- Report: #73423
Complaint Review: Dr. Ben Thomas Primary Care Physician Center - Atlanta Georgia
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Author Not Confirmed
Why?
Dr. Ben Thomas Primary Care Physician Center
6343 Roswell Rd. NE Atlanta, 30328 Georgia, U.S.A.
Phone:
404-851-0056
Web:
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Dr. Ben Thomas, Primary Care Physician Center never submitted office visits to insurance and now over a year later sent me a bill for almost $500 refuses to give dates and breakdown of services Atlanta (or Sandy Springs) Georgia
In the summer of 2002 I had recently moved to Georgia and needed to go to a doctor. I went to Ben Thomas because he works mainly as a walk-in clinc and he accepted my insurance. My responsibility was a $10 copay. About a month later I went back, paid my second copay.
The next month or so I found out that I was pregnant my morning sickness was severe. I went to Ben Thomas a few more times. I paid my copays. He never remembered who I was. He would always say I was dehydrated or almost dehydrated and to go to the ER. In May of 2003 I went to his office for a severe cold/flu. He gave me a breathing treatment but never bothered to tell me that insurance would not cover it. I received this bill in September.
That was ALL I OWED. I payed the bill at the beginning ov November it took them a month to actually cash the check. When I called at the beginning of November I suddenly owed $655 for past appointments. Some of the appointments were supposed to have been over a year before. I had insurance I paid my copays. They had a new billing manager who said he guessed that they didn't submit the bills to insurance. I called the insurance company about the 1 date I could get out of him. They had never heard anything of it it had never been submitted.
If the doctor's office doesn't submit the bills to insurance in a timely fashion it is supposed to be their own fault and their write-off. Of course NOT THE CASE WITH BEN THOMAS!!! They are holding ME responsible for their mistake. The billing person was rude. He said that if insurance won't pay them, it's my responsibility they want their money and they'll get it. He was supposed to send me a breakdown it contains no dates of cervice, nothing about what services were except for the final May appointment.
Some of the past appointments must have been recently submitted to insurance and were paid but I still owe almost $500 for the others. I have no idea when the appointments were or what they were for. I can't check to see if they were ever filed with insurance without dates and descriptions. Thomas' office won't tell me.
They say I have to pay them. ALL WAS COVERED BY INSURANCE. It is now 7 months since the last time I was at that office this is my only bill. I have no idea how they came up with this amount. What do I do? I should NOT be obligated to pay this bill. I DO NOT have the money to pay this bill. I SHOULD NOT be billed in November/December of 2003 for Sometime in 2002. Can you help me?
Not Going to be Ripped-Off
Alpharetta, Georgia
U.S.A.
The next month or so I found out that I was pregnant my morning sickness was severe. I went to Ben Thomas a few more times. I paid my copays. He never remembered who I was. He would always say I was dehydrated or almost dehydrated and to go to the ER. In May of 2003 I went to his office for a severe cold/flu. He gave me a breathing treatment but never bothered to tell me that insurance would not cover it. I received this bill in September.
That was ALL I OWED. I payed the bill at the beginning ov November it took them a month to actually cash the check. When I called at the beginning of November I suddenly owed $655 for past appointments. Some of the appointments were supposed to have been over a year before. I had insurance I paid my copays. They had a new billing manager who said he guessed that they didn't submit the bills to insurance. I called the insurance company about the 1 date I could get out of him. They had never heard anything of it it had never been submitted.
If the doctor's office doesn't submit the bills to insurance in a timely fashion it is supposed to be their own fault and their write-off. Of course NOT THE CASE WITH BEN THOMAS!!! They are holding ME responsible for their mistake. The billing person was rude. He said that if insurance won't pay them, it's my responsibility they want their money and they'll get it. He was supposed to send me a breakdown it contains no dates of cervice, nothing about what services were except for the final May appointment.
Some of the past appointments must have been recently submitted to insurance and were paid but I still owe almost $500 for the others. I have no idea when the appointments were or what they were for. I can't check to see if they were ever filed with insurance without dates and descriptions. Thomas' office won't tell me.
They say I have to pay them. ALL WAS COVERED BY INSURANCE. It is now 7 months since the last time I was at that office this is my only bill. I have no idea how they came up with this amount. What do I do? I should NOT be obligated to pay this bill. I DO NOT have the money to pay this bill. I SHOULD NOT be billed in November/December of 2003 for Sometime in 2002. Can you help me?
Not Going to be Ripped-Off
Alpharetta, Georgia
U.S.A.
1 Updates & Rebuttals
Tasha
Canton,Ohio,
U.S.A.
Notify your insurance carrier
#2Consumer Suggestion
Wed, February 11, 2004
Whenever a physician "participates" with an insurance company, there are guidelines to which they must adhere. It is the physician's responsibility to submit the claims in a timely manner and your only monetary responsibility should be your co-pay. You are correct in your assumption that if the physician never submitted the claims for the office visits, he gets to eat the charges above and beyond your co-pay amount. One recourse you would have is to notify the insurance company that his office is not complying with the terms of his agreement with them due to the fact that he is trying to charge you more than your co-pay. With regards to services he administered that are non-covered by your insurance, in this respect you need to take the initiative to know your coverage. If you are not sure it will be a covered service, don't be afraid to ask if it will be paid by your insurance and if not find out how much the cost is PRIOR to receiving the service so that you don't get "sticker shock" when you see the bill. And last but not least, is this physician aware that his office staff has not submitted any of your claims and that they are in essence "breaching" his participation agreement with the insurance company? He may need a heads-up to realize that he needs competent people to run his office and make sure that they are not putting his "status" as a health care provider in jeopardy. I hope that I have given you at least a starting point to resolving this issue. Good luck!
