I never thought I would be on the same side as United Health Care/Oxford on a medical billing issue. But that day has come!
The series of events that has led to this united interest is as follows:
1. In September Eliza saw Dr. A for a routine office exam of 20 minutes or so. No tests, no bloodwork, not even a pin prick!
2. The bill as usual was $450.00. I paid my $50.00 co-pay and UHC/Oxford reimbursed Dr. A $350.00. So a not-so-bad write down to him of $50.00.
3. In October I get a bill from NYU Medical Center, the hospital with which Dr. A is affiliated. His office is not in the Medical Center, but at a building owned by NYU Medical Center.
4. The bill is for $530.85. UHC/Oxford paid $530.35 and NYU Medical Center was seeking payment from me of $50.00 for my co-pay. Huh? Eliza never went to NYU Medical Center that day, just the routine exam at Dr. A's office.
5. During my first call to NYU Medical Center Billing I was told that they could not tell me what service was rendered by NYU, but that UHC/Oxford could tell me that. Huh? My insurance company would know this but not the entity rendering the bill. UHC/Oxford was quite at a loss. Not only could they not tell me what services were rendered by NYU Medical Center, but now they were curious and wondering why they had paid $530.35 of the $580.35 bill.
6. In my attempts to clarify this with NYU Medical Center Billing, I am repeatedly told that this bill is for either blood work (nope!), pre-op testing (nope!) or some type of scan or x-ray (nope!). One clerk even told me that perhaps I had forgotten what was done to Eliza during the visit. Uh. No.
7. I make 6 more calls to NYU Medical Center Billing, each more useless than the next. I am now told that only Dr. A can tell me why NYU Medical Center generated this bill.
8. So I leave 6 (lucky number) messages for Dr. A's billing clerk and finally speak with her today.
Here is the answer:
NYU Medical Center has changed Dr. A's designation from "outpatient office" to "outpatient facility." Because it is now a "facility" I will get two bills for each office visit: $450.00 from Dr. A and $580.35 from NYU Medical Center for the mere use of the facility (since any testing would generate yet a third bill). There is no extra service being rendered by NYU Medical Center, yet they will bill UHC/Oxford $580.35 and I will now have two co-pays, $50.00 for Dr. A and $50.00 for NYU Medical Center for their facility fee. So now a visit to Dr. A will cost me and UHC.Oxford a total of $1030.35.
Now if that doesn't sound like fraudulent double billing, I don't know what does (the billing clerk was clearly in disagreement with my assessment).
So now for our 6 visits a year I will gave to shell out $600.00 instead of the usual $300.00. Eliza has four other doctors at NYU and I am waiting to see if NYU Medical Center adds the same bogus charges for each of those visits. If so, the co-pays for this set of doctors will be about $3,000.00 per year.
Anyone else out there see anyone at NYU Medical Center?
Anyone with a similar experience?
Oh, and for $1030.85 I am making sure that Eliza gets at least an hour's face time with Dr. A. Maybe two hours.