Becker Ear, Nose & Throat Center

Review: Went to office on 3/28/14 for initial consult paid $50 copay. Was scheduled for hearing test. Went back for test on 5/5/14 paid copay was given test told of slight hearing loss by audiologist. Was told to follow her & was put in another room. After 5 or 10 minutes Doctor came in, said I have slight hearing loss & if I wanted to come back to discuss hearing aids it would be covered by this visit. Was then thanked & walked out to the checkout counter where they gave me a visit report & sent me on my way. Today, I received a bill for a $50 copay. When I called to question it I was told that it was for the test & the copay I paid that day was for the office visit & seeing the doctor. I was also told that they do it because the insurance company allows it. I didn't ask for nor was I given an option of seeing the doctor. I already had my results from the test & the information I received from the doctor, I could have gotten over the phone at no charge. Why do I have to pay twice for 1 visit? Or why wasn't I informed that there could be an extra copay? In my train of thought, I was just scammed out of $50 for a 2 minute consultation I didn't need. On top of that, A report to my primary care doctor which was requested at both visits, weren't sent & had to be requested again by my primary office.I have also filed a complaint with my insurance company who, when I described the situation said it shouldn't be done because it doesn't look right.Desired Settlement: Just cancel the bill as paid & either stop the practice or advise the patient of the possible billing ahead of time.

Business

Response:

This patient was seen by two practitioners on the same day. Each patient's insurance company dictates how and when co-pays are collected. If this patient received a bill for a co-pay is it because his insurance required us to collect one for each practitioner visit, not the number of times the patient was in the office. It is illegal to not collect a required co-pay when billing an insurance company, and therefore we are required to comply with his plan's policy. Upon receiving this complaint, our billing department contacted his insurance company directly to assure there had been no error. I understand the patient's impression that he received the same information twice, however an analogy may help clear up the confusion. If a physician orders a CT scan it is performed by radiology staff, not the physician. If the staff member then tells the patient that everything seemed fine on the scan, the patient will still have to follow-up with his physician to discuss the results. In fact, most patients would be upset if they did not have this discussion with their physician. Our audiologist tests hearing and makes professional recommendations on hearing aids and other technologies. This is where her expertise lies. There are times when hearing test results indicate a significant medical condition that requires further work-up or treatment. Without a review by the physician, these cases may be missed, delaying treatment or worse. It is for the reason that we often review results of any test, hearing test, X-Ray, labs, e.g., in a follow-up visit. It is often great news if test results are normal or insignificant, however this does not mean that follow-up is unnecessary.

Consumer

Response:

[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]

I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me. My insurance company to which they refer, has told me to disregard the bill & they are looking into the matter themselves.