- Report: #642505
Complaint Review: Dr. Andrew Cassidy - Internet Internet
Reported By:
efl325 -
Austin, Texas, United States of America
Submitted:
Updated:
-
Author Not Confirmed
Why?
Dr. Andrew Cassidy
11614 Fm 2244 Ste 150 Austin, TX 78738 Internet, Internet, United States of America
Phone:
512.263.5454
Web:
http://www.lonestarpodiatry.com/
Categories:
Business Rating:
(0)
Tell us has your experience with this business or person been good?
Dr. Andrew Cassidy Lone Star Podiatry went in to get a bum toe checked out and left spending $375 on custom orthotics Internet
I saw Dr. Cassidy (Lone Star Podiatry) twice; once to get the
fungal infection on my toe addressed and a second time to get fitted for
custom orthotics. The first time I saw him he seemed distracted
throughout the consult. I was there to get an infection on my toe fixed.
I was prescribed a compounded RX available at only one pharmacy.
Because the RX was a compounded (mixture of various drugs) variety, I
had to submit endless forms to my insurance provider directly in order
to get reimbursed. If I had been warned of this by anyone at the
doctor's office I would have very unlikely agreed to the treatment as I
needed to jump through hurdles every time I got refill to get
reimbursed.
The second time I went in it was to get fitted for custom orthotics. Dr. Cassidy seemed present and attentive this time. He even cracked a few jokes and shared a few insightful tips on running and riding - a few hobbies we share. Thirty minutes later I was done. The receptionist checked me out and said I was to pay them full retail for the orthotics, $375. I reluctantly paid but had my doubts since all of the doctors I see are preferred, in-network providers of BCBS and my out-of-pocket costs are either a co-pay of $20 or a contracted rate before I meet my deductible. The doctor and his staff seemed nice enough and said charging full retail is what they always do with their other patients so I just paid and waited for them to call to get my brand new, custom-fitted orthotics. They gave me a sheet to submit to my insurance provider, Blue Cross/Blue Shield, to get reimbursed. I submitted the necessary forms to BCBS and was told the following: Dr. Andrew Cassidy is a preferred in-network provider (a participating provider) whereby BCBS and the doctor have agreed to contracted rates he is allowed to charge his patients. He should have charged you $190.63, not $375. You are entitled to recuperate the overpayment of $184.37. He refused to comply with refund request and BCBS has since filed a grievance with him on my behalf. Ultimately, if Dr. Cassidy/Lone Star Podiatry does not agree to refund the overpayment, he will no longer be a participating provider and I will be out $184. I need to note that I have made several attempts with the doctor's office to resolve this before getting BCBS to intervene, however, Rose, their manager, insisted they always charged full price for custom orthotics to avoid dealing with insurance providers themselves. Since they don't submit claims to to insurance companies themselves "they do not need to comply with the contracted rates". HOWEVER, BCBS has since confirmed that they have indeed filed an insurance claim but not on my behalf but for themselves, so essentially they double-billed; they billed me once and got $375 and they billed BCBS to get more money! And this is how they've been doing business for as long as he's been fitting for custom orthotics!
NOTE: the service provider (in this case, Dr. Cassidy/Lone Star Podiatry) is responsible for submitting claims directly to your insurance provider if they are a network provider. The onus is on them to recuperate whatever fees they have agreed to with your insurance; it is never the patient's responsibility.
The second time I went in it was to get fitted for custom orthotics. Dr. Cassidy seemed present and attentive this time. He even cracked a few jokes and shared a few insightful tips on running and riding - a few hobbies we share. Thirty minutes later I was done. The receptionist checked me out and said I was to pay them full retail for the orthotics, $375. I reluctantly paid but had my doubts since all of the doctors I see are preferred, in-network providers of BCBS and my out-of-pocket costs are either a co-pay of $20 or a contracted rate before I meet my deductible. The doctor and his staff seemed nice enough and said charging full retail is what they always do with their other patients so I just paid and waited for them to call to get my brand new, custom-fitted orthotics. They gave me a sheet to submit to my insurance provider, Blue Cross/Blue Shield, to get reimbursed. I submitted the necessary forms to BCBS and was told the following: Dr. Andrew Cassidy is a preferred in-network provider (a participating provider) whereby BCBS and the doctor have agreed to contracted rates he is allowed to charge his patients. He should have charged you $190.63, not $375. You are entitled to recuperate the overpayment of $184.37. He refused to comply with refund request and BCBS has since filed a grievance with him on my behalf. Ultimately, if Dr. Cassidy/Lone Star Podiatry does not agree to refund the overpayment, he will no longer be a participating provider and I will be out $184. I need to note that I have made several attempts with the doctor's office to resolve this before getting BCBS to intervene, however, Rose, their manager, insisted they always charged full price for custom orthotics to avoid dealing with insurance providers themselves. Since they don't submit claims to to insurance companies themselves "they do not need to comply with the contracted rates". HOWEVER, BCBS has since confirmed that they have indeed filed an insurance claim but not on my behalf but for themselves, so essentially they double-billed; they billed me once and got $375 and they billed BCBS to get more money! And this is how they've been doing business for as long as he's been fitting for custom orthotics!
NOTE: the service provider (in this case, Dr. Cassidy/Lone Star Podiatry) is responsible for submitting claims directly to your insurance provider if they are a network provider. The onus is on them to recuperate whatever fees they have agreed to with your insurance; it is never the patient's responsibility.
6 Updates & Rebuttals
anonymous
Austin,Texas,
USA
issue isn't about paperwork
#2Author of original report
Sat, October 02, 2010
dude can go ahead and TRY to sue me. i've got a file of documents between me and BCBS that will support everything i am stating as pure fact. what chance does he have if it's not slander?
my issue wasn't about completing paperwork myself. my issue is with his billing practices. he insisted that he would not bill BCBS but they confirmed that he did, therefore, he essentially duped me and them by double-billing for one service.
debtexpert
United States of Americayes you did
#3General Comment
Tue, September 28, 2010
Yes, and you missed my point again. I you read what I wrote I was only pointing out that it is the patients responsibility to make sure their insurance is doing what it is supposed to.
The only time a medical office is REQUIRED BY LAW to completely handle the insurance is Medicare. I didnt write the law, and I said I didnt completely agree with it either.
So yes, you missed my point.
Flynrider
Phoenix,Arizona,
USA
I missed the point?
#4Consumer Comment
Mon, September 27, 2010
The OP submitted the claim to BCBS :
"I submitted the necessary forms to BCBS and was told the following: Dr. Andrew Cassidy is a preferred in-network provider (a participating provider) whereby BCBS and the doctor have agreed to contracted rates he is allowed to charge his patients. He should have charged you $190.63, not $375"
It would seem to me that the OP's complaint was being overcharged.
debtexpert
United States of Americayes
#5General Comment
Sat, September 25, 2010
Yes thats true but you entirely missed the point.
What I was saying is--and anyone can check if they think I am not being truthful-- it is the policy-holders responsibility to make sure the claim is processed and followed though with if there is any problem--NOT the doctor.
Flynrider
Phoenix,Arizona,
USA
Actually, actually
#6Consumer Comment
Fri, September 24, 2010
"Since YOU have the contract with YOUR insurance agency, not the doctor,"
If the doctor is in the insurance provider's network, he also has a contract with the ins. co. that details how much he will bill their customers for specific services.
debtexpert
United States of Americaactually
#7General Comment
Fri, September 24, 2010
I am sorry but you are wrong about one aspect. Since YOU have the contract with YOUR insurance agency, not the doctor, it is YOUR responsibility to make sure the insurance was billed, and YOUR job to find out if it was taken care of properly.
True, most(if not all) doctors offices will do this for you, but AS A CURTISY TO YOU, they don't have to. I know you will disagree with me, I'm not saying I like it either, but it is an absolute fact. Ask anyone who works in HIT.
Also FYI: doctor Cassidy sued the last person who posted something here about him, just so you know.
