| Posted By |
Message |
bobbysworld
LIF Zygote
Member since 5/12 1 total post
Name:
|
pregnant & seeing a specialist?
I am at my wits end & need advice! I am 30 weeks pregnant & have been seeing a perinatologist every two weeks since my 16th week of pregnancy! I have insurance coverage through my job & have been charged a $50 specialist copayment everytime I go to the office. I have recieved various explaination of benefits from my insurance company which indicate that I do not have a copay & every time I have spoken to reps at bcbs they have told me that i should not be charged a cpayment and that i am covered under my maternity benefits at 100%. However when I have spoken to the billing manager at the doctors office she inisists that I owe the $50 copay because the doctor is a specialist. Needless to say this is costing me a lot & do not know who to believe!
Has any one else had a similar situation?
I have 6 more appointments to go before i deliver!
|
Posted 5/2/12 10:56 PM  |
| |
|
Long Island Weddings
Long Island's Largest Bridal Resource |
waterspout4
My loves
Member since 5/06 19150 total posts
Name:
Kelly
|
Re: pregnant & seeing a specialist?
Tell her to show you on the explanation of benefits where it says you owe $50. Bring them into her.
|
| Posted 5/2/12 11:15 PM |
| |
|
gina409
TWINS!
Member since 12/09 27635 total posts
Name:
g
|
Re: pregnant & seeing a specialist?
my co pays were def more when it was a specilaist
|
| Posted 5/2/12 11:56 PM |
| |
|
ArmyOfBabies
Growing older but not up
Member since 7/07 4427 total posts
Name:
Jeri
|
Re: pregnant & seeing a specialist?
I know how costly that can be. When I was seeing the RE my copay was $50 and sometimes I was going several times a week
Is there any way your insurance company can send you a letter or explanation of benefits that you can show to billing at the peri?
Wouldn't it be nice if they owed you money
|
| Posted 5/3/12 12:23 AM |
| |
|
|
|
Re: pregnant & seeing a specialist?
My maternity benefits for OB visits are one copay at the beginning then none the whole pregnancy. The office said this is typical. I also see a peri but hes OON, but I pay my regular visit copay, not the specialist.
I'd definitley have your ins co call them or show you in the benefits it is written to show the office. The office might not know how to bill correctly.
|
| Posted 5/3/12 7:45 AM |
| |
|
BlessedMomma
LIF Adult
Member since 12/11 6163 total posts
Name:
Momma Bear
|
Re: pregnant & seeing a specialist?
I would get something in writing from your insurance about what your benefits are... I would also ask your insurance for copies of your eob... And the drs office ask them for eobs...
|
| Posted 5/3/12 8:49 AM |
| |
|
LoveBug302
Baby Girl #2 is Here!
Member since 7/11 1652 total posts
Name:
|
Re: pregnant & seeing a specialist?
when I go to my reg OB appointments I have no co pay, but when they send me to the Peri I also have a $50 co pay. Ive been there about 4 times during my pregnancy just for the big sonos at 12w,16w,20w and then again and 22w. I'll be going next week at just about 30w. Everytime I have had to pay $50. It really hurts but I never fought it because they are considered a "specialist". I figured there was nothing I could do about it.
|
| Posted 5/3/12 8:53 AM |
| |
|
alli3131
Peanut is here!!!!!!
Member since 5/09 18388 total posts
Name:
Allison
|
Re: pregnant & seeing a specialist?
Each insurance is different but I did not have a copay after the first visit with my OB but when I went to the high risk Dr I did have a $40 specialist copay.
|
| Posted 5/3/12 9:07 AM |
| |
|
LadyS
LIF Toddler
Member since 8/11 382 total posts
Name:
Vicki S
|
Re: pregnant & seeing a specialist?
This is me as well. For my regular OB checkups, I only had to pay the first time and everything after is covered under maternity benefits. However, each time I see the peri (which is at least once a month and will be more now that I'm towards the end), I have a $50 copay.
On top of that, I was diagnosed with GD and the nutritionist I see is ALSO a doctor/specialist. My insurance tells me I shouldn't have to pay a copay for those since GD care is covered under maternity coverage as well. I let the billing dept and my insurance duke it out, but ended up having to pay those copays in the end, since they showed the nutritionist I was seeing was a MD and therefore a specialist.
I feel like I've spent upwards of $500+ on copays alone, which don't count towards my deductible!
|
| Posted 5/3/12 10:04 AM |
| |
|
colesmom
Brady's mom too!
Member since 5/05 1989 total posts
Name:
Lea
|
Re: pregnant & seeing a specialist?
Call your insurance company and then ask them to conference call your doctor's office to inform them that you have no obligation.
|
| Posted 5/3/12 5:20 PM |
| |
|
mrssoto
LIF Adolescent
Member since 5/10 833 total posts
Name:
Lorin
|
Re: pregnant & seeing a specialist?
Posted by colesmom
Call your insurance company and then ask them to conference call your doctor's office to inform them that you have no obligation.
i agree!! i would be furious. insist to your insurance company that they call the doctor and make sure you get the name of the person they speak to. better yet, try to conference like the above poster said. speak to a manager if necessary. another thing i think you should do is call your doctor's office, ask to speak to the doctor personally and explain that their front desk is charging you and your insurance company said they are incorrect. ask the doctor to call or have them instruct their staff to call your insurance.
they owe you money!
|
| Posted 5/3/12 10:07 PM |
| |
|
FergieK
Loving my girls
Member since 7/09 2533 total posts
Name:
Fergie
|
Re: pregnant & seeing a specialist?
Get something in writting from your insurance to prove what they are saying cause if they are charging you and shouldnt thats illegal.
I have seen a hemotolgist and Diabetic educator and both times I have had to pay because they are outside my OB visits.
but it definetly depends on the plan.
You can write that off on your taxes though at the end of the year just keep the receipts.
HTH
|
| Posted 5/4/12 8:18 AM |
| |
|
