OT - Doctor Owes Me Money - How to Proceed

[momofboys]

In early September I had outpatient surgery to remove skin cancer (a canerous mole) on my face. It was much more intense of a procedure then I could have ever imagined despite all the research I did ahead of time. I had to have reconstructive surgery & honestly it will be a while before things look normal on my face. I'm okay with it knowing it can be fixed or made to look better eventually. I guess what I am trying to convey is that is was a traumatic experience because it has left my lip/area below my nose somewhat disfigured. But that aside initially before going to have the surgery the dr office estimated I would have to pay about $1000 out of pocket. We have good insurance but opt for a high deductible plan so because our deductible was not met (deductible is exempt for general office visits, scripts, etc) I was told this would be my portion. We had the money thankfully due to our FSA (flexible spending account) so I happily forked over $800 on the day of the surgery figuring I could pay the rest later. Then about 2 1/2 weeks post op we got our insurance EOBs (around Sept 20). Insurance co had changed their mind - they considered my cancer surgery 100% necessary so for whatever reason they said I now only owed 20% which would equal about $200. I was very happy but also unhappy to now realize I would have to get the extra $$$ back from the dr. I have spoken to the financial person in their office 3 x in the past month & she agrees they owe me a $600 refund & promises to "get on it" right away but nothing has happened. This is a lot of $$$ - if it was only $20 I wouldn't care so much. Plus, this is FSA $$$ that has to be spent in this calendar year. It's use it or lose it I believe. How would you proceed?I drafted a nice but firm letter to the dr but have yet to send it. I thought I would wait another week or two to see if the office actually pays me on their own after my promptings from the past several weeks. What are my options?

[Angelsj]

You need to get someone, preferably a lawyer, to draft a demand letter, giving them two weeks to get the money to you.

However, if you have a high deductible plan, you should be using an HSA not an FSA. You are allowed to do that with a HDP and you do not lose that money, it just grows.

[Mister Sir Husband]

I'm not sure if its possible with your schedule, but I've always been a fan of the talking to people in person for certain situations. The office told you over the phone they would get right on it, but didn't. I would make sure the next time I talked to them it was in a situation where I was standing in front of their desk. It can be easier to get someone off the phone by telling them what they want to hear than doing it in person.

[momofboys]

You need to get someone, preferably a lawyer, to draft a demand letter, giving them two weeks to get the money to you.

However, if you have a high deductible plan, you should be using an HSA not an FSA. You are allowed to do that with a HDP and you do not lose that money, it just grows.

Sorry I used the wrong verbage - part of the $$$ in our health reimbursement account is use it or lose it, half of it is not. So part of it is FSA, part of it is not a use it or lose it (or a HSA). The account is empty now so if the $$$ is returned I am not sure what account it will go to as the $$$ came from both parts of the account. Not sure if that makes sense! So you would not send your own letter but have a lawyer draft one. Not sure how much that would cost.

[Cradle2crayons]

Sorry I used the wrong verbage - part of the $$$ in our health reimbursement account is use it or lose it, half of it is not. So part of it is FSA, part of it is not a use it or lose it (or a HSA). The account is empty now so if the $$$ is returned I am not sure what account it will go to as the $$$ came from both parts of the account. Not sure if that makes sense! So you would not send your own letter but have a lawyer draft one. Not sure how much that would cost.

I wouldn't pay a lawyer for a demand letter just yet. I would go up there and demand to speak to someone in billing, preferably a supervisor.

[momofboys]

I'm not sure if its possible with your schedule, but I've always been a fan of the talking to people in person for certain situations. The office told you over the phone they would get right on it, but didn't. I would make sure the next time I talked to them it was in a situation where I was standing in front of their desk. It can be easier to get someone off the phone by telling them what they want to hear than doing it in person.

I do have to go in for an appt soon - the appt keeps getting cancelled on their end b/c the dr is just returning from maternity leave so they keep rescheduling her appts. But I am supposed to go in soon just not sure when as they have not rescheduled since she is coming in on a week by week basis (different each week). Ughhhhhh -the office is 45 min away from my home.

[Cradle2crayons]

I do have to go in for an appt soon - the appt keeps getting cancelled on their end b/c the dr is just returning from maternity leave so they keep rescheduling her appts. But I am supposed to go in soon just not sure when as they have not rescheduled since she is coming in on a week by week basis (different each week). Ughhhhhh -the office is 45 min away from my home.

You could try one more time on the phone, but I would be sure I spoke to a billing supervisor, and give her a deadline and be sure they know you are serious.

I would explain they didn't give you weeks after the procedure to PAY and you don't expect to have to wait weeks for your REFUND.

[momofboys]

You could try one more time on the ohone, but I would be sure I spoke to a billing supervisor, and give her a deadline and be sure they know you are serious.

I would explain they didn't give you weeks after the procedure to PAY and you don't expect to have to wait weeks for your REFUND.

I last spoke to someone on the 22nd or 23rd. I think I will wait until early next week & see what happens. I will ask to speak to this woman's supervisor - she told me she had to get authorization from someone else prior to sending payment. Allegedly the person "was not in the office" when I called last. I will keep you all posted. It's just frustrating. We pay our bills when dr's ask us to - frustrating that they won't pay us back promptly. Of course if I never looked at my EOB I am guessing they would keep the extra $$.

[momofboys]

Thank you for all your advice. I will update next week or if they pay me beforehand.

[momofboys]

Update!!!! :-)

Yay! I received my refund check in the mail late last week!!! I didn't have to send a letter thank goodness (but did call 3x ). Funny thing is & I truly believe God works in mysterious ways - - Last Thurs we had a massive wind storm (winds 70-80 mph) & late that night a tree fell on our house. Well thankfully it did not do damage to our home although it fell on electrical lines & could have damaged our lines to the extent of getting an electrician involved. Well we got a professional to remvoe the tree & it was not an easy task & since the tree removal was $550 we decided not to make a claim with our homeowner's ins (our deduct is $500 so it didn't make sense to make a claim for $50!). Well I didn't realize it until the next day but on Saturday we got our refund in the mail for $550 some dollars. Almost exactly what we owed for the tree!happyface So l although I was hoping to use the refund toward Christmas gifts I am happy we got it back at just the perfect time!