Billing problems after switching practices

I switched practices about a month into my 2nd trimester, and I just got a bill from the old practice (Suffolk OB/GYN) for visits back in March, April, and May. They are charging me a copay for each visit even though my insurance is supposed to cover all routine prenatal visits with no copay.

So I called my insurance company and was told the doctors office billed the visits wrong, as regular office visits instead of prenatal visits and that I have to tell them to recode the visits as prenatal visits. Sounded like an easy fix. But then I called the doctor's office billing dept. and was told that since I switched practices before delivering they HAVE to bill each visit I had with them separately and there's no other way they can bill it. They told me it was a mistake on the part the insurance company and that if they looked at the claim carefully they would see the visit was pregnancy related. So then I called back insurance and was told again that there's nothing they can do.

So basically insurance says its because of how the doctor's office is billing it, and the doctor's office is saying it's the only way they could bill it since I left their practice. And apparently DH and I are left with a bill that we shouldn't have to pay because all of my prenatal visits are supposed to be covered completely. I didn't think it would matter that I switched practices and feel as though I'm being penalized by the original doctor's office for switching.

Has anyone else switched practices and dealt with something like this? I'm not sure if there's anything else I can do but I really don't feel that I should have to pay this bill!

Billing problems after switching practices

The doctor's office needs to fix it. I would call them back and say they are not going to get paid because they can't bill properly. I would also mention what they are doing is fraud and will be reported if it is not adjusted.

Re: Billing problems after switching practices

I switched also.
My insur told me that if you don't stay w/practice til delivery they can bill you differently.
Something like - b/c usually they would get paid by insurance after delivery. ??

Re: Billing problems after switching practices

I've heard that drs offices can do this. If they deliver you, they will get paid at the end of your pregnancy. If you change practices, they don't get paid, so they have the right to bill you.

I bet you're talking to someone in customer service at your insurance company who is just reading the basic coverage without really understanding what's going on.

You can always file a formal complaint via insurance and they will contact your drs office.

Re: Billing problems after switching practices

i changed practices and also received a big bill from my previous practice. good to now know the likely reason (i was too lazy to call about it)

Re: Billing problems after switching practices

I changed practices at 37 weeks and never got a bill from 1st group. I also never paid a co-payment. I wonder if its different with different insurance companies. I had Government Empire.

Re: Billing problems after switching practices

Billing problems after switching practices

Drs office should fix it. I switched at 20 weeks and never had a bill from the old practice.

Re: Billing problems after switching practices

It's the drs office that needs to fix it. They either need to bill under the correct code or eat up the co-pay and not send you a bill for it!