A medical practice scheduled me for two appointments on the same day, then denied me service for the second one when I arrived, saying my private health insurance doesn’t allow it and I can’t pay for it any other way. I’m working on compensation for time spent on this screw-up, but I would like to understand the cause of the situation so I am better-informed as to who is to blame and how to avoid something like this in the future as I continue multiple practitioners for treatment.
One appointment was a follow-up with a specialist and the other was with a physical therapist, both within the same practice. Staff apologized for the double-scheduling and said they could not fulfill the second appointment. I got two different explanations, neither of which make sense to me. One was that the insurer prohibits two bills to my policy on the same day, and that I cannot pay in cash as an alternative because I have insurance; they could not explain why filing an insurance claim or not isn’t my decision. The other explanation was that billing twice in one day for the same patient is prohibited under federal law as “insurance fraud,” despite the fact that the appointments, services, and medical conditions are real and no one involved has criminal intent.
Can anyone shed light on the two-appointment restriction, and especially if this is an actual legal prohibition or just something practices do to make their lives easier for some bureaucratic issue related to coding etc.? Will I also have problems if I try to see two practitioners at different offices on the same day?
submitted by /u/groundish
[link] [comments]A medical practice scheduled me for two appointments on the same day, then denied me service for the second one when I arrived, saying my private health insurance doesn’t allow it and I can’t pay for it any other way. I’m working on compensation for time spent on this screw-up, but I would like to understand the cause of the situation so I am better-informed as to who is to blame and how to avoid something like this in the future as I continue multiple practitioners for treatment. One appointment was a follow-up with a specialist and the other was with a physical therapist, both within the same practice. Staff apologized for the double-scheduling and said they could not fulfill the second appointment. I got two different explanations, neither of which make sense to me. One was that the insurer prohibits two bills to my policy on the same day, and that I cannot pay in cash as an alternative because I have insurance; they could not explain why filing an insurance claim or not isn’t my decision. The other explanation was that billing twice in one day for the same patient is prohibited under federal law as “insurance fraud,” despite the fact that the appointments, services, and medical conditions are real and no one involved has criminal intent. Can anyone shed light on the two-appointment restriction, and especially if this is an actual legal prohibition or just something practices do to make their lives easier for some bureaucratic issue related to coding etc.? Will I also have problems if I try to see two practitioners at different offices on the same day? submitted by /u/groundish [link] [comments]Read Morer/HealthInsurance