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Old 12-29-2009, 09:06 AM
AOII Angel AOII Angel is offline
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Join Date: Apr 2007
Location: Santa Monica/Beverly Hills
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Quote:
Originally Posted by AXiDTrish View Post
I must say, I LOVE this thread. Kevin, AOII Angel, KSig....your discussion has been very interesting!!

Not that I want to bring this up and interrupt, but...



Doctor's absolutely have the right the collect money that is owed to them and should! It's when balance billing takes place or collector's balance bill on a doctor's behalf that is the problem. Ex: A doctor bills $100 for a procedure and their negotiated rate based on their contract is to receive payment of $75 whether from an insurance company or through a members/patients copay, coinsurance, deductible or a combo of all three. The doctor, by signing a contract (and they don't have to) has agreed to write off the other $25. Balance billing is when they bill the member for the additional $25 making them in breach (sp?) of their contract. Many times that ends up in a collections agency's queue. I'm working a scenario right now where the doctor closed their practice and sold all their accounts to a collector. The collector going after a member for a claim from three years ago that they paid correctly according to their benefits! The collector doesn't care that the member has paid everything they are supposed to and the provider is in breach of contract. All they care is that they get a cut of any money they collect at the expense of a member/patient. It's infuriating and unfair. Balance billing is very, very common. Sometimes it's due to a simple A/R mistake, sometimes inexperienced billers, sometimes intentional.
I agree...That is wrong.
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