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Old 08-26-2006, 12:53 PM   #1
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unethical billing by llmd!!!

i haven't posted much as i've been pretty ill lately. but today tops them all, i went right into hysterics, crying and screaming.

i went to a so-called llmd back in november to february. he practices in north texas, near dfw airport. won't give name but i left him because he was abusive and i something just didn't feel right. i paid the office visits of 50 dollars per visit. every time he took blood.

well today i got a bill for $4,187.83 cents!!!! i am just beside myself. the insurance has paid and now they say i owe him this much money. the statement was from bc/bs and said he was out of network and i will be receiving a bill from him.

i can't believe this. the guy was a jerk and now this.......i don't have that money, hubbie is retiring, i'vebeen ill and now this....

where am i going to get this money??? what in the world did this doctor do besides be abusive that i owe him this much?????

what am i going to do????????

 
Old 08-26-2006, 01:49 PM   #2
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Re: unethical billing by llmd!!!

Let me get this straight:

The insurance company paid for some treatment with him, but then changed their minds and said he was out of network?

Was he in network when you went to him? Did the insurance company approve going to him at one point in time?

Last edited by raylp; 08-26-2006 at 01:50 PM.

 
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Old 08-26-2006, 04:28 PM   #3
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Re: unethical billing by llmd!!!

i knew he was out of network when i went to him but his office said they would work with the insurance company. every time i went he drew blood which was sometimes every week.

now i read the bc/bs report and he claims "diagnostics" and his office visit is 250!!! for one day i owed over 800 dollars just for bloodwork and office visits.

i can't believe this. i read what he submitted to bc/bs and he even charges for consultation and an office visit on top of that!!!!!

i am absolutely outraged. i called a friend and she said not to panic and not to do anything until i get a bill from him. i haven't seen him since february of 2006 and now i get these tremendous bills from, uh, ok, not bills, it says explanation of benefits. so it's not a bill but it says i owe the provider and that's this jerk.

i don't know what to do.......i guess i just wait until i hear from him and then panic at that time........

right now, i'm just sick to death and i don't need this........

 
Old 08-26-2006, 04:59 PM   #4
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Re: unethical billing by llmd!!!

So let me get this straight. They told you when you started that they would work with the insurance company, because you were out of network. You went to them from November through February and paid a fixed sum of $50/visit. What was this, a copay?

Did the insurance pay them for anything?

You need to calm down and sort out the details. If everything lines up, you may be fine, and not responsible for these costs.

Last edited by raylp; 08-26-2006 at 05:04 PM.

 
Old 08-26-2006, 05:12 PM   #5
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Re: unethical billing by llmd!!!

Hi Earle....DEEP BREATH!!! I'm thinking you are not responsible...maybe problems with the billing...Monday call your insurance company...and carefully explain the situaiton and what you said here...then from there call the billing department for the doctor....tell them what was told to you....I would think you would of gotten some kind of bill wayyyy before this.....

Let us know how it goes....

 
Old 08-26-2006, 05:20 PM   #6
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Re: unethical billing by llmd!!!

ok, ray, sweetie, here's the poop. i went to this turkey knowing he was out of network. first visit cost over $800, first 400 for igenex testing, then the rest was for office visit. then i went pretty much every couple of odd weeks, until the first of february 2006. i only about a total of 5 times to his office tho cause i only have records that show that times.

yep, bc/bs paid him a ton of money and the bills list something as not covered expenses and they total it and say "you owe the provider this amount."

ok, i'm trying to remember. i went to er one time and i ended up paying the doctor the out of network expenses cause the doctor wasn't covered, hospital was, but not the doc. but i think someone told me that you don't have to pay the difference, but the thing is, that he is out of network and you are responsible for the difference. i'm pretty sure it's in the bc/bs handbook.

from what i hear, his office staff is terrible at bookeeping and he's under some investigations of sorts. so i don't know what's going on.

but i truly believe that this amount is totally exorbatant, don't you?

 
Old 08-26-2006, 06:29 PM   #7
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Pearlscale HB User
Re: unethical billing by llmd!!!

Hi Earle
I understand your problem. I am facing a similiar one. I have BCBS of NC. The LLMD I see is in-network, but the doctor is billing me for almost $5000 because the insurance company decided that I didn't need to be treated as long as I was. The Dr is facing conditions set by the medical board due to the length of time he can treat lyme with IV's and orally. I feel that because they were in network, it is between the insurance co and the Dr. But I think I will have to battle it out. Even though the investigation by BCBS began early January, neither the Dr or BCBS thought it was important to advise me until the decision was made in March ..

With yours out of network, I'm not sure what will happen. You can always take it to the Insurance Commissioner if necessary. Or as some on here advised me, talk to your insurance co, the dr, and if need be an attorney. Let us know what you find out. I will be very interested. In the meantime, don't stress. It is hard to think clearly and do what you need to when you are so ill. I hope this works out for you and you find out soon. It is an additional burden you don't need. Believe me I know.

Prayers....Marsha

 
Old 08-26-2006, 06:41 PM   #8
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Re: unethical billing by llmd!!!

The details sort of confuse me, but overall I'd say have the attitude that you aren't going to pay. Find every reason possible to not pay. Write them all down. Doctor's are used to not getting paid.

It does sound exorbinant, but I think that I wouldn't have that be the main reason for not paying. You want to avoid responsiblity for this. Meaning you want to put it back on them and clearly illuminate how it was their responsbility. They told you that they would deal with the insurance company. That is really what it comes down to.

Another good thing going for you is that because they are terrible at bookkeeping and possibly an investigation, it shows that they have limited resources available for a clearly strategized fight. So, it's likely under those conditions that they'd give up easily.

But imagine yourself in their shoes. It's worth a shot sending you the bill, right?

I agree with Jojo, call the insurance company first.

Last edited by raylp; 08-26-2006 at 06:48 PM.

 
Old 08-27-2006, 08:36 PM   #9
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Re: unethical billing by llmd!!!

Hi earle,

Sorry you are having to go through this on top of being ill. What a shock if you weren't expecting it.

I, too, am somewhat confused. I am not sure what you mean by unethical. When they said they'd "work with the insurance company", what did they mean exactly? Did you ask them what they meant by that and what exactly they would do? Did you ask them for some kind of specific agreement and if so do you have it in writing? If you do, then I don't think you can be held responsible. Did you agree to a specific amount of money you would pay beforehand?

It is unfortunate that these doctors are being harrassed for treating us, and then the patients are the ones who end up being penalized when certain of these insurance companies decide not to pay.

I realize this must be very upsetting, but I wouldn't worry about it until you actually get the bill. It hasn't come yet, right? Worst case scenario, if you end up having to pay it, call the office and work out an installment plan. $10 a week, month, whatever. So far as I know, depending on your state, as long as you pay regularly they can't turn you over to creditors. Best case scenario, you may never get billed.

Last edited by TINUVIEL; 08-27-2006 at 08:37 PM.

 
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