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Can your doctors office legally charge you 2 co-pays for 1 visit?


Sorry if I have this in the wrong catergory, I wasn't sure where to ask it, so here goes.

I went to my doctor for my annual check up. While there, I mentioned that for 3 weeks it felt like there was something stuck in my throat. She referred me to a ENT (ear, nose and throat) doctor. And then she told me that I would have to pay another co-pay because I was treated (so to speak) for 2 different things and insurance required a copay for each treatment. Has anyone ever heard of this? If so, is this legal?
Thanks!

I have recently had a somewhat similar experience...my son's contact got stuck behind his eye, causing not only tremendous pain, but fear for his vision, so we ventured off to the ER. We checked in, they took his vital signs and we waited...an hour passed by and my son went to the restroom and fortunately removed the contact on his own. We were sent home and told that we would not be charged because he had not been seen by the physician.

I then received an invoice for my co-pay of $50 and noticed the insurance company was charged $236.34...for what?! When I called the insurance company, the explanation of the services rendered was " patient care and management:ER"

The insurance company thanked me for calling and advised me to file an appeal, giving me instructions in order to do so. After a few weeks, the hospital removed the charges.

Long explanation from a layman, but I'd suggest calling the insurance company and ask about filing an appeal. When you are charged a co-pay, the insurance company has to pay their portion as well...and we wonder why insurance premiums are so high!

Good luck! xoxox

Yes it is legal. Some hospitals and insurance companies actually require it. As to the hospital, remember doctors are affiliated with a hospital, at least in the case we are talking about. Some hospitals don't do it. I remember a while back in the local paper they were talking about the 2 major hospitals in the area and their policy on this. It is really a ploy to get more money from the insurance company in the end though. Sure you pay two co-pays, but the insurance company does as well and they usually pay more then you.

When you go to the doctor's office the insurance company has no idea why you went there in the first place. The insurance company only has the information when the doctor's office submits a form for a claim & payment.
Looks like this doctor wants two payments. Therefore, needs to charge you too; because he may need to show proof of service to the insurance company (even if it's only on paper) She counts this as a
referral (visit)

In order to find out for sure, contact your insurance co and explain what occurred. Do you have a receipt for the payments? The insurance co can tell you if it's allowed, and if it's not, can send you a letter to use to request the excess money back from your doctor.
Do it ASAP so that you can get this corrected as quickly as possible one way or another.

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