drs refused to see me unless I paid cash

[toastnjelly4all]

What is the name of your state? wa

I was in an accident on Aug 28, we were rear ended. I had pains in my neck and shoulder but didn't go to hospital...my shoulder was already injured and I am having surgery on it Monday, but the neck pains were caused by accident. I thought I would just go to my regular clinic after the Labor Day weekend. The following Tues, I went and asked to make appt for the next day. I told them we were rear-ended a few days before, my neck was hurting and I needed to see the dr. I was told I have to pay cash for the appointment and services (x-rays) because they "do not bill auto insurance companies". I do not have the money and told them so. I made the appt for the next day and went home and called both auto insurance companies. I was informed by both that I am covered for medical expenses and the clinic should bill them directly and I shouldn't have to pay anything in order to be seen. The next day I called the clinic again, and was told again that they wouldn't see me unless I had cash for them. The book-keeper got on the phone and said "we do not bill auto insurance companies because they do not pay for any bills until the case is settled and sometimes they do not settle for 5 years or longer" and "no they will not accept my medical insurance either" for this injury. I told her I have been going to this clinic all my life, my kids go there, my parents and grand parents have gone there. I have never been asked to pay for an appointment, nor have I ever been denied an appointment, nor has my insurance ever been denied either. I couldn't believe they would let one of their patients (me) go through this much pain and still refuse to treat unless I had cash for it. I felt absolutely betrayed by them. I told her that if indeed they were refusing to treat me for that reason, that I wanted her to send those statements to me in writing. I was very hurt, disappointed and pissed! Well, yesterday, I got a certified registered letter from the clinic stating "we will no longer be your physicians" and I have 30 days to find another dr. There were no explainations, no statements regarding why they had refused me treatment previously, as I had requested of them. I feel like I am being stomped on and kicked by my life long medical clinic. I do not believe they were acting lawfully when they refused to see me unless I had cash, because there are other means of being paid for their services available. After all, that is why I pay for insurance both medical and auto. Can anyone here give me some legal advise and tell me where to go to file a complaint against the clinic?

 

[ecmst12]

Find another doctor that will bill your auto insurance. They are not required to see you and you should be GLAD to not give that clinic any more of your business anyway.

 

[lya]

What is the name of your state? wa

I was in an accident on Aug 28, we were rear ended. I had pains in my neck and shoulder but didn't go to hospital...my shoulder was already injured and I am having surgery on it Monday, but the neck pains were caused by accident. I thought I would just go to my regular clinic after the Labor Day weekend. The following Tues, I went and asked to make appt for the next day. I told them we were rear-ended a few days before, my neck was hurting and I needed to see the dr. I was told I have to pay cash for the appointment and services (x-rays) because they "do not bill auto insurance companies". I do not have the money and told them so. I made the appt for the next day and went home and called both auto insurance companies. I was informed by both that I am covered for medical expenses and the clinic should bill them directly and I shouldn't have to pay anything in order to be seen. The next day I called the clinic again, and was told again that they wouldn't see me unless I had cash for them. The book-keeper got on the phone and said "we do not bill auto insurance companies because they do not pay for any bills until the case is settled and sometimes they do not settle for 5 years or longer" and "no they will not accept my medical insurance either" for this injury. I told her I have been going to this clinic all my life, my kids go there, my parents and grand parents have gone there. I have never been asked to pay for an appointment, nor have I ever been denied an appointment, nor has my insurance ever been denied either. I couldn't believe they would let one of their patients (me) go through this much pain and still refuse to treat unless I had cash for it. I felt absolutely betrayed by them. I told her that if indeed they were refusing to treat me for that reason, that I wanted her to send those statements to me in writing. I was very hurt, disappointed and pissed! Well, yesterday, I got a certified registered letter from the clinic stating "we will no longer be your physicians" and I have 30 days to find another dr. There were no explainations, no statements regarding why they had refused me treatment previously, as I had requested of them. I feel like I am being stomped on and kicked by my life long medical clinic. I do not believe they were acting lawfully when they refused to see me unless I had cash, because there are other means of being paid for their services available. After all, that is why I pay for insurance both medical and auto. Can anyone here give me some legal advise and tell me where to go to file a complaint against the clinic?

You had a real easy solution to your problem.

You could have filed your regular insurance, sent the medical bills/insurance billing statement to the auto insurance company with a request to reimburse your insurance company for payments made. (Insurance companies do not drag out payment times for med-pay only claims; payment would have been prompt.)

Instead, you attempted to bully the clinic into doing things your way and have now been dropped as a patient by the clinic. Don't be surprised to see your whole family's being dropped by the clinic.

By the way--I absolute love your username!

 

[>Charlotte<]

Your insurance coverage is an agreement between you and your insurance company, not you and your insurance company and the clinic. If I'm not mistaken, billing insurance companies is a courtesy that is often provided by medical offices but they are not required to do so, and may demand payment by you at the time of service. Your insurance company would then fulfill their obligation to you by reimbursing you directly for that payment.

I'm not 100% sure of this, but pretty sure. If I'm wrong, there are many people on this forum who are very knowledgeable about this type of issue and one of them will be along to correct me. Responses tend to slow down on weekends, so keep checking.

Edited to add: Ah, and there's Lya, one of whom I mentioned. Weird, though--Lya's post wasn't there when I started mine, and I know it didn't take me almost two hours to finish my post! Time stamp glitch?

 

[lya]

Your insurance coverage is an agreement between you and your insurance company, not you and your insurance company and the clinic. If I'm not mistaken, billing insurance companies is a courtesy that is often provided by medical offices but they are not required to do so, and may demand payment by you at the time of service. Your insurance company would then fulfill their obligation to you by reimbursing you directly for that payment.

I'm not 100% sure of this, but pretty sure. If I'm wrong, there are many people on this forum who are very knowledgeable about this type of issue and one of them will be along to correct me. Responses tend to slow down on weekends, so keep checking.

You are not mistaken.

Some providers choose to contract with certain insurance companies and therefore are required/committed/duty-bound to accept that insurance without demanding payment up fronts, but only for the services included in the contractural agreement.

 

[JustAPal00]

I don't think we're getting the whole story here! I have a hard time believing that a medical clinic would send a certified letter to a patient telling them to find other care just because they asked them to accept a payment directly from an auto insurance company. Something smells like fish here!

 

[toastnjelly4all]

Justapal....yes you got the whole story. I can't believe it myself!

Lya...I do not believe that asking for their "policy" in writing is an act of bullying.

I did request to use my medical insurance, and they refused that too.

I am wondering if their refusal to see me unless I pay cash for this appointment is legal;
and if they can legally stop treating me for asking for their policy in writing. Do I have any recourse?

 

[justalayman]

A provider is not required to accept any insurance unless they are contractually required to (as in a PPO situation). I suspect that by law, your auto insurance would be primary on this situation and due to that, your reg med insurance would not pay at all. So, basically, the doc would not be required to accept the auto insurance and it can require you to pay for treatment at the time of treatment (which most every office I have ever been to requires) except in the cases of the PPO or other insurance contracts that require something different.

 

[lya]

I am wondering if their refusal to see me unless I pay cash for this appointment is legal;
and if they can legally stop treating me for asking for their policy in writing. Do I have any recourse ?

It is legal; it's their business and they don't have do business with you. You have no recourse.

 

[barry1817]

dismising patient

Justapal....yes you got the whole story. I can't believe it myself!

Lya...I do not believe that asking for their "policy" in writing is an act of bullying.

I did request to use my medical insurance, and they refused that too.

I am wondering if their refusal to see me unless I pay cash for this appointment is legal;
and if they can legally stop treating me for asking for their policy in writing. Do I have any recourse?

Doctors have bills to pay, in order that they can stay in business. When I walk into a supermarket I can't leave without paying and they don't care whether I have the money or not.

I am sorry that you were having problems, but experiencing problems from an auto accident none of my medical providers are billing the auto insurance for payment, and expect payment at time of service. That I will get paid when the case settles isn't their problem.


Not that it helps but I have been speaking for a long time for the need for young people to get group medical insurance when they are young so that they can't be denied insurance based on conditions that can arise with age, and when they are part of a group that insurance is no longer dependent on the generosity of an employer.

Barry1817@aol.com

 

[moburkes]

OP, in order for your medical provider to bill the auto insurance company they would need to know that you WERE insured at the time of the incident, that you were AT FAULT at the time of the incident, that you had the correct COVERAGE that would pay the bills, and the meximum amount of coverage that the insurance company would pay. They are NOT going to get involved in trying to figure out who was at fault, which is the correct company to bill, whether or not you really had coverage by that particular policy for that particular accident, etc. That is not the business they're in. I know that this was previously answered, but I wanted to explain in more details the WHY.

 

[JustAPal00]

Justapal....yes you got the whole story. I can't believe it myself!

Like I said I don't think we're getting the "whole truth and nothing but the truth". As was stated before, the doctors office is a business. I can understand why they won't treat you for your auto accident injury, they don't want to have to possibly wait years to get paid. But the letter telling you to find another doctor, tells me you've become more trouble than you're worth.

I told her that if indeed they were refusing to treat me for that reason, that I wanted her to send those statements to me in writing. I was very hurt, disappointed and pissed!

I think this is probably the key to why you now need another physician. You can't tell them that they have to treat you or you are going to sue! I would tell you to hit the bricks if I was the doctor too!