Slightly off topic - need some help with Dr Billing Issue

I need some help and don't know exactly what to do.  First, I HAVE called the insurance co several times, I have tried to reason with the office staff, I have tried to call through the hospital where I was a patient, I have tried to speak with the specialists in Fraud and Abuse again, but NOTHING helps.

For some background....I was in the hospital as an outpatient WAY over a year ago.  A staff Heart Dr came by my room and read some reports.  I was let out the next day (basically 23 hours observation) and he billed me for both my hospital stay and for an office visit.  I told them then that I had not been to the office, but the billing lady was freaking out and saying they were allowed by law to charge me both visits and I HAD to pay the co-pay...which I did pay at the time ($45.00).  I saw him one time after, but decided he was NOT the Dr for me and never used the practice again. 

When I got the original bill, I saw the way it was billed and, after getting nowhere with the office staff, filed a complaint with the insurance company..fraud and abuse department.  Fast foward one year and the fraud department found in my favor (believe it or not), but sent back a new explaination of benefits saying patient responsibility....so I called and it was a mistake in the way the paperwork was completed at the fraud department.  They sent the Dr (and me a copy) a letter saying they could not bill me for this visit.  A month later, I got a bill for not only the money the Dr had to return to the insurance company, but interest on the account.

I have only spoken to the one lady who who handles the billing on two occasions....she hung up the phone on me both times....she said she was going to have me arrested for defaimation of character for "saying fraud" when trying to explain the situation to her.  She would not give me the fax number or an email for contact, but wanted me to come in person....at which time I'm virtually certain they would have called the police claiming I was threatening them.

The insurance company has removed the entire claim from the system and the only information is now found with the fraud division, however, nobody can or will tell me anything.  Nobody anywhere.....now my new bill came with just a statement that I am past due and no other info. 

I don't know what to do from here.

Any ideas????

Thanks!

Post Edited (cogito) : 7/9/2012 10:34:30 AM (GMT-6)

The amount is about 100.00.  I have legal insurance and made a claim on that today.  I will contact the attorney tomorrow and set up an appointment.  This is a pain in the butt!  I don't like this type of problem.  I pay my bills on time and I have perfect credit.  I don't want to ruin my credit and I am NOT going to pay him another penny for something I don't owe.

This guy is s creep!  The one time I went in to see him...follow-up, he demanded to know if I was going to see another doctor.  I told him I wasn't sure and he freaked out himself.  Apparently he and his officeworkers are a very low quality group.  I also wasn't too keen on using a cardiologist who doesn't have an answering service...only an answering machine.  What a waste of time and energy.

Turns out the lawyer they referred me to lives one road over and my daughter has been to his house several times to play with his daughter (and vice versa).  I hope we can end this with just a simple letter!!!  I don't want to do the court thing over a hundred bucks! 

I do believe I would be arrested if I were to go into the office because I feel they would find some excuse to call and claim I was "disturbing the peace".  I used to work law enforcement.  People can call and claim anything and these people seem nuts to me.

Any other opinions would be appreciated!

Sorry it took so long to answer the questions.  I've been so busy lately :[  Anyway, the bill wasn't given to me until after a year because it took the insurance company over a year to finish the fraud case.  I had a zero balance, then I had a balance of about 100.00 due to the insurance company making the Dr reimburse them for the illegal charge....so no, it could not have been sent to collections yet...but they probably will.  I will dispute it of course (and I have absolutely perfect credit, so I'm not too upset about that yet).

I do have legal insurance and I have called an attorney.  I am waiting for the return call.  It's small here and he's been in court all week.  I called again today just to make sure they had all the info and they have already verified my member ID and case number with the legal insurance company.

I am hoping this is going to be a letter thing, but who knows...crazier things have happened.

I don't owe this money and I am not going to pay it...period!  (I hope I don't have to eat my words....lol).

They owe me the 45.00 co-pay that I had to pay a year ago to keep the darn thing out of collections while I waited on the insurance company to do their part.  It's a real mess, but as stated...it's the principle of the thing...not the money so much, though the money is an issue since I need what I have to pay my real bills.

I am going to talk to my psych about it too when I go in next week and then get it on record how much it has upset me and my anxiety condition.  Perhaps there will be reprocussions if we do have to go to court because he is a cardiologist....hello...heart dr harasses patient that he fraudulently charged.  It doesn't sound too good to me.  I was also law enforcement, but not on this end.  It was the real criminal stuff and that is why I am so certain they will claim some BS if I go in to the office. 

I have to go in to the building (same area) tomorrow to my PM for med pick-up and I won't be going in to the cardiologist office for any reason!!!!  They won't recognize me because they don't know me.

It is making me very nervous though!!!

Anyway, wish me luck with my attorney....turns out my daughter and his daughter have played together on occasion....so we'll see what happens there.

Thanks All!!