..but....
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In the same letter, I said that the alternative would be $5/month (I actually make it $5.01 for making it more of a hassle for data entry - to "spread the angst") and that it will be (however - up to 83 in one case) xx months for full payment. Since I use BillPay, the postage isn't really an issue (you get so many payments for the minimum fee - which is less than postage).

My best coup was a scam ambulance service. My daughter needed to go to Childrens Hospital of Phila (CHOP) since the local hospital was more aligned with geriatrics than pediatrics. The attending was going to get local transportation when CHOP preempted him and said "OH, we have our own transport". A private outfit shows up ..and I get a bill for $1700 for a 30 26 mile ride. My insurance, in an oddity of coverage, only covered $150. I call them up and ask for an explanation. They said that since she was on oxygen, it was "advanced life support" and bumped the $1100 fee to $1700. I said it was a routine transport of an asthma patient and no "life support" was provided in any manner. I also stated that I could have rented a Winnebago and two per diem nurses for less. They said "Yeah, so?". I gave them the same stuff (dpw, etc..etc) and, again, SINCE I was covered but underly so, they expected 100% of the "funny money" inflated charges (all medical charges are in "funny money" $$).

I finally told them that I was going to have the Attorney General investigate the relationship between the hospital and the ambulance service since this wasn't a CHOP ambulance.

I never got another bill. I have to assume that the guy who called the outfit was running a kickback scam. In either event, they would have waited an eternity to get their money for the lack of sensible charges.

This is a "policy". That is, I'm convinced that there is some advice/advised doctrine of how to handle (or actually, not handle) this situation. Otherwise it would not be so wide spread and uniform. "Don't you dare tamper with the funny money culture as it has stood and developed over decades!!!" type thing.
 
Originally Posted By: Gary Allan
Good luck if it comes to financial issues between the insurance company, you, and a physician. I don't know your particulars, but I've been through enough of them myself.

Put him on the $5/month club. Nothing can be done to you.



My dad is paying $25/month. He still gets harassed over the phone by bill collectors to pay more. He told me he got charged $500 for each doctor visit in the hospital and they just came in to talk for 5 minutes to make sure he was doing okay.
 
Originally Posted By: Cutehumor
Originally Posted By: Gary Allan
Good luck if it comes to financial issues between the insurance company, you, and a physician. I don't know your particulars, but I've been through enough of them myself.

Put him on the $5/month club. Nothing can be done to you.



My dad is paying $25/month. He still gets harassed over the phone by bill collectors to pay more.


Just ignore them and pay the original practice. It's important to do this before it goes to collections. I imagine that it may vary state to state and I'm sure that the AMA (in some other form, perhaps "physicians financial somethingorother) lobby seeks ways to squeeze more, but they cannot decline your offer to pay. If something is "overdue" then they can call you once a day forever. OTOH, if you're making payments and it never went to collections, then they're just spinning their tires. I assure that they spin them and burn as much rubber as possible. Anything that I've had that was overdue was usually due to the j/o clerical with my doctor's office. He was a specialist, but I wasn't seeing him as a specialist. He was my general physician. So, for about 5 years my $15 copay worked fine. The I started getting $5 bills in the mail. I'd normally take care of it the next visit, but those receiving the copay couldn't also accept additional money at the point of service. I also couldn't preemptively over pay the copay that was stated on the card. So ...another $5 bill. When I asked if I could talk to the person ..while I was there ...I was told I could make an appointment ..

So, $50 racks up (meanwhile probably thousands of $$ have changed hands between my insurance company and the practice) it's submitted to a collection agency. Upon their first call I tell them ...no ..I'll just pay it to the original creditor and you can manage to get anything you bid for out of them. That is, putting them in the same labyrinth of hassle and stifling of resolution that they appear to thrive on.

One must be prepared with effective countermeasures for any assault.
 
That's excellent. :) I like the idea of paying the original creditor and letting the collection snakes hassle it out for themselves.

Cutehumor, if your dad is making payments in good faith, one letter to the collection agency should shut them up. There are a number of websites that offer good (and legal) advice about dealing with collection agencies.
 
Most of this is unnecessary. Those who are well versed on this are fully aware of the issue and appear like a deer in the spot light when confronted with the absurdity of the whole thing.

My kids need pediatric dental surgery. My one son got done ..no problem. My oldest daughter got done ..no problem. The youngest daughter ..the hospital require pre-authorization before scheduling ..they got it from the insurance company ..submitted the bill ..the insurance company rejected it ...What the...??? I said YO!! You stated the conditions of the whole thing ..and you are far more qualified to sort this out ..YOU DO IT. They declined to even negotiate the price and AGAIN because I was insured but decline they wanted $5000 instead of the $3500 managed care fee. I think they eventually got their money.

Totally senseless hassle for people who have no competence in the realm. It's a fixed game and, mostly, highway robbery.
 
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